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PCORI and Other Funding Sources. K Scholars Program * April 2013 Michael Steinman, MD Associate Professor of Medicine, Division of Geriatrics Director of Comparative Effectiveness Research, CTSI. Disclosure. No conflicts of interest. Outline. What is PCORI?

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pcori and other funding sources

PCORI and Other Funding Sources

K Scholars Program * April 2013

Michael Steinman, MD

Associate Professor of Medicine, Division of Geriatrics

Director of Comparative Effectiveness Research, CTSI

disclosure
Disclosure
  • No conflicts of interest
outline
Outline
  • What is PCORI?
    • And what is its relation to CER?
  • Funding opportunities through PCORI
  • Other funding opportunities in CER and PCOR
pcori
PCORI
  • 2010 health reform created Patient Centered Outcomes Research Institute
    • CER politically unpalatable (“lead to rationing”)
    • So…focus on PCOR
    • Quasi-governmental organization funded by tax on insurers
      • Protected from annual congressional appropriations
      • Cannot consider cost in coverage decisions; cannot use QALYs; will not fund cost-effectiveness analyses
      • Otherwise fairly open mandate to create something new
pcori1
PCORI
  • Different approach to research
    • PCOR
    • Stakeholder engagement
    • “Community based participatory research for health care systems”
patient centered outcomes
Patient-Centered Outcomes
  • “Given my personal characteristics, conditions and preferences, what should I expect will happen to me?”
  • “What are my options and what are the potential benefits and harms of those options?”
  • “What can I do to improve the outcomes that are most important to me?”
  • “How can clinicians and the care delivery systems they work in help me make the best decisions about my health and healthcare?”
patient centered outcomes1
Patient-Centered Outcomes
  • Prognosis; comparative options for diagnosis and treatment; improved communication and decision-making
  • 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
stakeholder engagement
Stakeholder Engagement
  • Central to PCORI’s mission
    • Stakeholders should be involved in ALL aspects of research
      • Developing research plan, measures, etc.
      • Patients, providers, policy-makers, etc.
    • Stakeholders sit on review panels
guidance
Guidance
  • PCORI Methodology Report and Methodology Standards
    • Explicit guidance on preferred methods

http://www.pcori.org/research-we-support/methodology/

pcori funding opportunities
PCORI Funding Opportunities
  • PFAs – investigator initiated projects
  • Targeted announcements
  • Special programs
pcori funding announcements pfas
PCORI Funding Announcements (PFAs)
  • PCORI Funding Announcements
    • 3 cycles per year
    • 3 years, up to $500K per year
    • ~$350 million in 2013
  • Five priority areas
first round of pfas
First Round of PFAs
  • 25 proposals funded (out of ~500)
    • $41 million over 3 years
first round of pfas1
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
first round of pfas2
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)

targeted announcements
Targeted Announcements
  • Five target areas
    • Treatment options for uterine fibroids.
    • Treatment options for severe asthma in African-Americans and Hispanics/Latinos.
    • Preventing injuries from falls in the elderly.
    • Treatment options for back pain.
    • Obesity treatment options in diverse populations.
  • Actual funding announcements will be posted by July 2013 (in theory)
special opportunities
Special Opportunities
  • PCORI Challenge
    • Developing a patient/research “matching” system
    • $50,000
  • Others coming down the pike…
not only pcori
Not only PCORI
  • Alternative funding sources
    • AHRQ
    • NIH
    • VA
    • Foundations
  • Can do things that PCORI cannot
    • Career development
    • Cost effectiveness
    • Non-patient centered outcomes
slide18
AHRQ
  • Beginning series of FOAs in PCOR
    • Mentored Career Development in PCOR
      • Junior Investigator: K01; K08
      • UCSF K12 PARTNERS Program
      • Mid-career or Senior Investigator: K18
    • Infrastructure Development Program in PCOR
      • R24

http://www.ahrq.gov/funding/research/announcements/index.html

http://grants.nih.gov/grants/guide/notice-files/NOT-HS-13-003.html

http://accelerate.ucsf.edu/training/partners

slide19
AHRQ
  • CER is one of seven AHRQ “portfolios”
  • Intramural and contract-based work in CER
    • Effective Health Care Program
    • Evidence-Based Practice Centers
      • Synthesize evidence for conditions or technologies
    • CERTs
      • Research and education drugs and devices
    • DeCiDE Network
      • Practical studies on outcomes, CER, safety, appropriateness

http://www.ahrq.gov/cpi/portfolios/comparative-effectiveness/index.html

slide20
NIH
  • Lots of funding in 2009-10 under ARRA
  • Now selected RFAs:
    • Secondary Analyses of Comparative Effectiveness, Health Outcomes and Costs in Persons with Multiple Chronic Conditions (R21; NIA)
    • Dissemination and Implementation Research
      • R01; R21; R03 (multiple institutes)
slide21
VA
  • Not much specific to CER and PCOR
resources
Resources
  • CER Program
    • http://accelerate.ucsf.edu/research/cer
    • Consultation resources
      • 5 free hours of consultation thru consultation services
      • Links to high value consultation opportunities
        • Community Engagement & Health Policy
        • CELDAC
        • SF Bay Area Collaborative Research Network
    • Symposium
    • Updates and Announcements – listserv
    • Collaboration around RFAs
questions comments
Questions / Comments ?

Mike Steinman

[email protected]

http://accelerate.ucsf.edu/research/cer

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