Clinical Effectiveness and Decision Science

When deciding how to address a health problem, patients and those who care for them often need to choose between two or more options. To make the best decision, they must be able to access and use reliable information about the options’ potential benefits and harms.

Often, the available evidence is incomplete. It also may be difficult to interpret the evidence for an individual patient’s circumstances. The available information may describe health outcomes that are not the most relevant to patients or which may not apply to certain patient populations, such as the very young, the very old, or those with several medical conditions.

The Clinical Effectiveness and Decision Science (CEDS) program seeks to fill clinical information gaps by producing valid, trustworthy, and useful new evidence comparing the effectiveness of different clinical options. In situations where there already is adequate evidence, CEDS seeks approaches to raise patients and caregivers’ awareness of this information so they can make use of it in choosing the best option for them.

The CEDS Program is thus responsible for addressing three of PCORI’s five National Priorities for Research by managing projects in the following areas:

Assessment of Prevention, Diagnosis, and Treatment Options

This priority area focuses on CER across a broad range of clinical conditions and patient populations. This research compares the outcomes of two or more healthcare options, addressing gaps in the current evidence base. The studies compare clinical services known to be effective—or in widespread use because of perceived effectiveness—but for which current evidence has not indicated which option is most effective for individual patients. These services can be specific medical or surgical therapies, as well as complementary or self-care approaches. We are particularly interested in randomized trials in typical clinical populations and addressing the full range of relevant patient-centered outcomes. We also invite studies of variation in outcomes across relevant patient groups.

Communication and Dissemination Research

This priority area seeks to compare approaches for providing high-quality CER evidence in the most effective ways for empowering people to use this information. We manage research that addresses critical knowledge gaps in communication and dissemination of research results to patients and their caregivers. This work advances the understanding of effective approaches to promote shared decision making between patients and their providers. We also look to fund research on ways to explain uncertainty in healthcare evidence to patients and their providers.

Accelerating Patient-Centered Outcomes Research and Methodological Research

This priority area focuses on improving methods for the design and conduct of clinical studies, thereby improving PCORI’s and the nation’s capacity to conduct high-quality patient-centered CER. This priority area is complementary to the work of the PCORI Methodology Committee, which defines methodological standards for patient-centered CER and identifies methodological gaps that can be filled through research on best methods. Finally, the CEDS Program works to disseminate and facilitate the adoption of insights provided by these research projects on better methods of conducting patient-centered CER—both within PCORI-funded research and more broadly across the landscape of clinical research.

Posted: March 29, 2017