TY - JOUR
T1 - Practice-based research networks and the mandate for real-world evidence
AU - Hall-Lipsy, Elizabeth
AU - Barraza, Leila
AU - Robertson, Christopher
N1 - Publisher Copyright:
© 2018 American Society of Law, Medicine & Ethics.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - The 21st Century Cures Act encourages the Food and Drug Administration to consider “real-world evidence” in its regulation of the safety and efficacy of drugs and devices. Many have interpreted this mandate to focus on non-randomized observational research. However, we suggest that regulatory science must also move from rarefied academic hospitals to community-based settings, where the vast majority of patients in fact receive care in the fragmented U.S. healthcare system. This move is especially important if innovations are to reach, and be validated in, more diverse populations. A solution can be found in the 183 Practiced-Based Research Networks (“PBRN”), i.e., groups of primary care clinicians and practices in all 50 states working to improve clinical care and translate research findings into practice. This symposium contribution seeks to describe some of the common shortcomings of clinical trials, explore the opportunities and challenges posed by use of real-world evidence as a basis for drug and device regulation, briefly describe the history and evolution of PBRNs, and articulate the challenges and opportunities for using PBRNs to fulfill the 21st Century Cures Act mandate for real-world evidence.
AB - The 21st Century Cures Act encourages the Food and Drug Administration to consider “real-world evidence” in its regulation of the safety and efficacy of drugs and devices. Many have interpreted this mandate to focus on non-randomized observational research. However, we suggest that regulatory science must also move from rarefied academic hospitals to community-based settings, where the vast majority of patients in fact receive care in the fragmented U.S. healthcare system. This move is especially important if innovations are to reach, and be validated in, more diverse populations. A solution can be found in the 183 Practiced-Based Research Networks (“PBRN”), i.e., groups of primary care clinicians and practices in all 50 states working to improve clinical care and translate research findings into practice. This symposium contribution seeks to describe some of the common shortcomings of clinical trials, explore the opportunities and challenges posed by use of real-world evidence as a basis for drug and device regulation, briefly describe the history and evolution of PBRNs, and articulate the challenges and opportunities for using PBRNs to fulfill the 21st Century Cures Act mandate for real-world evidence.
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U2 - 10.1177/0098858818789428
DO - 10.1177/0098858818789428
M3 - Article
C2 - 30106651
AN - SCOPUS:85053531078
SN - 0098-8588
VL - 44
SP - 219
EP - 236
JO - American Journal of Law and Medicine
JF - American Journal of Law and Medicine
IS - 2-3
ER -