From Questions to Funding: About Our Topic Generation and Research Prioritization Process

Several steps comprise the process of generating topics for research to the final selection of the specific topics that will become the subject of our targeted funding announcements. We seek questions from patients and other stakeholders through a range of sources, including through our website and social media and through our engagement activities and other events. We also review similar efforts undertaken by other healthcare organizations and funding agencies, such as the Agency for Healthcare Research and Quality (AHRQ), the Institute of Medicine, the National Institutes of Health (NIH), and professional and advocacy groups.

PCORI staff reviews each topic against a set of criteria designed to ensure that it is appropriate for us. This means it must fit within our mission and authorizing law.

Questions must compare the effectiveness of two or more strategies for prevention, treatment, screening, diagnosis, or management; compare alternative system-level approaches; or compare factors that may differentially affect patients’ adherence to the alternatives (such as out-of-pocket costs). We may receive questions without a comparator but that are considered appropriate for PCORI funding because of their potential to be comparative.

Expert staff from each of PCORI’s program areas reviews the topics based on a specific set of prioritization criteria that we believe will help start us on the path to selecting the most promising topics.

Initial criteria:

• Patient-centeredness. Is the proposed research focused on questions and outcomes of specific interest to patients, their caregivers, and clinicians?
• Burden. Is the condition or disease associated with a significant burden in the US population (in terms of prevalence, mortality, morbidity, individual suffering, or loss of productivity)? Alternatively, is it a rare disease?
• Potential for improving healthcare practice. What is the likelihood that this research will change clinical practice or clinical decision making?
• Timeliness. Are potential projects associated with this topic likely to be accomplishable within a short time frame (3-5 years)?

The topics are then sent out to an external contractor who performs a review of existing evidence-based around the criteria described below, resulting in a Topic Brief. Final assessments are undertaken after a topic is selected by a PCORI Advisory Panel.

Under a contract with PCORI, AHRQ will lead this analysis and review each topic against criteria that reflect our research priorities.For the inaugural cycle of this process, however, we worked with researchers from Duke University, Johns Hopkins University, and the University of North Carolina, Chapel Hill. Topic lists, associated topic briefs, and other related information about this process can be found on the associated Advisory Panel pages pages below.

• Assessment of prevention, diagnosis, and treatment options.
• Improving healthcare systems.
• Addressing disparities.

We finalized this prioritization process in late 2012. This set of prioritization criteria were simplified based on feedback received in the pilot process after initial testing of a more extensive list.

Criteria for Topic Briefs and Advisory Panels

Patient-Centeredness. Is the proposed research focused on questions and outcomes of specific interest to patients, their caregivers, and clinicians? Is the proposed research focused on questions and outcomes of specific interest to patients, their caregivers, and clinicians?

Impact of the condition on the health of individuals and populations. Is the condition or disease associated with a significant burden in the US population? Burden of disease may be measured by how many people have the disease (prevalence); how many new cases occur every year (incidence); and other measures such as mortality, morbidity, individual suffering, and loss of productivity. PCORI is also interested in rare diseases.

Assessment of current options. What current guidance is available on the topic, and is there ongoing research? How does this help determine whether further research in this area would be valuable?

Likelihood of implementation in practice. Would new information generated by research be likely to have an impact in practice? Research is valuable when it leads to the use of more beneficial treatments or interventions. Providing new evidence by itself does not ensure that the research results will be used in clinical practice. Several factors may influence uptake in practice, including the knowledge and behaviors of health professionals, the acceptability to patients, and coverage or payment policies.

Durability of information. Would new information on this topic remain current for several years, or would it be rendered obsolete quickly by subsequent studies? Durability is generally associated with the rate at which new clinical evidence and/or better alternatives for patient management are emerging. Durability might be limited when there are rapid modifications to procedures and techniques. This commonly occurs in such domains as medical device development.

The topic briefs are shared with PCORI’s Advisory Panels. Panel members assess and rank the topics according to our criteria for research prioritization and produce a short list of research topics. Topics that are not short-listed may be considered in future funding cycles. PCORI Program Leads will commission landscape reviews on these topics in order to fully evaluate what is currently known in these areas and to more fully assess their suitability for further research. Based on these reviews, the Program Leads will decide which topics to submit to our Board of Governors for consideration to develop into PFAs.

The Board reviews the short list and approves a final list of topics to be developed into PFAs.

In consultation with external experts, PCORI staff develops funding announcements based on the Board-approved topics.

Learn more about our how we selected the topics for our first round of research prioritization.

Posted: April 15, 2013; Updated: July 24, 2013