How Does PCORI Choose

What to Fund?

Chad Boult, MD, MPH, MBA

Director, Improving Healthcare Systems Program

August 1, 2013

What Is PCORI Looking For?

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PCORI supports high-quality research

that produces trusted information

that will improve health care and outcomes

that patients and their families care about

Which Outcomes Do Patients Care About?

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Examples:

Health

Relief from symptoms

Health-related quality of life

Function (ability to do what they want to do)

Safety from medical harm

Survival

How Does PCORI Select the Most

Promising Research Proposals to Support?

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Two Parallel Solicitation Processes

Stakeholder-initiated (“targeted”) funding

announcements

Specific questions suggested by patients, clinicians, and

other stakeholders

PCORI solicits applications to answer to these questions

Investigator-initiated (“broad”) funding

announcements

Broad topic areas announced every four months

PCORI solicits applications to answer questions posed

by investigators

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Stakeholder-initiated (“Targeted”) Funding

Announcements

How we get from stakeholders’

questions to funded research

projects

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Cast a Wide Net

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Topics submitted through PCORI’s web site

www.pcori.org/questions

Topics posed at PCORI-sponsored workshops

Topics identified by IOM, NIH, AHRQ, and other

organizations and associations

Topics submitted by PCORI staff members

Screen the Catch

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To remove certain questions

About cost-effectiveness

About the causes of disease

That do not address patient-centered outcomes

That do not compare approaches to improving

patient-centered outcomes

That have already been answered, or are in the

process of being answered

Select the Best 10–20 Questions

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Criteria

1. The question addresses a problem that puts a large burden on society, or on a subset of it

2. The question focuses on a patient-centered topic and outcome

3. Answers to the question are likely to improve healthcare practices and patient-centered outcomes

4. Answers to the question could be obtained within a few years

Advisory Panels Prioritize the Top 10–20

Questions

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Advisory panels (21 people) include patients, caregivers, stakeholders, and researchers. Meetings are webcast to the public and archived.

Before meeting, panelists receive a “topic brief” to provide background information on each of the questions to be prioritized

Panelists meet in person, using discussion and software, to prioritize the top questions for possible funding announcements in the future

Criteria for Prioritizing Questions

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1. The burden that the problem puts on society

2. The patient-centeredness of the question

3. The need for new information about benefits and harms to choose between alternative interventions

4. The likelihood that answers to the question would be implemented in practice

5. The durability of the answer(s) to the question

Targeted Funding Announcements

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Following approval by PCORI’s board, PCORI

staff members write and release solicitations

(PFAs) for applications for contracts to conduct

research to answer the highest priority questions

Merit review of submitted applications

By scientists, patients, caregivers, and stakeholders

First Two Rounds

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1. The first “targeted” funding announcements

were released earlier this summer

Treatment Options for African Americans and

Hispanics/Latinos with Uncontrolled Asthma

Preventing Injuries from Falls in the Elderly

2. The second set will be released later this year

and next year

Investigator-Generated (“Broad”) Funding

Announcements

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PCORI’s Research Portfolio

PCORI has approved 76 awards totaling $123 million

through the first two cycles of our broad PCORI funding

announcements (PFAs)

Cycle III awards will be made in September 2013

PCORI will award more than $355 million in 2013 and

upwards of $500 million in 2014

The first PFA cycle of our second year of funding opened

May 15, and applications are due August 15

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Get Involved

Patients, stakeholders, and researchers can

participate in this selection process at

http://www.pcori.org/get-involved

Submit questions for possible future funding

Apply to be a member of a merit review panel

Engagement Awards and

Pipeline to Proposal Awards

Concept Origin

Proposed by participants at October 2012 Transforming

Patient-Centered Research patient engagement workshop

Workshop participants identified that few resources have

been directed to non – research entities for community

development, capacity building, or for infrastructure

development for engagement in research as partners.

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Engagement's Strategic Pillars = Three

Arms of Engagement Awards

Develop PCOR Community: Knowledge Awards will help PCORI to develop the PCOR community by enabling us to partner with organizations and individuals equipped to cull the best examples of PCOR and CER from the field, and to expand understanding of and connection to PCOR. Examples of potential activities to be funded through Knowledge Awards, listed in the green box in the diagram below, include things like landscape reviews, background papers, and mechanisms for sharing key CER and PCOR information.

Engage the PCOR Community in Research: Training and Development awards will help PCORI accomplish our second pillar by funding the cultivation of a larger, more educated and research-ready PCOR community. Examples of specific activities, listed in the purple box in the diagram below, will include but are not limited to efforts to link interested patients, stakeholders and researchers together to build research partnerships and the Pipeline to Proposals Awards, formerly known as Micro-Contracts.

Promote Dissemination and Implementation of Research: Implementation Awards will allow PCORI to evaluate our engagement work and share our findings. These awards will cover two sets of activities, examples of which are listed in the orange box in the diagram below; working with and through key partners to review the effectiveness of our engagement strategy, and widely disseminating information about and encouraging implementation of the best patient engagement, PCOR, and CER practices.

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Engagement Awards

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First Engagement Awards Opportunity:

Pipeline to Proposal Awards

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Tier I Pipeline Awards

(Up to $15,000 for 9 months)

Available to individuals,

consumer/patient organizations,

clinician(s) or researcher(s) or a

combination of the above to

support:

Community building

Creation of structure and

communication strategies

Develop an understanding of

PCORI, and “research done

differently”

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Tier II Pipeline Awards

(Up to $25,000 for 1 year)

Available to emerging

research/non-research

partnerships to support:

Data network development

Development of infrastructure

Generation of research

questions through community

events, town hall meetings, etc.

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Tier III Pipeline Awards

(Up to $50,000 for 1 year)

Available to advanced

research/non-research

partnerships- including those who

submitted PCORI proposals and

were not funded - to support:

PCORI research proposal

(re)submission

Research partnership skill

development

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Three Tiers

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Tier I Awards:

Role of Intermediate Funders

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Questions?