PCORI Answers Critical Questions
Sex and gender differences can affect physiological functions and impact many diseases, such as cardiovascular, pulmonary, and autoimmune conditions. To explore those differences, PCORI funds studies to help patients, clinicians, and others answer critical questions about women’s health, such as:
Physician: I treat an African-American woman with lupus who has had insomnia for most of her adult life. Are there any non-medication-based treatments that might work better for her than drugs?
Patient: I read a lot about the importance of breast cancer screening but I have no family history of the disease. How do personal risk factors affect how often I should get a mammogram?
Substance abuse counselor: Some of my clients are expectant mothers with opioid use disorder. How can I best advise them on whether to seek treatment through the clinic where they receive maternity care or a specialty addiction program?
Women's Health Study Spotlights
Federal data show that about one in nine expectant mothers in the United States experiences symptoms of postpartum depression. This study is assessing whether a lay home visitor-led prevention program can be as effective as a mental health professional-led program in teaching expectant mothers how to manage their moods and bond with their babies.
Women have different levels of risk for breast cancer, so the traditional approach of deciding when to have mammograms based mainly on age might not be the best one. This study compares two screening schedules—one based on risk and one on age—to see how well each detects cancer, how women feel about using a risk-based schedule, and whether that approach decreases false alarms that may lead to unneeded tests or treatments.
Experiencing depression during or after pregnancy can make it hard for women to take care of themselves and their newborns. This study is comparing two ways to help pregnant women and new mothers get the care they need for their depression symptoms.
Study Results that Support Better-Informed Decisions
|A Risk-Based Approach for Triaging Mammography Examinations
An algorithm based on clinical indication, breast symptoms, breast cancer history, and age successfully maximized cancer detection, according to this PCORI-funded study‘s research team. Reporting in JAMA Network Open, the study found that 12 percent of mammograms with very high or high cancer detection rates accounted for 55 percent of detected cancers, while 44 percent of mammograms with very low cancer detection rate accounted for just 13 percent of detected cancers. The findings suggest that triaging individuals most likely to have cancer detected during periods of reduced capacity, such as the COVID-19 pandemic, could result in detecting the most cancers while performing the fewest examinations compared with a non-risk-based approach.
|Individualized Patient Decision Making for Treatment Choices among Minorities with Lupus
Lupus is an illness in which the immune system attacks parts of the body; it primarily affects young women. Lupus can cause a kidney disease called lupus nephritis, a swelling of the kidneys. Lupus nephritis is more common and severe in minority groups. In this PCORI-funded study, based at the University of Alabama at Birmingham, the research team made an online decision aid specifically for women with lupus nephritis to help them make choices about available treatments. They then compared the use of this tool with reading an educational pamphlet about lupus. They found that compared with women who read the pamphlet, women who used the decision aid felt less doubt about their choices.
Evidence for Decisions from PCORI-Funded Studies
|Evidence Updates: Treating Urinary Incontinence in Women without Surgery
Millions of women experience urinary incontinence; however, many women don’t seek treatment because they don’t realize that improvement is possible. A recent review of research found that several nonsurgical treatments for urinary incontinence can help.
|Evidence Visualization: Effect of Pelvic Floor Muscle Training on Urinary Incontinence
This new interactive evidence visualization on pelvic floor muscle training, or PFMT, uses data from randomized controlled trials to assess the efficacy of PFMT to treat urinary incontinence, or UI. It stemmed from a PCORI-funded systematic review on nonsurgical treatments for urinary incontinence. Pelvic floor exercises were also highlighted as an effective nonsurgical treatment for UI in the Evidence Updates.