Comparative Effectiveness Research to Inform Medical Decisions: The Need for Common Language

On a daily basis, oncologists and their patients must make choices regarding the approach to treatment. Although treatment selection is often straightforward, decision making in oncology is increasingly complexbecauseofexpandingtreatmentoptions,thetoxicityoftreatment, uncertain outcomes, out-of-pocket cost of therapy, and a highly charged clinical setting in which mortality is a central element. A key consideration in these decisions is the value of available therapeutic options. The ability to integrate considerations of clinical benefits, toxicities, and costs and compare alternative approaches has become essential for physicians and patients. Reliable information and the skillstoclearlycommunicatethisinformationtopatientsaretoolsthat are needed to assist clinical decision making, but unfortunately, these tools are currently inadequate. Although the importance of integrating patient preferences into the decision-making process has been longrecognized,dataarenotroutinelyavailabletopredictthepatient experience of care and hence inform the application of these preferences.Clearly,oursuccessingrowingtheclinicalarmamentariumhas