Final Research Report

View this project's final research report.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

The following are strengths and limitations noted in peer review, and the researchers’ responses:

  • The reviewers applauded the researchers for providing a clear presentation not only of the research but also of their difficulties in implementing the palliative care intervention in nursing homes and in collecting data from staff.
  • The reviewers requested clarification regarding the nature of this study, which the report described as testing efficacy (i.e., whether the intervention works when compared with no intervention). The researchers revised the report to indicate that the study looked at the intervention’s effectiveness (i.e., how well the intervention works in a real-world context). 
  • The reviewers asked the researchers to provide results from tests of the study’s main hypotheses in the final report’s abstract. The researchers responded that the report did provide results for the first hypothesis, but they were unable to test the second and third hypotheses because of problems collecting data.
  • The final report emphasized the results of a sensitivity analysis showing that nursing home teams that were more functional, or working, had better implementation of the intervention than teams that were less functional, or nonworking. The reviewers noted that while the idea for this analysis came from preplanned in-depth interviews with nursing home staff, the analysis comparing working and nonworking nursing home teams was not preplanned and therefore should not be presented as key findings. The researchers responded that the report clearly presents these findings as sensitivity analyses and not as main findings.
  • The reviewers asked the researchers to soften the conclusion that the intervention was effective, pointing out that the prespecified analysis across all nursing home teams, the main result, did not show the intervention to be effective. The researchers declined to revise their conclusions to downplay the importance of the analysis of working versus nonworking teams’ outcomes. The final report retains a focus on this post-hoc result, which reviewers described as hypothesis generating and not a confirmation of the intervention’s effectiveness.

Conflict of Interest Disclosures

Project Information

Helena Temkin-Greener, PhD
University of Rochester
Improving Palliative and End-of-Life Care in Nursing Homes

Key Dates

December 2012
July 2018

Study Registration Information


Has Results
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Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Funding Opportunity Type
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
Research Priority Area
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 4, 2022