Results Summary and Professional Abstract
Final Research Report
View this project's final research report.
Related PCORI Dissemination and Implementation Project
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 wondered why the study compared three groups of patients rather than two, that is two intervention arms and a third group of patients that had usual care. The researchers said that the usual care arm allowed them to control for outside factors that could have influenced shared decision making (SDM) in asthma care over the time of the study.
- Reviewers asked why the researchers did not assess patients’ baseline SDM levels so that the change in SDM within practices could be measured over time. The researchers responded that they measured SDM only at the end of the study since they did not plan to assess changes in SDM over time but instead in comparison to usual care.
- Reviewers expressed concern about the statistical analyses given the lack of accounting for the possibility of patients completing the anonymous survey more than once, or the possibility of clustering within sites. The researchers acknowledged that they were unable to account for patients completing the survey more than once and that this was a limitation of the study. They did note that they analyzed survey data at the practice level and added some related caveats to the study limitations related to this.
- Reviewers noted that the report did not discuss the costs of intervention. The researchers said cost analysis wasn’t part of this project. They suspected, however, that there would be significant benefits to improved SDM training because it would lead to improved management of asthma for patients, including reduced emergency visits and hospitalizations. However, future research would be needed to assess the costs and benefits of intervention.
- Reviewers expressed concern that the results were subject to bias because of clinic practice and demographic differences not accounted for in analyses. For instance, the set of practices with facilitator-led SDM training, which had the greatest change in observed results, also had younger patients, who were more often Caucasian. The researchers said the numbers involved were too low to give them the power to analyze demographic effects. They noted that stratifying by practice size before randomization could have helped them perform more-detailed statistical analyses.
Conflict of Interest Disclosures
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