The Patient-Centered Outcomes Research Institute (PCORI) is poised to develop and oversee a vast portfolio of new comparative effectiveness research. For this endeavor to transform patient care, new evidence must be disseminated to clinicians and patients, understood and considered relevant, and used in the decisions that inform clinical care. According to a Health Affairs paper by Timbie et al., however, there are five reasons why PCORI may fail to change day-to-day medical practice. These reasons include:
- Financial incentives, such as fee-for-service payment, that may militate against the adoption of new clinical practices.
- Ambiguity of study results that hamper decision making.
- Cognitive biases in the interpretation of new information. For instance, confirmation bias leads one to embrace evidence that confirms preconceived ideas and to reject contrary evidence; pro-intervention bias, leads one to choose treatment options that result in action rather than inaction; and pro-technology bias causes some providers to uncritically believe that newer forms of technologyare superior.
- Needs of end users are ignored by researchers.
- Limited use of decision support by patients and clinicians.
- Justin W. Timbie, Eric C. Schneider, Kristin Van Busum, and D. Steven Fox. Five Reasons That Many Comparative Effectiveness Studies Fail To Change Patient Care And Clinical Practice. HEALTH AFFAIRS 31,
NO. 10 (2012): 10.1377/hlthaff.2012.0150.