Final Research Report
View this project's final research report.
Related Journal Citations
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. Those comments and responses included the following:
- The reviewers disagreed with the report’s initial conclusions that the revised decision tool for bariatric surgery reduced decisional regret in patients deciding among different weight loss options. The reviewers noted that these initial conclusions were not based on the main study, a randomized controlled trial (RCT), but on a comparison of the usual care arm of the RCT against a later survey testing the feasibility of the revised decision aid. In addition, the reviewers noted that the significant amount of missing data in the trial hampered the ability to make any conclusions from the study results. The researchers agreed to qualify their conclusions based on the lack of a formal test of the revised decision aid. However, they also completed propensity score analyses to check for possible selection bias or significant differences between the sample receiving the original decision aid and the sample receiving the revised decision aid that would make these preliminary results more questionable.
- The reviewers suggested the researchers delete the report’s sentences on disseminating the decision tool since it has yet to demonstrate clear benefits in a RCT. The researchers agreed that additional research is necessary. However, given the positive feedback they had received from patients, patient advisors, surgeons, and others, the researchers plan to disseminate the tool. They explained that they do not make any claims that the tool is effective in any particular domain, but a wide range of people feel that any improvement in patient education and engagement when considering bariatric surgery would be of benefit to patients, providers, and society. The researchers added that a larger RCT may not be feasible for bariatric surgery.
- The reviewers asked why use of certain aspects of the original decision tool was low, suggesting that low use could be a barrier to widespread dissemination of the tool. The reviewers also asked how long it took for patients to complete the tool. The researchers responded that when they interviewed patients to understand how to revise the tool, patients expressed that they had trouble with information overload. So, the researchers revised the tool to be more streamlined and to present information in a more stepwise way. The researchers added that it was hard to say what amount of time spent with the tool was appropriate or necessary. However, they said they felt it was more beneficial for patients to use the tool for short amounts of time over a longer period of time, including before making a decision about surgery and when adjusting postoperatively.
Conflict of Interest Disclosures
^Nancy Birkmeyer, PhD, was the original principal investigator on this project.
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