Final Research Report

View this project's final research report.

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. The comments and responses included the following:

  • Reviewers observed that the study did not focus on addressing which strategies are effective for enhancing access but instead on finding strategies that patients and other stakeholders identify as important or promising. The researchers agreed that their focus was to find patient-centered strategies to improve access to care. Rather than find the most effective strategies, the researchers wished to identify a collection of useful strategies. They removed the word, effective, from the research question.
  • Reviewers also noted that the second research question, which regards the Delphi panel approach and modeling to identify the best strategies and policies, did not involve any evaluation that could actually test whether the best strategies were identified. The researchers acknowledged that the work on this research question did not involve a test of healthcare strategies but rather used an iterative process to derive the best strategies based on expert opinion.
  • Reviewers noted that the study did not completely implement the culture-change intervention although it seemed to hold promise as a feasible and impactful strategy. The researchers explained that completing the culture-change intervention would take years, but even so, they felt the study was of value in providing a structured approach that helped clinics start the process.

Conflict of Interest Disclosures

Project Information

Huanmei Wu, PhD^
Indiana University- Purdue University at Indianapolis
Improving Healthcare Systems for Access to Care and Efficiency by Underserved Patients

Key Dates

May 2013
January 2019

Study Registration Information

^ Bradley Doebbeling, BS, MD, MS was the original principal investigator for this project.


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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
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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
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Last updated: March 4, 2022