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As we complete our third year of publication, we can reflect on many changes in health care and evidence-based medicine that have occurred worldwide. In the United States alone, the passage of the Patient Protection and Affordable Care Act in March 2010 has the potential to change American health care to a greater extent than anything since the passage of Medicare and Medicaid in 1965. The Affordable Care Act (ACA) was designed to implement policies related to fair health insurance premiums, guaranteed availability and renewability, risk pools, and catastrophic plans, thus increasing access to health insurance for the more than 45 million uninsured Americans. Numerous other notable outcomes of the passage of this bill resulted. For example, the Patient-Centered Outcomes Research Institute was authorized by Congress to conduct research that provides the best available evidence to help patients and their health care providers make more informed decisions about treatments and treatment options. The ACA encourages improvements in health care information technology infrastructure to make the most of available data and improve data collection on health care. In addition, there is explicit emphasis on comparative effectiveness research.