HETEROGENEITY IN ACTION: THE ROLE OF PASSIVE PERSONALIZATION IN COMPARATIVE EFFECTIVENESS RESEARCH
研究发现，比较效果研究（CER）常忽略临床实践中已存在的被动个性化（PP），导致平均治疗效果无法反映个体差异，可能损害临床实践并产生更差结果。基于抗精神病药物在Medicaid精神分裂症患者中的实证分析，支持PP的存在，并表明提供个性化证据可带来显著益处。
Despite the goal of comparative effectiveness research (CER) to inform patient-centered care, most studies fail to account for the patient-centeredness of care that already exist in practice, which we denote as passive personalization (PP). Because CER studies describe the average effectiveness of treatments rather than heterogeneity in how individual patients respond to therapies, clinical or coverage policies that respond to CER results may undermine PP in clinical practice and generate worse outcomes. We study this phenomenon empirically in the context of use of antipsychotic drugs in Medicaid patients with schizophrenia using novel instrumental variable methods. We find strong support for PP in clinical practice and demonstrate that the average effects from a CER study cannot be replicated in practice because of the presence of PP. In contrast, providing physicians with evidence to further personalize treatment can produce significant benefits.