PCORI Punt is More Than a Bit Ironic

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Those waiting to see if the Patient-Centered Outcomes Research Institute (PCORI) would make any facet of radiology part of its initial focus were disappointed—or relieved—Monday when the independent research organization issued its first set of research priorities.

The five research "priorities" issued by this Accountable Care Act created organization were so vague in nature and low on specifics that almost any comparative effectiveness research could qualify as something the institute would consider funding. You can click here for a PDF of the full report. Skip to the research agenda part and you'll find that PCORI will focus on funding research on comparisons of prevention, diagnosis, and treatment options.

Really? After two years and multiple board member meetings at costly hotel conferences across the country is that all the institute's leaders could come up with?

Contrast this with the independently funded West Health Care Center that launched this week in Washington, D.C. Within a day of launching, it announced its first research fellow, a partnership with a health analytics company to get de-identified patient data to study and a clear goal all fellows need to aim for: Uncover $1 billion in health care savings that can be achieved right now through the use of technology or innovation.

Of course, one could say that no news is good news when it comes to federally funded independent research organizations diving into health outcomes research. The rush to endorse research findings that justify decreasing utilization of certain forms of diagnostic imaging most recently led to the controversy over mammography screening guidelines here and in Canada.

Properly handled, however, outcome research is the friend of radiology. It puts to rest the argument that greedy radiologists are the ones driving up the cost of health care. Instead, it places diagnostic imaging in context as a powerful way to hold down the cost of care by ensuring the right diagnosis quickly and catching expensive and dangerous conditions early when treatment is most effective. When a particular procedure does not do that, radiologists are the first who want to know.

However, that's not the true reason I got so steamed up about the vagueness of PCORI's first set of priorities. What bothers me is the irony of an organization dedicated to comparative effectiveness research being itself so comparatively ineffective.

With a significant head start and federal funds 10 times the amount of the private donation that established the West Health Care Center, the institute has somehow managed to publicly accomplish less in two years than the center has in a week. Perhaps PCORI should start its comparative effectiveness research by looking at itself.