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PCORI’s Research Will Answer Patients’ Real-World Questions

March 25th, 2014

As a physician, I know the challenge of helping patients determine which health care options might work best for them given their personal situation and preferences. Too often they — and their clinicians — must make choices about preventing, diagnosing and treating diseases and health conditions without adequate information. The Patient-Centered Outcomes Research Institute (PCORI) was created to help solve this problem — to help patients and those who care for them make better-informed health decisions.

Established by Congress through the Patient Protection and Affordable Care Act as an independent research institute, PCORI is designed to answer real-world questions about what works best for patients based on their particular circumstances and concerns. We do this primarily by funding comparative clinical effectiveness research (CER), studies that compare multiple care options. But more research by itself won’t improve clinical decision-making. Patients and those who care for them must be able to easily find relevant evidence they can trust. That’s why our mandate is not just to fund high-quality CER and evidence synthesis but to share the results in ways that are meaningful to patients, clinicians and others. We’re also charged with improving the methods used in conducting those studies and enhancing our nation’s capacity to do such research.

We will be evaluated ultimately on whether the research we fund can change clinical practice and help reduce the variations and disparities that stand between patients and better outcomes. We’re confident that the work we’re funding brings us and the audiences we serve closer to that goal.

Recently, some questions have been raised in health policy circles about our holistic approach to PCORI’s work. That view holds that direct comparisons of health care options — especially those involving high-priced interventions — should be the dominant if not sole focus of PCORI’s research funding approach as a path to limiting the use of expensive, less-effective options.

We agree that discovering new knowledge on how therapies compare with one another is a critical mandate of PCORI and is essential to improving the quality and effectiveness of care. However, ensuring that patients and those who care for them have timely access to and can use this knowledge, so that they can effectively apply it to improve their decisions, is also very important. That is the reasoning behind our integrated approach path that addresses the gaps in available evidence, and also studies how best to make the evidence available and usable.

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Health Care Community Helps PCORI Take The Next Step

December 4th, 2012

Editor’s note: For more on PCORI and comparative effectiveness research, see the October 2012 issue of Health Affairs,”Current Challenges In Comparative Effectiveness Research.”

Earlier this year, the Patient-Centered Outcomes Research Institute (PCORI) satisfied one of its foundational requirements mandated in the Affordable Care Act. With public input, we established national research priorities to guide our work and support our mission of improving health by producing trustworthy information that will help patients make better-informed decisions about their care.

We are implementing those priorities through an ambitious research agenda, expecting to commit up to $96 million in contracts by the end of the year in response to funding announcements we issued in May. That’s on top of $31 million in funding we announced this past spring for our Pilot Projects Program.

Complementing that work, we are engaged with patients and the entire healthcare community to select specific research topics for targeted funding announcements. In particular, we are focused on conditions that occur frequently and impose heavy burdens on patients and their families, where outcomes can be substantially improved through new research.

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Enhancing Communication To Advance Research And Practice Is Among PCORI’s Key Priorities

November 5th, 2012

Editor’s note: Joe Selby’s post below responds to David Introcaso’s Health Affairs Blog post, also published today. For more on the concept of patient centeredness, comparative effectiveness research, and the Patient-Centered Outcomes Research Institute, see Health Affairs’ October issue, “Current Challenges In Comparative Effectiveness Research.

The Health Affairs Blog post by David Introcaso, PhD, “PCORI’s Problem: Reasons Are Not Causes,” emphasizes the critical importance of the patient-provider relationship and communication in improving health outcomes. It also notes the challenges to changing practice through the creation and dissemination of new evidence, including the non-linear nature of the process of turning knowledge into action. But it argues that PCORI has missed the boat on these issues, specifically having failed to address them either in the $30 million in Pilot Project awards we issued earlier this year or in our current research priorities and funding announcements.

We genuinely appreciate the serious thought Dr. Introcaso has given to these matters and fully agree with him on their importance if we are to change practice and improve patient outcomes. And that’s why both our work to date and the work we continue to pursue focuses directly on these questions in a number of concrete ways – a point he seems somehow to have missed.

The significance we at PCORI place on communication between patients and those who care for them is evident throughout our work: in our foundational research roadmap; in our initial round of research support (the Pilot Projects Program); and in the scope and detail of our primary research funding announcements’ requirements.

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Getting Specific: Selecting Patient- And Stakeholder-Initiated Topics For PCORI Funding

October 19th, 2012

Every day, patients, caregivers and clinicians must make any number of complex health care decisions. They might have to choose between several options for preventing, diagnosing or treating a disease or condition. They might need to decide between doing something specific and not doing anything at all. And often, they make these decisions without the evidence or information that answers the questions that matter most to patients.

The Patient-Centered Outcomes Research Institute (PCORI) was established to address this problem by funding comparative clinical effectiveness research to help patients make better-informed health and health care decisions, taking full and meaningful account of the concerns they have about the issues they face. Based on these principles, we developed our National Priorities for Research and Research Agenda, which guides our decisions about the kinds of research to fund.

To do this most effectively, we have implemented two complementary but equally critical paths: a broad, “investigator-initiated” funding process and a more directed “patient- and stakeholder-initiated” path. Together, they will help us build a robust portfolio of patient-centered outcomes research that will address the unmet needs of patients, caregivers, clinicians and other health care stakeholders.

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