Results Summary and Professional Abstract
Research to Help People with Serious Mental Illnesses Improve Their Health
People with serious mental illnesses often struggle to receive care to address common chronic physical health problems. Several PCORI-funded research projects are testing ways to help people with serious mental illness get the physical health care they need.
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 reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:
- Reviewers asked for a stronger justification for the study design and the choice of outcomes measured. For example, they found it puzzling as to why the researchers chose to follow up on those patients who did not improve in the first part of the study, rather than follow up on those who improved. The researchers revised the report to explain that patients who had not shown improvement were at the highest risk for increased illness, morbidity, and mortality. The researchers designed the pilot intervention especially for patients who did not report improvement using the available services at the wellness center.
- Reviewers asked for a more coherent presentation and synthesis of the findings in Aim 1 because it was not clear which outcomes were most important and merited further study. The researchers restructured the presentation of findings for Aim 1 to clarify.
- Reviewers asked for greater recognition of the limitations introduced in the stakeholder-driven approach for selecting a control group that is unrepresentative in its motivation. The researchers added to their discussion of the limitations introduced by self-selection and using propensity-matched controls. They acknowledged that participants may not be representative of other people with serious mental illness who may be less motivated to address their physical health needs.
- Reviewers expressed concern about missing data, such as the loss of some control subjects to follow-up. The researchers provided details on how much data was missing and they handled missing data in linear mixed models.
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