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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. 

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

Project Information

Karen Joanne Wernli, PhD, MS
Kaiser Permanente Washington Health Research Institute^
$1,942,141
10.25302/5.2019.CE.13046656
Comparative Effectiveness of Surveillance Imaging Modalities in Breast Cancer Survivors

Key Dates

September 2013
June 2018
2013
2018

Study Registration Information

^Kaiser Permanente acquired Group Health Cooperative in February 2017.

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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
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
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 4, 2022