PCORI at Age Seven: Results That Matter, with Much More to Come

A Growing Portfolio of Research That Can Improve Care

Not long ago, in 2015, we celebrated the first appearances in the scientific literature of results from some of our earliest-funded patient-centered comparative clinical effectiveness (CER) projects. This initial trickle of findings became a steady stream in 2017 and continues to grow monthly, a trend we expect to see continue through 2018. The results of PCORI-funded CER studies, as well as those from funded projects on CER methods, can be found in two places: in scientific journals and on PCORI’s website, as summaries of peer-reviewed final research reports for each funded project.

During 2017 alone, major medical journals published nearly 30 papers summarizing CER results from our awardees’ projects. At least 175 additional published papers reported other types of important results, such as qualitative results and descriptive analyses, from these studies. We post links on our website to all of those articles, and we support free access for all readers to the full text of dozens of these through our public access initiative.

Also in 2017, our peer-review process ramped up substantially, with draft final research reports from 166 studies undergoing independent assessment by scientists, patients, and other stakeholders. By year’s end, 14 of those studies had completed peer review, a number that will increase sharply in the months ahead. And we reached a related milestone: we started to post professional and lay-language abstracts of each peer-reviewed final report on our website. These abstracts are designed to help patients and those who care for them make better-informed decisions about their healthcare options.

Posting these abstracts and, eventually, the full research reports themselves, is part of our wide-ranging dissemination and implementation effort, which kicked into high gear this past year. Other elements include a growing set of downloadable summaries of some of our important research findings; awards to support dissemination and implementation activities, which help research teams test and refine innovative strategies to share their findings and promote their uptake in practice; Eugene Washington PCORI Engagement Awards promoting evidence dissemination; and continuing professional education activities for clinicians.

Evidence that Matters

I like to update you throughout the year about some of the compelling studies that illustrate the practice-changing potential of our research portfolio. A few that stood out recently:

• Provided men and their clinicians clear-cut evidence about the trade-offs of the three main treatment options for prostate cancer at low risk of spreading to other tissues;
• Showed how a health system's initiative to reduce high-dose opioid prescribing worked without patients reporting poorer pain control; 
• Showed how a shared decision making tool can safely reduce unnecessary hospital admissions for patients who experience chest pain but are not experiencing a heart attack;
• Demonstrated that daily finger sticks to monitor blood sugar levels are not necessary for people with type 2 diabetes who do not use insulin.

These projects and others like them exemplify the kind of research PCORI was created to fund—studies that can make an important, positive difference in patients’ lives as well as help support a patient-centered healthcare system that provides value to all.

We were also excited this past year to see the first draft results of our Evidence Synthesis Initiative appear for feedback from the community. In collaboration with the Agency for Healthcare Research and Quality, we developed and posted for public comment three updates of previous systematic reviews on treatment of posttraumatic stress disorder, rheumatoid arthritis, and urinary incontinence. We look forward to releasing the final reports of these updates in 2018. We’re also eagerly anticipating the findings of a large meta-analysis we funded of the evidence on using progesterone to prevent preterm births. This compelling collaborative effort involves the many researchers who have conducted studies on this question.

All of these initiatives aim to get new evidence to patients, their families, clinicians, and other healthcare stakeholders faster, and in more useful forms, than has been the case in the past. This is part of our mandate to improve the quality and relevance of evidence available to help healthcare decision makers.

Building on Our Current and Future Funding

It was another busy year on the funding front in 2017. Our Board approved nearly $340 million to support nearly 60 patient-centered CER and related studies, including research that can make a difference in addressing such high-burden topics as cancer treatment, relieving pain while reducing opioid use, mental and behavioral health, cardiovascular disease, sickle cell disease, palliative care, and multiple sclerosis treatment.

This brings our total investment to date to about $2 billion in projects that meet the mandates Congress gave us, including funding for nearly 400 CER studies, as well as projects to improve the methods and infrastructure for such research.

Even as we celebrate our 2017 achievements, we have much more work to do, and we look forward to a very productive 2018.  

We expect to see scores of additional PCORI-funded study results in coming months, via articles in scientific journals and the summaries we post on our website. Our multifaceted dissemination and implementation efforts will ramp up even more.

And of course, we will continue to offer research funding opportunities to support studies on topics our stakeholders tell us are important. For example, we now have eight open PCORI Funding Announcements (PFAs) that together offer up to $215 million to support research as well as dissemination and implementation and other activities. We’ll be posting another set of funding announcements shortly. And our multi-stakeholder review panels will soon start going through invited research funding applications that we received under another set of announcements, which offer a total of up to $180 million in support. We encourage anyone who is interested to explore all the funding opportunities listed on our website.

We’ll continue to assess and refine topic areas and develop new funding opportunities based on our stakeholder-guided topic prioritization process, in 2018 and beyond. We are still seeking researchers’ best ideas for studies that fulfill clearly defined patient-centered needs.

Throughout much of this past year, our nation engaged in a vigorous debate about the best ways to make the healthcare system more efficient, effective, and patient centered—in short, to make it a system that provides value to all. An essential, if underappreciated, step toward achieving that goal is research that compares which healthcare approaches work best for whom, given a patient’s needs and preferences. Providing information that can help patients choose care that’s more likely to be effective for them and less likely to be wasteful is a cost-saving strategy everyone can support. And that’s what PCORI does, funding work that complements the kinds of research supported by other public and private funders.

In the year ahead, we will remain focused on the mission we’ve been pursuing since we were established in 2010: funding studies that can help patients and those who care for them make better-informed healthcare decisions. We’ll do that by continuing to support ongoing studies, make new awards, and issue new funding opportunities to support research on topics that our stakeholders tell us are important. And we’ll do so with a continued commitment to be good stewards of the public funds entrusted to us and the commitments we make to the research teams we support.

We believe the results emerging from our research portfolio—and the impact of our leadership in advancing engagement of patients and other stakeholders in clinical research to make it more relevant to their needs and concerns—demonstrate the need for this work to continue for years to come.

We firmly believe this growing body of evidence will improve care and patient outcomes. As it does, we look forward to the patient-centered outcomes research community to grow even further and, along with it, our impact and influence.

I invite you to learn more about PCORI's research, which provides useful, relevant information that can help patients choose healthcare options that best meet their needs. We look forward to an even more exciting 2018.