|This project's final research report is expected to be available by April 2019.|
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.
Peer review identified the following strengths and limitations in the report:
- The reviewers stated that the report incorrectly described confounding. In the draft report, the researchers said confounding based on patient characteristics was a major limitation in previous breast cancer surveillance studies. The reviewers believed this statement to be incorrect because confounding is usually considered problematic in comparison studies, not in descriptive studies. The researchers countered that patient characteristics were still important factors in descriptive studies because they could influence imaging test results. Therefore, the researchers explained, confounding is relevant for earlier imaging studies.
- The reviewers expressed concern that the report’s results did not justify its conclusions. The concern stemmed from inconsistent performance outcomes about which surveillance strategy was superior. Also, reviewers noted that some outcomes had insufficient power to identify minimal, but clinically significant, differences. The researchers noted that although some outcomes were underpowered, the basis for the conclusions was a holistic assessment. This assessment looked across performance outcomes because no single measure could best assess the performance of the diagnostic tools.
- The reviewers asked for more information on missing data and patient attrition for the comparison study. The researchers added more information to the methods section about their plans to input missing data. The researchers also acknowledged that missing data could be a study limitation because they were unable to assess some potentially important confounders due to missing follow-up information.
- The reviewers requested additional details on the results of the third aim, including a new table displaying all of the statistical information about the results. The researchers responded that this aim was a pilot study for the development of the decision aid. To reduce confusion, the researchers included the methods for developing the decision aid but no results.
Conflict of Interest Disclosures
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Getting Buy-In Before Results (right)
The involvement of multiple stakeholders should help ensure that research results will be used not just by physicians, but by patients as well.
Making Medicine Better by Working Together
Produced by GroupHealth Research Institute
^Kaiser Permanente acquired Group Health Cooperative in February 2017.