Results Summary and Professional Abstract
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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 reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:
- The reviewers asked that the researchers expand the background section of the report to describe the years of work that occurred before PCORI funding. They also asked for early clarification of the distinction between the broad construct of quality of life and the more specific health-related quality of life (HR-QOL) construct. The researchers edited the background section to better justify the practical need for this research and tried to clarify the theoretical arguments behind the importance of cognitive appraisal in making evaluations such as HR-QOL. The researchers also noted that all of the measures discussed in this report related specifically to HR-QOL but might overlap with non-health-related measures of well-being.
- The reviewers cautioned that drawing strong conclusions about the two instruments tested may not be warranted at this point. In particular, the reviewers were not convinced that both instruments were practical and interchangeable given the difference in the length of the instruments. The researchers edited the discussion section to soften some of their recommendations and provide a clearer rationale for their conclusions. They also expanded their comparison of the two instruments’ usability, noting especially the trade-offs between the longer and shorter measures. They said that further validation is needed to make a stronger recommendation about the two instruments and is underway.
- The reviewers noted that the stakeholder panel, including those stakeholders with experience as patients, was drawn from highly trained professional fields and not representative of patients generally. The researchers said they brought together stakeholders who had expertise as clinicians, policy makers, or researchers because they expected the discussions to be technical. The fact that some of the stakeholders also had experience as patients was not considered when the researchers recruited the stakeholders. The researchers also based most of their consideration of patient needs on a decade of earlier research that involved asking patients questions about appraisal assessment.
- The reviewers reminded the researchers that the Draft Final Research Report’s instructions ask for numerical results to include 95 percent confidence intervals that will convey the magnitude of the effect rather than only p-values to address statistical significance. The researchers explained that this information would not change the interpretability of the report, since they chose only statistically significant predictors to include in their regression models, so the magnitude of the relationship is not important. The 95 percent confidence intervals would also not fit well in the results tables, which are already quite large. In the discussion, the researchers went on to say that they would need to complete several more studies and a meta-analysis of appraisal and response shift differences in order to calculate the magnitude of the effect on appraisal of study and sample characteristics.
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