Results Summary and Professional Abstract
Results of This Project
In Care Transitions, a Chance to Make or Break Patients' Recovery
A narrative on what happens when patients are harmed by poorly executed transitions between healthcare settings.
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 noted that researchers adopted an unusual number of major protocol changes after the project began. These protocol changes may have diminished the rigor of the work but in some cases were due to factors beyond the researchers’ control. The report is explicit and detailed about protocol changes. The reviewers noted that the report acknowledged the study’s limitations and was cautious in its interpretations.
- Reviewers suggested that the analysis of patient-reported outcomes might have been better handled using Rasch Measurement Theory instead of Classical Test Theory, since the latter does not take ordinal data into account. The researchers acknowledged the growing use of Rasch Measurement Theory but explained that its use in this situation would still be an exception not the norm. The researchers noted that using Rasch Measurement Theory would have been another major modification to their original research plan.
- The reviewers noted that because the Shepherd Center, where they conducted this study is a national leader in rehabilitation of patients with severe spinal cord injury, the cohort may not be representative. The researchers agreed that the center may be unique and results may not be entirely generalizable. However, researchers noted that while the cohort had the advantage of being at a leading spinal cord injury treatment center, the patients at the center also tend to be more significantly impaired than patients with spinal cord injury who are typically admitted into inpatient rehabilitation.
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