National Priorities for Research Topics in the United States

The US Institute of Medicine (IOM) was recently tasked with developing a list of 100 national health priority topics. The request came from the US Congress as part of a $1.1 billion funding initiative to improve the delivery of health care through comparative effectiveness research. 

The report provided impartial recommendations, informed by extensive public engagement, on national priorities for research. The report also provided advice on how to spend the $400 million specifically allocated by Congress to invest in comparative effectiveness research.

The 100 health priorities selected by the IOM were based on input from clinicians, policy-makers, the public, and others. Criteria were developed to assess the relevance of the topics suggested by stakeholders. The criteria included potential impact (based on prevalence of condition, burden of disease, variability in outcomes, and cost of care), potential to evaluate comparative effectiveness in diverse populations and patient subpopulations, uncertainty within the clinical and public health communities regarding management decisions, a need or gap addressed that was unlikely to be addressed through other funding mechanisms, and potential for multiplicative effect (e.g., lays foundation for future comparative effectiveness research or generates additional investment outside government). 

The selected topics relate to a range of diseases, research methodologies, and care models. The priority list includes 29 research areas (see Figure 1) affecting a broad range of ages and population groups. Randomized controlled trials were recommended as the most appropriate method of generating evidence for 49 of the 100 research priorities. Observational research, literature reviews, and database registries were also recognized as potential study methods.