Interesting Perspective from New England Journal of Medicine:
“Performance metrics must also be changed. Clinicians today are assessed according to the number of tests and procedures performed and the number of patients seen. Researchers are judged by the numbers of grants won and articles published. Neither set of metrics clearly leads to improved health outcomes. Integrated, “learning” health systems would result in novel metrics that focus on improving patient-centered outcomes, but they would also focus on active participation in research by multiple stakeholders to advance the same goals. Clinical departments, collaborating with community-based physicians and patient-advocacy groups, would have to prioritize entering patients in trials, and the value of research would have to be recognized in promotion decisions. This alignment of goals, incentives, and metrics would lead to better, more patient-centered clinical research and boost participation among both patients and clinicians, facilitating further improvements in health status.”
Annetine C. Gelijns, Ph.D., and Sherine E. Gabriel, M.D. Looking beyond Translation — Integrating Clinical Research with Medical Practice. N Engl J Med 2012; 366:1659-1661. May 3, 2012.
The issue is how to measure what matters, a point raised by Wells and Whitworth:
“It is no longer enough to measure what we can – we need to measure what matters.”
Robert Wells and Judith Whitworth. Assessing Outcomes of Health and Medical Research: Do We Measure What Counts or Count What We Can Measure? Australia and New Zealand Health Policy 2007, 4:14 doi:10.1186/1743-8462-4-14.