It’s been a season of milestones for PCORI in research funding, making important study findings widely available, preparing a range of additional funding opportunities, and planning a series of new resources to help our stakeholders make better-informed healthcare decisions.
Focus on Funding and Results
First, an update on our funding. With our Board of Governors’ latest round of award approvals, we’ve invested more than $2 billion in nearly 600 patient-centered comparative clinical effectiveness research (CER) studies and related projects to enhance the methods and infrastructure needed to conduct CER rigorously and efficiently.
Among our latest awards are studies that aim to improve treatment of opioid use disorder, obesity, behavioral and mental health issues, and low back pain.
But even as we mark this achievement, we have a substantial number of additional funding opportunities in the works. For example, we’ve just closed the application process for our first 2018 funding cycle. It is making up to $206 million available for studies under our five national priorities for research and $9 million more for projects to disseminate the results of our funded studies. In June, we plan to release or reopen three targeted funding announcements offering up to $53 million to support studies on psychosocial interventions for opioid use disorder, symptom management for patients with advanced illness, and medication-assisted treatment delivery for pregnant women with substance use disorders. We’ll also be offering up to $6.5 million to fund projects that can support implementation of evidence from major PCORI-funded studies.
We anticipate releasing funding announcements in September for cycle 3 of 2018 and in January for cycle 1 of 2019. Each of these will be Broad PCORI Funding Announcements, with funding of up to $5 million per project for three-year projects aligned with our priority areas for research.
In addition to robust funding plans, we’ve been pleased to see the ongoing growth in the number of completed funded studies that have results posted on our website, in professional and lay language versions. That number has topped 100, with dozens more due to post in coming months. These studies and others also have produced scores of scientific journal articles reporting their findings, all cited on our website with links to some of the articles available in full text free of charge. Many more will be published in the year ahead.
Putting Evidence to Work
But we know that a growing collection of important results, though vital, doesn’t fully meet stakeholders’ needs for practical information that can effectively inform the health decisions they need to make.
Our dissemination and implementation efforts help meet our mandate to improve the quality and relevance of evidence available for decision making. As part of these efforts, we offer funding through three award opportunities: awards for implementing evidence from PCORI studies by adapting findings to different contexts and promoting uptake in real-world settings; awards supporting the integration of shared decision making approaches in healthcare settings; and Eugene Washington PCORI Engagement Awards supporting dissemination activities. We have plans in place to fund several cycles of these awards through at least 2020.
With the input of stakeholders, we are planning a series of products and resources that will provide useful, timely information for patients, clinicians, and payers on new and emerging drugs, devices, and technologies.
PCORI also recognizes the particular needs created by the appearance of new, typically high-cost, therapies and technologies that hit the market with little or no information on comparative effectiveness. So, with the input of stakeholders, we are planning a series of products and resources that will provide useful, timely information for patients, clinicians, and payers on new and emerging drugs, devices, and technologies. Examples include:
- Horizon scans. These will systematically identify new healthcare technologies and therapies of interest to payers, patients, clinicians, and researchers before they hit the market. We’ll work with stakeholders to develop a framework for forecasting which technologies and treatments could have the greatest impact on health care and delivery, patient outcomes, use of resources, and what kinds of CER studies may be worthy of investments by PCORI or others.
- Topic briefs on emerging technologies and therapies. These will focus on summarizing what is known about the effectiveness and potential adverse effects of new products at the time they appear. Briefs will list any relevant research studies that are currently under way or completed, as well as the patient populations and care settings that have been studied. This information is intended to help put these exciting, still emerging, and often expensive developments in broader context early in their use.
- Evidence maps. These will be visual representations of evidence available on specific health research topics. They will provide a clear picture of the current research landscape on areas of interest, identifying what we know and where new research is needed to fill evidence gaps.
- Evidence syntheses. These evaluate all relevant studies on specific clinical questions to clarify what is known and what evidence gaps still exist. There are several types, but the most common is the systematic review, which answers questions by analyzing published and unpublished data from all relevant studies on a given topic. We just completed one of these, working with the Agency for Healthcare Research and Quality, an update on an earlier review on Posttraumatic Stress Disorder. We are developing others on atrial fibrillation, rheumatoid arthritis, and urinary incontinence.
- Evidence Updates. These provide practical, easy-to-interpret information that can help inform decision making by patients, clinicians, and policy makers based on systematic reviews and very strong study findings. We are already creating and disseminating Evidence Updates in collaboration with patient, provider, or other organizations. We’ve produced two so far: Antipsychotics for Children with Hyperactivity or Disruptive Disorders and Current Treatments for Localized Prostate Cancer and Symptom-Related Quality of Life. More are in the pipeline.
In addition to developing these products, we’ll use additional research funding and other initiatives to continue to improve our processes for collecting and acting on stakeholder input about how we can best serve patients and those who care for them.
The report was a straightforward description of our work, with no GAO criticisms or recommendations for improvement. What we found especially gratifying were the comments the GAO cited from the stakeholders it interviewed in preparing its report. We were particularly pleased to see that most stakeholders recognize our leadership in changing the way health research is conducted by engaging patients and prioritizing research outcomes most meaningful to them. And we were excited that the GAO highlighted the importance of disseminating the findings of our funded studies quickly, in ways readily available and understandable to experts and the public.
As we look to the future, we’ll continue to do what we have done since our earliest days—work closely with stakeholders to develop and implement ways to provide patients, clinicians, payers, and others with the evidence our funded projects generate in forms they can easily and quickly use. We’re confident the results emerging from our funded studies, and our leadership in patient-centered, stakeholder-driven health research, demonstrate the value and need for our work. It’s clear to us and many others that that work is critical to achieving the goal we all share—a more patient-centered and value-based healthcare system.