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The New Imperative: Producing Better EvidenceThe era of evidence-based medicine, long in gestation, has arrived in full flower as an increasing number of individuals and organizations are coming to accept its potential to improve the quality of care delivered and to make that care more affordable. Reflections of this new emphasis are apparent in many places: from newspaper editorials that promote the concept, to broader government efforts to invest more resources in producing solid evidence, to private-sector initiatives that use evidence in the search for better value. To underscore the more aggressive pursuit of better evidence, Health Affairs is devoting this issue to a set of papers that discuss this subject in depth. The issue begins with a historical view of the subject, authored by one of the leading architects of the field, David Eddy. What follows is an eclectic set of papers that cover an array of subjects relevant to the theme. We acknowledge with gratitude the support that was provided for this issue by the Agency for Healthcare Research and Quality (AHRQ). Ever since the agency was formed in 1989, it has been involved in a variety of ways in the promotion of evidence-based medicine and policy. In 1997 it conceived the Evidence-based Practice Center program to support the collection and synthesis of evidence. The program was also designed to encourage private organizations (health plans and professional societies) to improve practice through guidelines, quality initiatives, and coverage decisions. I am pleased to report that the online readership of Health Affairs has quadrupled during the past year and now totals more than eight million page views annually. Almost half of all subscribers have now activated their online subscriptions to gain Web access to every article that the journal has ever published. We encourage all subscribers to take advantage of this online resource at www.healthaffairs.org.
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