The Convergence of Science and Governance: Research, Health Policy, and American States

For more than a century, biomedical science has dominated health care research. In that time, scientific advances have yielded ever-more effective and technologically sophisticated—albeit expensive—treatments and diagnostic tools. The progress in clinical outcomes achieved has therefore been accompanied by an enormous increase in health care spending, which threatens the financial well-being of individual households and the country.

During roughly that same period, another field of health sciences has developed that is both complementary and in part a response to advances in biomedical science. Rather than investigating the biological mechanisms of disease, health services research concentrates on how health care—usually existing clinical interventions—can be most effectively delivered. It includes comparative effectiveness research, which undertakes head-to-head comparisons of treatment and diagnostic options, primarily by consolidating and analyzing the results of previous clinical trials in systematic reviews.