CER, PCOR, & the History of PCORI:Making Sense of Alphabet SoupMichael Steinman, MDDirector of Comparative Effectiveness R...
Thanks and Disclosure• Thank you to participants and organizers –   Tracy Lieu           – Howard Pinderhughes –   Kathryn...
History of PCORI• 2010 health reform created Patient Centered  Outcomes Research Institute  – CER politically unpalatable ...
Patient-Centered Outcomes• Patient-centered outcomes – outcomes that  directly impact patient’s lives and well-being  – Fu...
What is PCORI Funding?• Five priority areas:  –   Prevention, Diagnosis, and Treatment Options  –   Improving Healthcare S...
What is PCORI Funding?• 2011-2012  – Small grants; pilot grants - methods and research priorities• 2012  – Recurrent (main...
First Round of PFAs• 25 proposals funded (out of ~500)  – $41 million over 3 years  – (anticipate $355 million in 2013)
First Round of PFAs• Prevention, Diagnosis, Treatment  – Cognitive outcomes of antiepileptic drugs in pediatric epilepsy  ...
First Round of PFAs• Prevention, Diagnosis, Treatment  – Cognitive outcomes of antiepileptic drugs in pediatric epilepsy  ...
Stakeholder Engagement• Stakeholder engagement critical  – Identifying relevant outcomes  – Identifying pertinent research...
Stakeholder Engagement• How is this actually done?• Main focus of this symposium
Agenda8:30-9:15     Population-Based Networks for CER: Potholes and Potential               - Tracy Lieu, Division of Rese...
First Round of PFAs• Prevention, Diagnosis, Treatment   – Cognitive outcomes of antiepileptic drugs in pediatric epilepsy ...
UCSF CER - CER, PCOR, PCORI Overview (Symposium 2013)
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UCSF CER - CER, PCOR, PCORI Overview (Symposium 2013)

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UCSF CER - Comparative Effectiveness Program (Symposium 2013), Mike Steinman

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  • Mission “PCORI helps people make informed health care decisions – and improves health care delivery and outcomes – by producing and promoting high integrity, evidence-based information that comes from research guided by patients, caregivers, and the broader health care community. …”
  • Home IV vs. oral antibiotics - rehospitalization and quality of lifeCommunity engagement ↓ disparities in depression outcomes
  • Home IV vs. oral antibiotics - rehospitalization and quality of lifeCommunity engagement ↓ disparities in depression outcomes
  • Home IV vs. oral antibiotics - rehospitalization and quality of lifeCommunity engagement ↓ disparities in depression outcomes
  • UCSF CER - CER, PCOR, PCORI Overview (Symposium 2013)

    1. 1. CER, PCOR, & the History of PCORI:Making Sense of Alphabet SoupMichael Steinman, MDDirector of Comparative Effectiveness Research, CTSIAssociate Professor of Medicine, Division of Geriatrics
    2. 2. Thanks and Disclosure• Thank you to participants and organizers – Tracy Lieu – Howard Pinderhughes – Kathryn Phillips – Claire Brindis – David Thom – Mark Pletcher – Diane Allen – Kevin Grumbach – Aria Yow – Laura Schmidt – Deborah Grady – Michael Potter – Clay Johnston• No conflicts of interest
    3. 3. History of PCORI• 2010 health reform created Patient Centered Outcomes Research Institute – CER politically unpalatable (fears that → rationing) – So…PCOR – Define mandate, create systems to review and administer grants distinct from NIH or AHRQ – Clear mandate what is it not – cannot consider cost in coverage decisions; cannot use QALYs; will not fund cost-effectiveness analyses
    4. 4. Patient-Centered Outcomes• Patient-centered outcomes – outcomes that directly impact patient’s lives and well-being – Functional status; ability to concentrate; care for loved ones; pain – NOT biomarkers – Effect size should be meaningful – Evaluate heterogeneity of treatment effects – Real-world settings
    5. 5. What is PCORI Funding?• Five priority areas: – Prevention, Diagnosis, and Treatment Options – Improving Healthcare Systems – Communication and Dissemination – Disparities – Methodological Research
    6. 6. What is PCORI Funding?• 2011-2012 – Small grants; pilot grants - methods and research priorities• 2012 – Recurrent (main) PFAs • Up to $500,000 /yr for 3 years – Innovation Challenge • Match patients and researchers; $50,000• 2013 – Subject-specific grants • Treatment options for uterine fibroids; treatment options for severe asthma; fall prevention in the older adults
    7. 7. First Round of PFAs• 25 proposals funded (out of ~500) – $41 million over 3 years – (anticipate $355 million in 2013)
    8. 8. First Round of PFAs• Prevention, Diagnosis, Treatment – Cognitive outcomes of antiepileptic drugs in pediatric epilepsy – Helping patients choose peritoneal dialysis vs. hemodialysis• Healthcare Systems – Hospital discharge planning – impact on medication problems, functional status, re-hospitalization
    9. 9. First Round of PFAs• Prevention, Diagnosis, Treatment – Cognitive outcomes of antiepileptic drugs in pediatric epilepsy – Helping patients choose peritoneal dialysis vs. hemodialysis• Healthcare Systems – Hospital discharge planning – impact on medication problems, functional status, re-hospitalization Patient-centered outcomes (Outcomes, heterogeneous effects, real-world)
    10. 10. Stakeholder Engagement• Stakeholder engagement critical – Identifying relevant outcomes – Identifying pertinent research questions – Study design and implementation• Stakeholders = patients, families, caregivers, policymakers, clinicians, etc.• Key criterion - stakeholders an active role in partnering with investigators and developing proposals• Stakeholders involved in review process
    11. 11. Stakeholder Engagement• How is this actually done?• Main focus of this symposium
    12. 12. Agenda8:30-9:15 Population-Based Networks for CER: Potholes and Potential - Tracy Lieu, Division of Research, Kaiser Permanente NorCal9:15-10:00 What PCORI Wants – Priorities and Preferred Methods - Kathryn Phillips, UCSF TRANSPERS Center10:00-10:20 Refreshments and Networking10:20-11:30 Stakeholder Engagement – What is it? How do I do it? - Kevin Grumbach, Dept. of Family and Community Med., UCSF11:30-12:10 Resources at UCSF to Support CER and PCOR - Multiple speakers12:30-1:30 Cancer Interest Group Breakout – Room 384
    13. 13. First Round of PFAs• Prevention, Diagnosis, Treatment – Cognitive outcomes of antiepileptic drugs in pediatric epilepsy – Helping patients choose peritoneal dialysis vs. hemodialysis• Healthcare Systems – Hospital discharge planning – impact on medication problems, functional status, re-hospitalization• Communication and Dissemination – Dementia care for rural and Hispanic populations• Disparities – Literacy-adapted psychosocial treatments for chronic pain
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