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. Those comments and responses included the following:

  • The reviewers asked whether the study needed to be repeated with a larger sample size to determine which paper-based conversation aid – option grid or picture option grid – patients considered more useful. The researchers acknowledged that because of difficulties they had in participant recruitment, they were not able to conduct a direct comparison between these two options. The researchers also considered it sufficient to know that both option grids were rated better than usual care, and the choice of which to use could be left to the patient and provider based on their preferences.
  • One of the reviewers asked for more information regarding the surgeon’s experience with the conversation aids. The researchers explained that they did not have enough room in the current report to share that information but were working on a publication that would discuss surgeon experiences. In their response to reviewer comments, the researchers provided a summary of surgeons’ experiences with the conversation aids, noting that surgeons felt initially like the aids disrupted the flow of their medical encounters with patients, but after some use, about half of these surgeons experienced the aids as a normal part of the patient’s appointment. Surgeons in the picture option grid group were more likely than surgeons in the option grid group to feel like the conversation aids should be part of their consultations with patients. They also felt like other qualified clinic personnel could use the conversation aids.
  • The reviewers asked whether the patient partners and patient associates involved in this research represented patients of low socioeconomic status, similar to the target population for the study, so that they could provide meaningful input for participant recruitment. The researchers explained that they did not collect information about socioeconomic status from their patient partners or patient associates, but two of the patient associates were from ethnic minority groups. Furthermore, the site principal investigators were responsible for identifying a patient associate for their site, so the research team could not purposively sample potential candidates for appropriate representation. Most of the patient partners and all of the patient associates were breast cancer survivors, and one patient partner represented a patient advocacy group.

Conflict of Interest Disclosures

Project Information

Glyn Elwyn, MD, PhD, MSc^
Dartmouth College
Comparative Effectiveness of Encounter Decision Aids for Early-Stage Breast Cancer across Socioeconomic Strata

Key Dates

July 2016
February 2021

Study Registration Information

^Marie-Anne Durand, PhD, MSc, MPhil, CPsychol was this project's principal investigator when it was awarded.


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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: April 28, 2022