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Pitt, UPMC Receive Awards That Foster Comparative Effectiveness Research Projects

PITTSBURGH, Jan. 3, 2013 – The University of Pittsburgh Schools of the Health Sciences and the UPMC Center for High-Value Health Care have received two of 25 new awards from the Patient-Centered Outcomes Research Institute (PCORI) to conduct comparative effectiveness research projects and are collaborators on a third. 
James Schuster, M.D., M.B.A., chief medical officer for Community Care Behavioral Health, received a PCORI award through the UPMC Center for High-Value Health Care for a project titled, “Optimizing Behavioral Health Homes by Focusing on Outcomes that Matter Most for Adults with Serious Mental Illness.” The project will test two promising ways to promote the health, wellness and recovery of adults with serious mental illness.
Nearly 3,000 Medicaid-enrolled adults will be targeted for participation because they are at risk for chronic medical conditions and receive care at rural community mental health centers. Other principal investigators on this grant include Tracy Carney, Columbia Montour Snyder Union Counties Mental Health, Mental Retardation and Drug & Alcohol Programs; and Charles F. Reynolds III, M.D., UPMC Professor of Geriatric Psychiatry, University of Pittsburgh School of Medicine.  
Michael Schneider, D.C., Ph.D., assistant professor of physical therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, also received a PCORI award for a project titled, “A Comparison of Non-surgical Treatment Methods for Patients with Lumbar Spinal Stenosis,” which will randomly assign seniors who have pinched nerves in their lower backs to either usual medical care, such as oral or injected medications; individualized manual therapy, such as traction and exercise guided by physical therapists and chiropractors; or exercise in a group setting at two senior centers in Pittsburgh.
The two awards were part of $40.7 million in funding that PCORI is committing to 25 projects across the country. Such awards were subject to business and programmatic review by PCORI and were approved by its Board of Governors following a competitive, multi-stage review process involving scientists, patients, caregivers and other stakeholders. Proposals were evaluated on the basis of scientific merit, engagement of patients and stakeholders, methodological rigor and fit within PCORI’s National Priorities for Research and Research Agenda
“Our patients should be considered as collaborators in our research, and their experiences can point the way to better interventions,” said Arthur S. Levine, M.D., senior vice chancellor for the health sciences, and dean, School of Medicine, University of Pittsburgh. “The heightened focus on comparative effectiveness in the national health care research agenda has the potential to make a large impact, which the University is committed to advancing.”
The UPMC Center for High-Value Health Care, housed under the UPMC Insurance Services Division, was created in 2011 and is dedicated to working with patients, providers, payers and other stakeholders to improve health care quality and efficiency as well as the overall health of the population.
“Pittsburgh’s strength over other academic institutions and medical centers is integration and collaboration, as evidenced by Dr. Schuster’s project,” said Diane P. Holder, president and chief executive officer, UPMC Insurance Services Division.
“While there are proven strategies that can prevent and manage significant medical conditions that are common among adults with serious mental illness, providers need a better understanding of how to shape and deliver these interventions so that they can effectively support the outcomes that matter most to patients,” said Dr. Schuster.
Medicare rates show that lumbar surgery for spinal stenosis has increased 15-fold in the last decade, Dr. Schneider noted. These surgical procedures are associated with significant health care costs, risks, complications and re-hospitalization rates.
“Yet evidence is lacking for the effectiveness of the various non-surgical treatments offered to patients with this condition,” he said. “We aim to bridge this knowledge gap with a project that will compare interventions and help us develop clinical practice guidelines to choose the best treatment for individual patients based on their particular circumstances.”
In another project, Jeremy Kahn, M.D., and Doug White, M.D., both associate professors of critical care medicine, Pitt School of Medicine, will serve as co-investigators on the study “Improving Psychological Distress Among Critical Illness Survivors and Their Informal Caregivers,” for which Duke University received a PCORI award.
A public-private partnership established two years ago as part of federal health care reform legislation, PCORI is authorized by the U.S. Congress to use comparative effectiveness research to provide patients and their families the best prevention, treatment and care information.
This past June, PCORI awarded $30 million over two years to 50 pilot projects, including one led by Paul Pilkonis, Ph.D., professor of psychiatry, Pitt School of Medicine, to develop patient-centered outcome measurement tools in the area of substance abuse research.
The Comparative Effectiveness Resource Core (CER) was established at the University of Pittsburgh’s Clinical and Translational Science Institute to offer training in CER methodology, provide guidance on promoting stakeholder involvement, assisting researchers in obtaining external funding, and fostering collaborations between researchers and established CER/PCORI methodologists.
CERC Director, Sally C. Morton, Ph.D., professor and chair of biostatistics, Pitt Graduate School of Public Health, was approved by the PCORI Board on December 18, 2012 to serve as a statistical methodology expert to its Methodology Committee. She also is a co-investigator on the Schuster and Schneider projects.
“Pitt’s commitment to assisting patients and their clinicians in making the best health care decisions is humbling,” she said. “I am excited to be part of that endeavor, as well as a member of PCORI’s scientific effort at the national level.”

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