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Porzsolt F, Wiedemann F, Phlippen M, Weiss C, Weiss M, Schmaling K, Kaplan RM. The terminology conflict on efficacy and effectiveness in healthcare. J Comp Eff Res 2020; 9:1171-1178. [PMID: 33314965 DOI: 10.2217/cer-2020-0149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Designers and architects created the rule 'form follows function (FFF)' for their own profession. Our paper demonstrates that this FFF rule applies equally well to the designers of clinical studies. Four examples present are as follows: disregarding this FFF rule causes an inconsistent terminology to differentiate between efficacy and effectiveness, inconsistent differentiation of efficacy and effectiveness interferes with the consistent interpretation of the results of clinical studies, inconsistent interpretation of clinical studies results in an unexpectedly variance of recommendations in clinical guidelines and the fusion of the FFF designer rule and of the demands of Cochrane and Bradford Hill ('can it work?', 'does it work?' and 'is it worth it?') avoids the terminology problem and its misleading consequences. This strategy is presented.
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Affiliation(s)
- Franz Porzsolt
- Institute of Clinical Economics (ICE) e.V., D-89081 Ulm, Germany
| | - Felicitas Wiedemann
- Institute of Clinical Economics (ICE) e.V., D-89081 Ulm, Germany.,Department of General Surgery, University Hospital Ulm, 89081 Ulm, Germany.,Department of General Surgery, Diakonie Klinikum Stuttgart, 70176 Stuttgart, Germany
| | - Meret Phlippen
- Institute of Clinical Economics (ICE) e.V., D-89081 Ulm, Germany.,Department of General Surgery, University Hospital Ulm, 89081 Ulm, Germany.,Department of E.N.T., Vivantes Klinikum im Friedrichshain Berlin, 10249 Berlin, Germany
| | - Christel Weiss
- Institute of Clinical Economics (ICE) e.V., D-89081 Ulm, Germany.,Department of Medical Statistics & Biomathematics, University of Heidelberg, 68167 Mannheim, Germany
| | - Manfred Weiss
- Institute of Clinical Economics (ICE) e.V., D-89081 Ulm, Germany.,Department of Anaesthesiology, University Hospital Ulm, 89081 Ulm, Germany
| | - Karen Schmaling
- Department of Psychology, Washington State University, Vancouver, WA 98686-9600, USA
| | - Robert M Kaplan
- Clinical Excellence Research Center, Stanford University, Stanford, CA 94305-6015, USA
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