Comparative Effectiveness Research / PCORI

The analysis of the relative effectiveness of different medical treatments. The Patient-Centered Outcomes Research Institute (PCORI) is a government-sponsored organization set up to fund this analysis.  

Financial Incentives for Adherence to Hepatitis C Virus Clinical Care and Treatment: A Randomized Trial of Two Strategies

Jun. 29, 2017

David A. Wohl, Andrew G. Allmon, Donna Evon, Christopher Hurt, Sarah Ailleen Reifeis, Harsha Thirumurthy, Becky Straub, Angela Edwards, Katie R. Mollan

In Open Forum Infectious Diseases, David Wohl and colleagues, including Harsha Thirumurthy, assess the feasibility of two strategies for financially incentivizing adherence to Hepatitis C (HCV) care among patients with substance use disorders. Previous research has shown that, although rates of a sustained response to the virus (SVR) surpass 90%, patients experiencing substance use disorders may struggle to adhere to HCV care. The authors randomly assigned participants to either a fixed or lottery-based monetary incentive for attending clinic appointments, adhering to medications...

Association of Provider Specialty and Multidisciplinary Care With Hepatocellular Carcinoma Treatment and Mortality

Jun. 28, 2017

Marina Serper, Tamar H. Taddei, Rajni Mehta, Kathryn D'Addeo, Feng Dei, Ayse Ayatman, Michelle Baytarian, Rena Fox, Kristel Hunt, David S. Goldberg, Adriana Valderrama

In Gastroenterology, Marina Serper and colleagues, including David Goldberg, assess how various health care system factors affect survival rates in hepatocellular carcinoma (HCC). These factors included uptake of historically underutilized curative therapies, access to a hepatologist, and presentation of the case to a multidisciplinary tumor board. The authors found that, while curative treatments of HCC increased survival rates, only 25% of newly diagnosed HCC patients received treatment intended to cure the disease. Additionally, those who received care from only...

Association of Bystander Cardiopulmonary Resuscitation With Overall and Neurologically Favorable Survival After Pediatric Out-of-Hospital Cardiac Arrest in the United States

Jun. 22, 2017

Maryam Y. Naim, Rita V. Burke, Bryan F. McNally, Lihai Song, Heather M. Griffis, Robert A. Berg, Kimberly Vellano, David Markenson, Richard N. Bradley, Joseph W. Rossano

In JAMA Pediatrics, Maryam Naim and colleagues, including Joseph Rossano, investigate effects of bystander cardiopulmonary resuscitation (CPR) on pediatric out-of-hospital cardiac arrest. The authors analyze data from the Cardiac Arrest Registry to Enhance Survival, and find that out of 3,900 instances of out-of-hospital cardiac arrests, bystander CPR was provided in 1,814. Children who were treated with either conventional bystander CPR or compression-only CPR had higher survival rates and more favorable neurological outcomes than did those who were not treated with CPR....

Economic evaluation of a behavioral intervention versus brief advice for substance use treatment in pregnant women: results from a randomized controlled trial

Jun. 22, 2017

Xiao Xu, Kimberly A. Yonkers, and Jennifer Prah Ruger

In BMC Pregnancy and Childbirth, Xiao Xu and colleagues, including Jennifer Ruger, assess the economic impact of motivational enhancement therapy and cognitive behavioral therapy (MET-CBT) among substance-using pregnant women. The study was performed alongside a clinical trial that compared the intervention to brief advice about the risks of substance use and found no significant differences in the outcomes such as drug and alcohol use. As such, the authors conducted a cost minimization analysis, from the perspective of the health system. They found that, while the intervention...

A comparative effectiveness education trial for lifestyle health behavior change in African-Americans

Jun. 20, 2017

Chanita Hughes Halbert, Scarlett Bellamy, Vanessa Briggs, Ernestine Delmoor, Joseph Purnell, Rodney Rogers, Benita Weathers, Jerry C. Johnson

In Health Education Research, Chanita Hughes Halbert and colleagues, including Jerry Johnson, compared the effects of an education trial about risk factors for cancer and cardiovascular disease (CVD) within an African-American community. Participants were randomized to receive either integrated education about shared risk factors between cancer and CVD, or disease-specific education about CVD risk factors only. The authors assessed whether the type of education received affected fruit and vegetable intake or physical activity level. They find that when participants with less than...

Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: A systematic review and meta-analysis

Jun. 11, 2017

Ravishankar Jayadevappa, Sumedha Chhatre, Yu-Ning Wong, Marsha N. Wittink, Ratna Cook, Knashawn H. Morales, Neha Vapiwala, Diane K. Newman, Thomas Guzzo, Alan J. Wein, Stanley B. Malkowicz, David I. Lee, Jerome S. Schwartz, and Joseph J. Gallo

In Medicine, Jayadevappa, Schwartz, and colleagues analyzed the comparative effectiveness of localized prostate cancer treatments (active surveillance, radical prostatectomy, and radiation therapy) through systematic review and meta-analysis. They focused on outcomes that matter most to newly diagnosed patients: mortality; cancer recurrence; disease and treatment complications; side effects; and patient-reported outcomes such as health-related quality of life, satisfaction with care, and decision regrets. The systematic review included 58 articles published from 1995-2016, (29...

Evaluating the Impact of the Laborist Model of Obstetric Care on Maternal and Neonatal Outcomes

Research Brief
Apr. 26, 2017

Implementation of the laborist model was associated with a 15% decrease in the odds of the induction of labor and a 17% decrease in the odds of preterm birth.

Issues at the Heart of Advancing the De-Adoption of Low-Value Care

Issue Brief
Apr. 18, 2017

A diverse set of national leaders and stakeholders representing industry, think-tanks, provider and patient groups, and academic experts discussed how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable.

Value Frameworks for Cancer Drugs, US Style

Mar. 30, 2017

Developing a value framework for cancer drugs can sound like an arcane exercise without much relevance to clinical care. Restate it as a question of how, and how much, to pay for cancer drugs, and you’ve got everyone’s attention.

International Comparison of Frameworks for Valuing Drugs

Mar. 1, 2017

“Pay more for drugs that do more.” Although few would argue with the concept of paying for value, the mechanism for doing so has thus far eluded our multi-payer, market-based system. The Gant Precision Cancer Medicine Consortium at the University of Pennsylvania looked past US borders to learn about mechanisms in other countries, in its quest to recommend sustainable frameworks for valuing precision cancer drugs.

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