The truth about comparative effectiveness

It's all the rage now: Peter Orzag of OMB at the White House seems to think comparative effectiveness research is worth appropriations valued at $1.1 billion. Will it be worth the money?

I wasn't sure what "comparative effectiveness" actually meant, so I looked up the term at Consumer Reports:

What does it mean? Comparative effectiveness quite simply means comparing two or more treatments for a given condition. Studies may compare similar treatments, such as two drugs, or it may analyze very different approaches, such as surgery and drug therapy. Comparative effectiveness evaluations may focus only on the relative medical benefits and risks of each option, or they may also weigh both the costs and the benefits of those options. In some cases, a given treatment may prove to be more effective clinically or more cost-effective for a broad range of patients, but frequently a key issue is determining which specific types of patients would benefit most from it.

Transparent, unbiased, comparative research conducted without industry support? I'm all for it, so long as Congress doesn't bypass the clinical judgment of individual physicians -- or attempt to meter out care. Reminds me a bit of the Clinton-era attempt to develop standardized clinical recommendations for wide range of conditions, from chronic back pain to diabetes.

Here's a few independent takes at the NYT health blog, THCB, and The Gray Sheet (subscription required).