Perspective The Emerging Context For Advances In Comparative Effectiveness Assessment The world's best medical care system needs comparative effectiveness research to improve doctors' decision making

The call for an entity for independent assessment and guidance on alternative medical interventions is timely. The emergence of four developments underscores the im- portance and sets the stage for progress: an improving evidence base; growing recognition of the importance of variation in the effectiveness of treatments across patients; recent emphasis on transparency; and growing adoption of pay-for-performance initiatives. To ad- vance progress on these issues, the Institute of Medicine (IOM) has convened a Roundtable on Evidence-based Medicine. The roundtable is exploring ways to improve the develop- ment of evidence, the thoroughness with which it is applied, and the mechanisms for in- creasing national capacity for the work. (Health Affairs 25 (2006): w593-w595 (published