Nat Med. 2012 Aug;18(8):1164. doi: 10.1038/nm0812-1164.
The US Supreme Court's ruling in late June to uphold most of the Patient Protection and Affordable Care Act of 2010 decided more than just the fate of the law's individual mandate for health care. It also allowed many of the other provisions of the legislation to safely go ahead. Chief among those was the establishment of a comparative-effectiveness research hub called the Patient-Centered Outcomes Research Institute (PCORI), located in Washington, DC. With a budget of $3.3 billion over the next seven years and an independent status, PCORI is now tasked with creating the evidence base to help patients and doctors make more informed decisions about their medical choices. Leading the fledgling institute is executive director Joe Selby. A family physician and clinical epidemiologist, Selby joined PCORI in July 2011 after 13 years as head of research at Kaiser Permanente, the California-based health provider. Even amid all the uncertainty that surrounded the future of US healthcare reform, Selby, together with PCORI's board of directors, managed to help craft the institute's first research agenda and to fund 50 pilot projects totaling $30 million, all in the spring of this year. Elie Dolgin spoke with Selby to discuss how PCORI will influence the debate about which treatments work best.
美国最高法院于 6 月末裁定,维持 2010 年《患者保护与平价医疗法案》(Patient Protection and Affordable Care Act of 2010)的大部分内容,这一裁决不仅决定了该法案中关于医保的个人强制参保规定的命运,还使得该法案的其他多项条款得以顺利推进。其中最为重要的一条是建立一个名为“患者中心的医疗成果研究机构”(Patient-Centered Outcomes Research Institute,简称 PCORI)的比较效果研究中心,该机构位于华盛顿特区。PCORI 在未来 7 年内将获得 33 亿美元的预算,并拥有独立地位,其任务是建立一个循证医学知识库,帮助患者和医生在医疗选择方面做出更明智的决策。该机构的执行理事乔·塞尔比(Joe Selby)负责领导这个羽翼未丰的研究所。作为一名家庭医生和临床流行病学家,塞尔比在加入 PCORI 之前,曾于 2011 年 7 月在加利福尼亚州的 Kaiser Permanente 担任了 13 年的研究主管。即使在美国医疗改革的未来充满了种种不确定性,塞尔比和 PCORI 的董事会还是设法帮助制定了该机构的首个研究议程,并为 50 个试点项目提供了总计 3000 万美元的资金,所有这些工作都是在今年春季完成的。埃利·多尔金(Elie Dolgin)采访了塞尔比,探讨 PCORI 将如何影响关于哪些治疗方法最有效的争论。