The Patient-Centered Outcomes Research Institute (PCORI) has got the wrong idea. With its funding scheduled to expire in 2019, the organization should be focused on specific clinical questions that comparative effectiveness research can answer quickly and decisively rather than the broad research priorities outlined in its agenda, according to an article by Harold C. Sox, MD, published in the October issue of Health Affairs.

One political barrier PCORI can expect to encounter is a “September 2019 sunset date for PCORI, giving the institute seven years to convince Congress to reauthorize it,” Sox wrote. “To achieve this goal, PCORI needs some early successes. The Patient Protection and Affordable Care Act gave the institute power to influence its own destiny, in part by specifying processes by which it could shape a research agenda of studies with a good chance of producing finding that will find their way into everyday medical practice.”

PCORI’s current research agenda, adopted in May, stated its goal is to determine which interventions work best for distinct populations with specific health problems, but does not mention specific interventions, study populations or conditions, according to Sox. Additionally, four additional research priorities listed in the agenda address the need to upgrade the healthcare infrastructure to support patient-centered decisions, but does not directly address the the ability of comparative effectiveness research to inform clinical decisions.

To improve its chances for reauthorization, the PCORI research project agenda should be optimized to achieve maximum impact from the research it commissions, according to Sox. Strategic priorities should consider research topics developed, such as those outlined in the Institute of Medicine paper titled “Knowing what works in healthcare: a roadmap for the nation,” and each research topic should specify a target condition, interventions and a patient population.

Proving its worth for reauthorization in seven years while clinical research can often take a decade to complete presents a challenge to PCORI, but it has not met this challenge with a sense of urgency or strategic direction, according to Sox. “PCORI must start now to implement a strategy to make the largest possible impact before its day of reckoning.”