Final Research Report

This project's final research report is expected to be available by October 2022.

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 lauded the researchers’ efforts to make the most of their planned trial despite their failure to recruit enough participants to continue the study. The reviewers did advise the researchers to include an explanation early in the report about terminating the trial and the decision to continue with a qualitative study of engagement with palliative care and research more generally. The researchers added a paragraph at the beginning of the report explaining the report structure and where to find the information on the originally planned randomized controlled trial.
  • The reviewers hypothesized that study recruitment failed because the researchers did not approach primary care providers directly to recruit eligible patients, and that the researchers should have piloted their study algorithm before the main project  to determine whether the algorithm accurately identified patients who were eligible for home-based palliative care.  The researchers explained that although representatives from the insurance company and accountable care organization expressed enthusiasm for the study and promised that primary care providers would be engaged, they prevented the researchers from contacting primary care providers directly. In addition, the researchers noted that they did not pilot the algorithm themselves because the participating insurance company ran algorithms to identify the potential sample of patients eligible for home-based palliative care. The researchers acknowledged that they would likely have had more recruitment success if they had been able to recruit primary care providers directly.
  • The reviewers expressed concern about the researchers’ assertion regarding numerous inaccuracies in the claims data they used to identify patients eligible for home-based palliative care. The researchers explained that conclusions about inaccurate data arose from their qualitative findings and came up repeatedly in interviews and focus groups. The researchers did admit, however, that some of the problems they experienced with the data may have been a result of incorrect search terminology used to identify eligible patients.
  • The reviewers asked whether the researchers had considered potential bias in their results given the small number of interview participants and the likely self-selection of participants into the study. The researchers explained that they had reached thematic saturation early in interviews with patients and caregivers as well as with primary care providers, but they did acknowledge that they could have interviewed more accountable care organization leaders to reach thematic saturation in that group.

Conflict of Interest Disclosures

Project Information

Susan Enguidanos, PhD, MPH
University of Southern California
$2,350,241
Expanding Access to Home-Based Palliative Care through Primary Care Medical Groups

Key Dates

December 2016
October 2021
2016
2021

Study Registration Information

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Last updated: March 4, 2022