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Congress created the Patient Centered Outcomes Research Institute (PCORI) to fund comparative effectiveness research without encroaching on health care decision making in the private sector. This study asked if the organization's design is sufficient to insulate it from the hostile political environment that accompanied past comparative effectiveness research efforts. Data for the study came from key informant interviews, stakeholder interviews, content analysis of public comments, congressional hearings, and media and Internet content about PCORI. Drawing on theoretical frameworks of interest group behavior, the study assessed current and potential future stakeholder activity directed toward PCORI. The study found that PCORI's leadership has successfully mobilized patients and researchers in support of its mission. However, patient groups tend tomobilizewithin rather than across disease categories, limiting the collective impact these groups might have. Moreover, PCORI's success in including the patient voice in every stage of the research process has created only diffuse support for the organization. A lack of "practice-changing" findings--likely the result of the organization's interest group environment--leaves PCORI open to the criticism of ineffectiveness. [ABSTRACT FROM AUTHOR]

Presents the significant variations observed in gender-dysphoric patients' gender roles and identities over a four-year period following the completion of group psychotherapy. Evaluation of patient behavior before, during and after sex reassignment surgery; Division of the types of changes and adaptation into four categories.

Addressing criticism that the agency's Covid-19 response was lacking, the US Centers for Disease Control and Prevention (CDC) has proposed internal agency reforms intended to improve its performance during the next pandemic. They are aimed at improving surveillance and analytic capacity and agency communications. This essay, via a counterfactual analysis of the CDC's proposed reforms, asks how, if completed in advance of Covid-19, they might have changed outcomes in four cases of guidance controversy during the pandemic. CDC planned reforms, though they have merit, are predicated on the ability to come to "scientific closure" in a highly charged political environment. To improve outcomes in a future pandemic, the agency should consider how it plans to communicate with the public when recovering from error and when addressing controversy spurred by criticism from credible experts. However, the ability of future presidents to limit CDC performance and communications in the next pandemic and the lack of political consensus around the value of independent public health expertise threaten the agency's reform goals., (Copyright © 2024 by Duke University Press.)