By Ann Bonham, Ph.D.
The May 21st meeting of the Patient-Centered Outcomes Research (PCORI) Board of Governors allayed past fears in the academic medicine community that PCORI might be slow getting off the ground. The board approved its initial Research Priorities and Research Agenda, accepted the Methodology Committee’s impressive report (and finalized a comment process on the report). Additionally, we approved the four initial research funding announcements, approved initial peer review criteria and the application review process and guidelines, and discussed how to more formally engage stakeholders. The enormous amount of work behind each of these foundational milestones is indeed impressive.
At a time when the Affordable Care Act (ACA) is under constant attention and its future uncertain, PCORI, authorized in the legislation, is going strong. The PCORI funding announcements introduce a robust new source for research that, according to the PCORI Board and intended by the legislation, must be focused on such things as patient-centeredness. The funding allocations also move our focus to conditional impacts on the health of individuals and populations, effect on health care performance, and addressing disparities and underrepresented populations. PCORI plans to use to funding for rigorous research methods developed by the PCORI Methodology Committee that include communication, evaluation, and dissemination.
As a side benefit, the announcements might help alleviate the angst about funding for clinical comparative effectiveness and implementation research. To some extent, the funding could offset the ruminations and concerns in the biomedical research community about funding for biomedical research from the NIH. Concerns included the overall NIH budget, changes in the salary cap, additional review for applications from investigators that have received NIH funds of $1.5 million or more in total costs, and funding for new investigators. It was expressed by some that the proverbial pendulum would swing away from funding for fundamental basic science to funding for larger interdisciplinary translational science as well as for comparative effectiveness and health services research.
The short time frame proposed for the upcoming funding announcement cycle will make it a challenge for both experienced and new research performers to respond to the substantive demands of the announcements. Another challenge will come from mastering a new grant application and review process — a process likely to have its own growing pains. There is some uncertainty about how many applications these funding announcements will draw and whether the review process can be scaled to meet the challenge.
Despite the uncertainty, there is no doubt researchers and clinicians at medical schools and teaching hospitals will be well-represented in the PCORI application pool and will demonstrate the importance of this national commitment of resources to patient-centered research outcomes.