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Patient-Centered Outcomes Research Institute
TypeNonprofit organization
Legal status501(c)(1) organization
Joe V. Selby, MD, MPH
Websitewww.pcori.org

The Patient-Centered Outcomes Research Institute (PCORI) is a United States-based non-profit institute created through the 2010 Patient Protection and Affordable Care Act.[1] As a nongovernmental 501(c)(1) organization, it focuses on patient-centered outcomes research (PCOR) that produces findings about the comparative trade-offs of healthcare options that help people and caregivers make more informed healthcare decisions.

Purpose

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Created through the Affordable Care Act, PCORI seeks to "integrate the patient’s voice into the research process"[2] and fund research that that may result in a change in medical practice in areas of importance to patients, caregivers, and clinicians.[3] PCORI was created to

"to assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence concerning the manner in which diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed through research and evidence synthesis that considers variations in patient subpopulations, and the dissemination of research findings with respect to the relative health outcomes, clinical effectiveness, and appropriateness of the medical treatments, services, and items described."[4]

PCORI funds research studies that focus on patient-centered outcomes, rather than only on comparative effectiveness research (CER) alone.[5][6][7] Patient-centered outcomes research involves questions and outcomes "meaningful and important to patients and caregivers"[8]to help them make informed decisions for their own care. In this way, it is different from the United Kingdom's National Institute for Health and Care Excellence, which determines cost-effectiveness directly based on quality-adjusted life year valuations.

Funding

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PCORI is funded through the Patient-Centered Outcomes Research Trust Fund (PCORTF), which was authorized by the United States Congress as part of the Patient Protection and Affordable Care Act of 2010.[9] Its annual income comes from the general fund of the Treasury and a small fee assessed on Medicare, private health insurance, and self-insured plans. The act mandates a $2 fee, adjusted for inflation, for each person covered on a group plan.[10][11]

PCORI is fully U.S. government funded, and does not seek nor accept contributions from any other source. All its financial reports are public, along with an annual audit by the U.S. Government Accountability Office (GAO).[12][13] In 2018, its revenue was $506,485,458, with approved research awards of $308,000,000.[14] Since its founding, PCORI has funded over $2.5 billion USD in patient-centered outcomes research and related projects.[15]

Funded Research

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PCORI's authorizing legislation requires it "to guarantee peer review of all research results and to make those results publicly accessible within 90 days of their receipt, requirements that were the first of their kind for a US-based research funding organization."[16] To assist in this process, the PCORI board of governors requires all awardees to submit a comprehensive final report for PCORI-based external peer review, which is then posted and freely available on its website to include both "lay and technical abstracts of the report; the complete, approved final report and study protocol; and a summary of the peer review critiques and the authors’ responses to those critiques."[16]

National priorities were established to guide research. These include "assessment of options for prevention, diagnosis, and treatment; improving health care systems; dissemination and communications research; addressing disparities; and accelerating patient-centered outcomes research and methodology."[17] From these, there have been 65 research standards developed to support patient-centered outcomes research[18] used to guide over 600 funded studies awarded over the nine years PCORI has existed.[19] All studies that have been funded, their reports on results, and the articles that have come from them are searchable and available through the PCORI site.

Funding from PCORI enabled the development of PCORnet, a collaboration of several research networks that together facilitate clinical research using health data collected in the course of care through electronic health records, claims data, patient registries, and other sources.[20] Each participating site in PCORnet maintains its own data behind its own firewalls and transforms the data into a format specified by the PCORnet Common Data Model so that it can be used to conduct clinical research.[21][22]


