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Comparative effectiveness research — a proposal for a new NHMRC funding stream

John R Zalcberg
Med J Aust 2012; 196 (1): . || doi: 10.5694/mja11.10036
Published online: 16 January 2012

Opportunities to examine the relevance of health interventions in actual clinical scenarios need to be created

Evidence-based medicine underpins high-quality health care.1 The use of evidence in the practice of medicine informs appropriate decision making, reduces variability in clinical practice and helps ensure improvement of patient outcomes. Most evidence relating to new knowledge is derived from randomised clinical trials.2,3


  • Division of Cancer Medicine, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC.


Correspondence: John.Zalcberg@petermac.org

Competing interests:

I completed a 3-month sabbatical at the National Institute of Clinical Studies in 2009, was the recipient of multiple NHMRC project grants, and have served on various NHMRC committees. I am also Chair of the Australasian Gastro-Intestinal Trials Group, under whose auspices several of the trials mentioned or alluded to in this article have occurred.

  • 1. National Health and Medical Research Council. Clinical Practice Guidelines Portal. http://www.clinicalguidelines.gov.au (accessed Nov 2010).
  • 2. The Cochrane Collaboration. Cochrane summaries. http://www2.cochrane.org/reviews/index.htm (accessed Nov 2010).
  • 3. National Health and Medical Research Council. NHMRC standards and procedures for externally developed guidelines. 2007. http://www. nhmrc.gov.au/_files_nhmrc/file/publications/synopses/nh56.pdf (accessed Nov 2011).
  • 4. VanLare JM, Conway PH, Sox HC. Five next steps for a new national program for comparative-effectiveness research. N Engl J Med 2010; 362: 970-973.
  • 5. National Health and Medical Research Council. Clinical practice guidelines for the prevention, early detection and management of colorectal cancer. 2005. http://www.nhmrc.gov.au/publications/synopses/cp106/cp106syn.htm (accessed Nov 2011).
  • 6. Australian New Zealand Clinical Trial Registry. Short Course Oncology Therapy (SCOT). A study of post operative chemotherapy for 12 weeks versus 24 weeks with oxaliplatin/Fluorouracil (5FU) to establish disease free survival outcomes in locally advanced colon cancer. http://www.anzctr.org.au/ACTRN12609000662268.aspx (accessed Apr 2011).
  • 7. ClinicalTrials.gov. Combination chemotherapy for 3 months or 6 months in treating patients with stage III colon cancer. http://www.clinicaltrials.gov/ct2/show/NCT00958737 (accessed Apr 2011).
  • 8. MacDonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001; 345: 725-730.
  • 9. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006; 355: 11-20.
  • 10. Australian New Zealand Clinical Trial Registry. TOP GEAR: Trial of Preoperative Therapy for Gastric and Esophagogastric Junction Adenocarcinoma. A randomised phase II/III trial of preoperative chemoradiotherapy versus preoperative chemotherapy for resectable gastric cancer. http://www.anzctr.org.au/ACTRN12609000035224.aspx (accessed Apr 2011).
  • 11. Institute of Medicine. Initial national priorities for comparative effectiveness research. Washington DC: National Academies Press, 2009.

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