The Federal Agency for Healthcare Research and Quality (AHRQ) conducts research that “compares drugs, medical devices, tests, surgeries, or ways to deliver health care.” Traditionally, drugs and other interventions are approved if they meet basic criteria of effectiveness and safety, but they are not compared, so we may pay for and use expensive and wasteful tools. Comparative research is fought tooth and nail by the pharmaceutical industry and is sometimes implicated in hot public debates about health care reform (“death panels” and the like). Indeed, it can raise value-tradeoffs, for instance between price and effectiveness, as well as merely technical issues like which drug has more side-effects. Any time value onflicts arise, the legitimacy of decisions by an administrative agency will be questioned.
In the stimulus bill of 2009, the AHRQ was authorized or required (I am not sure which) to organize public deliberations on the topic. They define public deliberation by “three core elements”:
(1) Convening a group of people (either in person or via online technologies to connect people in remote locations),
(2) Educating the participants on the relevant issue(s) through dissemination of educational materials and/or the use of content experts, and
(3) Having the participants engage in a reason-based discussion, or deliberation, on all sides of the issue(s).
Implicitly, they distinguish public deliberation from “stakeholder” input, which is a separate objective. (See my complaints about stakeholder processes.) The agency is going to fund “a randomized controlled experiment comparing five distinct methods of public deliberation to find the most effective approaches for involving the general public.” Some of the methods will be online; others, face-to-face. They will also vary in the size of group and the duration of discussion.
Right now, they are seeking public comment on this whole project. Written comments should be submitted to: Doris Lefkowitz, Reports Clearance Officer, AHRQ, by email at doris dot lefkowitz at AHRQ.hhs.gov. Jan. 30 is the deadline.