References

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  1. ^ "Establishing Legislation", p. 728. Patient-Centered Outcomes Research Institute. Archived from the original on March 8, 2013.
  2. ^ Fleurence, Rachael; Selby, Joe V.; Odom-Walker, Kara; Hunt, Gail; Meltzer, David; Slutsky, Jean R.; Yancy, Clyde (2013). "How The Patient-Centered Outcomes Research Institute Is Engaging Patients And Others In Shaping Its Research Agenda". Health Affairs. 32 (2): 393–400. doi:10.1377/hlthaff.2012.1176. ISSN 0278-2715. PMID 23381533.
  3. ^ Selby, Joseph V.; Lipstein, Steven H. (2014-02-13). "PCORI at 3 Years — Progress, Lessons, and Plans". New England Journal of Medicine. 370 (7): 592–595. doi:10.1056/NEJMp1313061. ISSN 0028-4793. PMID 24521104.
  4. ^ Public Law 111–148: Title VI—Transparency and Program Integrity, Subtitle D—Patient-Centered Outcomes Research (PDF). Congressional Record. March 23, 2010. p. 728.{{cite book}}: CS1 maint: date and year (link) CS1 maint: url-status (link)
  5. ^ Methodology Committee of the Patient-Centered Outcomes Research Institute (PCORI) (2012-04-18). "Methodological Standards and Patient-Centeredness in Comparative Effectiveness Research: The PCORI Perspective". JAMA. 307 (15): 1636–1640. doi:10.1001/jama.2012.466. ISSN 0098-7484. PMID 22511692.
  6. ^ Neumann, Peter J; Weinstein, Milton C. (2010). "Legislating against use of cost-effectiveness information". New England Journal of Medicine. 363 (16): 1495–1497. doi:10.1056/NEJMp1007168. PMID 20942664.
  7. ^ "Social Security Act §1182". Social Security Agency. Retrieved April 13, 2014.
  8. ^ Frank, Lori; Basch, Ethan; Selby, Joe V. (2014-10-15). "The PCORI Perspective on Patient-Centered Outcomes Research". JAMA. 312 (15): 1513–1514. doi:10.1001/jama.2014.11100. ISSN 0098-7484. PMID 25167382.
  9. ^ "Patient Centered Outcomes Research Trust Fund Fee: Questions and Answers | Internal Revenue Service". www.irs.gov. Retrieved 2019-08-07.
  10. ^ Pipes, Sally. "Obamacare Increases Large Employers' Health Costs". Forbes. May 19, 2014.
  11. ^ "PCORI Fee Is Due by July 31 for Self-Insured Health Plans". SHRM. 2019-07-02. Retrieved 2019-09-04.
  12. ^ United States Government Accountability Office (March 2015). "Comparative Effectiveness: Initial Assessment of the Patient-Centered Outcomes Research Institute" (PDF).{{cite web}}: CS1 maint: url-status (link)
  13. ^ U. S. Government Accountability Office (2019-03-29). "Patient-Centered Outcomes Research Institute: Review of the Audit of the Financial Statements for Fiscal Year 2018" (GAO-19–413R).
  14. ^ PCORI. "2018 Annual Report: Patient-Centered Outcomes Research Institute" (PDF). Retrieved July 17, 2019.
  15. ^ "National Priorities and Research Agenda". www.pcori.org. 2014-05-01. Retrieved 2019-08-07.
  16. ^ a b Broitman, Marina; Sox, Harold C.; Slutsky, Jean (2019-04-16). "A Model for Public Access to Trustworthy and Comprehensive Reporting of Research". JAMA. 321 (15): 1453–1454. doi:10.1001/jama.2019.2807. ISSN 0098-7484. PMID 30920580. S2CID 85546386.
  17. ^ Beal, Anne C. (2012-04-18). "The Patient-Centered Outcomes Research Institute (PCORI) National Priorities for Research and Initial Research Agenda". JAMA. 307 (15): 1583–1584. doi:10.1001/jama.2012.500. ISSN 0098-7484. PMID 22511682.
  18. ^ "PCORI Methodology Standards". www.pcori.org. 2015-11-12. Retrieved 2019-07-26.
  19. ^ "Explore Our Portfolio". www.pcori.org. Retrieved 2019-08-07.
  20. ^ Fleurence, R. L.; Curtis, L. H.; Califf, R. M.; Platt, R.; Selby, J. V.; Brown, J. S. (2014-07-01). "Launching PCORnet, a national patient-centered clinical research network". Journal of the American Medical Informatics Association. 21 (4): 578–582. doi:10.1136/amiajnl-2014-002747. ISSN 1067-5027. PMC 4078292. PMID 24821743.
  21. ^ Qualls, Laura Goettinger; Phillips, Thomas A.; Hammill, Bradley G.; Topping, James; Louzao, Darcy M.; Brown, Jeffrey S.; Curtis, Lesley H.; Marsolo, Keith (2018-04-13). "Evaluating Foundational Data Quality in the National Patient-Centered Clinical Research Network (PCORnet®)". eGEMs (Generating Evidence & Methods to Improve Patient Outcomes). 6 (1): 3. doi:10.5334/egems.199. ISSN 2327-9214. PMC 5983028. PMID 29881761.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  22. ^ Klann, Jeffrey G; Abend, Aaron; Raghavan, Vijay A; Mandl, Kenneth D; Murphy, Shawn N (2016). "Data interchange using i2b2". Journal of the American Medical Informatics Association. 23 (5): 910. doi:10.1093/jamia/ocv188. ISSN 1067-5027. PMC 4997035. PMID 26911824.
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