|Article Highlight: Access to a patient portal can increase engagement in outpatient visits by patients with diabetes and those with multiple complex chronic conditions, according to a PCORI-funded study spotlighted recently in PLOS One. The study showed that portal use was associated with significantly fewer emergency room visits and preventable hospital stays for patients with multiple complex conditions. By increasing patient office visits, a portal could potentially help clinicians address unmet clinical needs and reduce health events that lead to emergency and hospital care. The observational study compared visit rates for 165,000 patients with and without portal access in a large healthcare system that implemented a patient portal.|
|This project's final research report is expected to be available by May 2019.|
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 were concerned that the report did not adequately acknowledge a significant limitation of the study design that could lead to systematic bias related to who did and did not access the web portal. The researchers rebutted that they recognized this problem but because they were aiming for a real-world test of the portal, they accepted this trade-off and used the best possible statistical approaches to account for its effects. They also added a limitation in their discussion of the study, noting that there may be unmeasured patient factors that could account for use or nonuse of the web portal and also influence the study outcomes.
- The reviewers requested more justification for the use of subsets of patients with specific health concerns in some of the analyses of web portal use. The researchers explained that their potential population was very large, and so they needed to use subgroups for some of the usage analyses. They chose specific subgroups for some of the analyses to illustrate how use of the web portal would affect the communication between physicians and patients within a specific chronic disease group.
- The reviewers questioned why the authors included only a limited number of indicators of disease severity in the measures for this study, when many more were likely available in the rich dataset. The researchers responded that they chose measures that were readily available and felt that the measures they chose were good indicators of disease severity and are captured precisely in time. They did add a limitation to the Discussion section acknowledging that there were other indicators of disease severity that they could have examined.
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