Results Summary and Professional Abstract
|This project's final research report is expected to be available by May 2021.|
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 how the researchers know that the population of patients treated at 17 centers in the United States were nationally representative. The researchers said they believe the population is representative because the contributing centers were geographically diverse, included patients who were part of clinical trials and patients who were not part of clinical trials, and the study population had clinical and demographic characteristics similar to those in large cooperative trials.
- The reviewers requested more information about who makes the choice whether chemotherapy recovery for pediatric acute myeloid leukemia occurs in the hospital or at home. Although the report indicated that this was the hospital’s choice, the reviewers asked if the choice is influenced by patients, parents, and clinicians, or solely determined by hospitals. The researchers said the standard practice at each institution determines discharge strategy. Patient characteristics and patient and family preferences typically do not influence whether patients recover within hospitals or at home after chemotherapy, or which management strategy is used.
- Given that individual hospitals determine patient discharge strategy, the reviewers expressed concern that there may be specific practices at hospitals or characteristics of patients at individual institutions that could confound the results. The researchers agreed this is an important issue and said that in order to try to mitigate such confounding factors, they captured detailed information on hospital-specific variables and standard practices. The researchers used statistical methods to address some potential confounders but acknowledged that, as for any observational study, there could have been confounding factors that they were unable to measure or measured imperfectly.
- The reviewers asked why the report presents parents’ economic concerns as part of their qualitative results. The researchers acknowledged that economic concerns were not the primary finding from their qualitative study, but when parents discussed their stress over caring for their children recovering from chemotherapy, financial pressures were an important component of parents’ anxiety. The researchers also acknowledged that patients who were discharged to recover at home had lower parental education and income than patients who recovered in hospitals. The researchers pointed out that if, as assumed, poorer, less educated, and larger families have a higher baseline risk for infection, then the risk of infection for recovering at home compared with at a hospital may be lower than measured.
Conflict of Interest Disclosures
The COI disclosure form will be posted here soon.