Clinical research often starts with experienced scientists adept at planning studies and applying for funding. Patients, their families, clinicians, and others with a stake in the results usually are brought in later, if at all.
At PCORI, we make it our mission to change that approach. One tool we’re using is our Pipeline to Proposal initiative, which provides funds and expertise to members of the health community as they take first steps in turning their concerns into full-fledged research projects. With these awards, we are building a community of healthcare stakeholders ready to work with researchers to lay the foundations for comparative effectiveness research (CER) that we or other funders can support.
We kicked off this initiative in late 2013 with 30 awards in the western United States. These initiated the first tier of a three-tiered program in which the awards become larger, and the activities more advanced, from one level to the next.
We are now pleased to announce that 27 of these awardees have been selected to receive Tier II support to bring their ideas closer to realization. The awardees include individual patients and patient advocacy groups, as well as caregivers, healthcare providers, and fledgling researchers.
We also expect to soon announce 50 new Tier I awards, expanding that initiative to the entire country. We are selecting up to 10 projects from each of the four US regions and up to 10 more that span multiple regions. Later in the year, we plan to announce our first Tier III awards.
Support from the Ground Up
In this system for grassroots project development, support goes beyond financing. Regional Pipeline Award Program Offices help awardees with administrative tasks, such as budgeting and strategic planning. The program offices also advise awardees on the day-to-day work of building two types of partnerships—with people throughout their community and with researchers who have the expertise to turn health issues into specific research questions and perform the studies to answer them.
We also provide training in CER to help awardees understand how to plan research that compares the effects of treatments or other interventions on the lives of patients. Last November, the Tier I awardees and their research partners met in Denver to share ideas and their enthusiasm.
Through the Pipeline
Tier I awards are intended to bring together communities of patients and others who share an interest in a particular health concern and to help them connect with researchers who are both qualified to conduct CER in the area of concern and eager to work with patients.
With Tier II awards, the awardees will further strengthen partnerships and develop infrastructure, such as communication networks and administrative arrangements, to facilitate working together. Stakeholders and researchers will collaborate to define the specific research question—which interventions to compare, for example—that will be addressed in their intended study.
By the end of the year, PCORI plans to announce the first Tier III awards. New applicants will have an opportunity to enter the Pipeline initiative at this level. Tier III awards might, for example, fund a period of preparation and guidance for researchers whose earlier applications for PCORI funding were denied because of a specific weakness in patient engagement or another aspect. The Pipeline support may help them turn such near-misses into studies worthy of support.
What Topics Are the Initial Projects Considering?
The health concerns addressed in the projects now moving from Tier I to Tier II extend from health literacy to HIV, from pre-term birth to Alzheimer's disease. Some health concerns can be fairly general, for example, improving diabetes management, or highly focused, for example, addressing obesity in Latino adolescents with spina bifida.
Other examples of awardees: