Decades of thoughtful, painstaking research has produced innovative new ideas in treating or preventing illnesses like diabetes, HIV/AIDS and heart disease.

Synthetic human insulin, for instance, is now manufactured for widespread clinical use. But challenges remain in determining the best ways of administering it — daily or weekly — and whether it can have the same effects in a pill.

Likewise, heart disease, the nation’s leading cause of death, involves many treatment unknowns.

“We don’t even know the dose to use for aspirin,” says local cardiologist Eric Topol. “We don’t know if it should be a baby or a 400 milligram, which is four times as much.”

Even the best methods for reducing pain, which has recently prompted the FDA to consider issuing stronger warnings over acetaminophen use, is an ongoing debate.

A new research initiative included in the economic stimulus package, signed into law in February, aims to produce the kind of information many doctors lack today:

• Is it better to treat chronic heart failure with medication alone or with drugs and home monitoring of weight and blood pressure?

• What is the best combination of therapies for elderly patients suffering from multiple symptoms?

• What’s the appropriate age for repairing a child’s cleft lip?

Of the $787 billion American Recovery and Reinvestment Act, $1.1 billion will be dedicated to the so-called comparative effectiveness research, or studies that draw conclusions about the effectiveness of one drug, procedure or medical technique over another.

Filling The Gaps

Consumer advocacy groups, labor unions and large employers have put their support behind the new initiative, saying it could serve to fill gaps in the kind of evidence that exists today.

“This has been happening since the dawn of time: Which is better, the leeches or the drilling a hole in your head?” said Jeffrey Bernstein, a policy analyst at U.S. PIRG, a nonpartisan consumer advocate that claims to stand up to “powerful special interests on behalf of the American public.”