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KM in healthcare: Distributed networks boost clinical research

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PCORI Funds Comparative Effectiveness Research

The Patient-Centered Outcomes Research Institute (PCORI) has approved more than $2 billion since 2012 to fund more than 400 patient-centered comparative effectiveness studies and other projects to enhance the methods and infrastructure necessary to conduct this type of research.

On May 1, 2018, its board approved more than $20 million in grant funding for studies that will use PCORnet to test ways to improve care for people with arthritis, blood pressure, depression and irritable bowel disease. The newly approved awards are the following:

♦ $7 million for a University of Alabama at Birmingham project that will determine whether a six-month course of abatacept, a common treatment for juvenile idiopathic arthritis (JIA), given soon after diagnosis will prevent the advancement of joint and eye inflammation or the need for additional treatment.

♦ $6.5 million for a study at the University of California, San Francisco that will compare two ways of helping doctors improve their methods for controlling patients’ blood pressure. It will also compare two types of home blood pressure monitors to see which is more effective at helping patients achieve personal goals.

♦ $4.8 million for a Massachusetts General Hospital project about patients with severe depression comparing the effectiveness of usual care to therapy that uses a patient’s genes to guide medication decisions.

♦ $2.4 million for a study led by the Crohn’s and Colitis Foundation to compare three treatments—ustekinumab, vedolizumab and tofacitinib—for patients with inflammatory bowel disease for whom TNF inhibitors, a class of biologic drugs, are not effective.

Aspirin dosage study

Besides Sentinel, another distributed research network is PCORnet, the network of the Patient-Centered Outcomes Research Institute (PCORI), which is used for observational and interventional studies in clinical settings. One example of its use is a study called ADAPTABLE. It is a $14 million, three-year pragmatic clinical trial that is comparing the effectiveness of two different daily doses of aspirin widely used to prevent heart attacks and strokes in individuals living with heart disease. (Pragmatic trials are designed to reflect “real-world” medical care by recruiting broad populations of patients, embedding the trial into the usual healthcare setting and leveraging data from health systems to produce results that can be readily used to improve patient care.)

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