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Journal Articles
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Subtitle
Now that a third COVID-19 vaccine has been given emergency-use authorization, Michelle Mello and colleagues ask whether individuals should be able to choose which vaccine they receive.
Journal Publisher
The New England Journal of Medicine
Authors
Michelle Mello
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Pascal Geldsetzer, PhD 
Assistant Professor of Medicine in the Division of Primary Care and Population Health

Title:  Regression Discontinuity in Electronic Health Record Data

Abstract: Regression discontinuity in electronic health record (EHR) data combines the main advantage of randomized controlled trials (causal inference without needing to adjust for confounders) with the large size, low cost, and representativeness of observational studies in routinely collected medical data. Regression discontinuity could be an important tool to help clinical medicine move away from a “one size fits all” approach because, along with the increasing size and availability of EHR data, it would allow for a rigorous examination of how treatment effects vary across highly granular patient subgroups. In addition, given the broad range of health outcomes recorded in EHR data, this design could be used to systematically test for a wide range of unexpected beneficial and adverse health effects of different treatments. I will talk about the broad motivation for this research and discuss examples from some of our ongoing work in this area. If there is time, I will also discuss some of my ongoing research on improving healthcare services for chronic conditions in low- and middle-income country settings. 

Zoom Meeting

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Alyce S. Adams, PhD 
Professor of Medicine, Stanford's Center for Health Policy & Center for Primary Care and Outcomes Research
Professor of Epidemiology and Population Health in the Stanford School of Medicine 
Associate Director for Health Equity and Community Engagement in the Stanford Cancer Institute 

Title: Health Policy and the Fight for Equitable Healthcare Outcomes: Why Access Isn’t Enough

Abstract: Using evidence from evaluations of natural experiments, Alyce Adams will discuss the intended and unintended consequences of changes in prescription drug policy at the state and federal level of low income and minority individuals with multiple chronic conditions. We will explore the potential for policy effects to have an immediate and dramatic increase in access to clinically essential treatments. However, she will also discuss where such policies can widen, rather than reduce disparities in treatment. We concluded that increasing access (while critical) is not sufficient to address inequities in treatment use and outcomes among high risk populations. Importantly, new strategies are needed to inform the design of policy interventions that promote access, while simultaneously advancing health equity.

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Stanford Medicine Innovation Professor
alyce_profile_2022.jpg PhD, MPP

Alyce Adams is a Professor of Health Policy and of Epidemiology and Population Health in the Stanford School of Medicine; Associate Chair, Partnership and Community Engagement for the Department of Health Policy; and Associate Director for Health Equity and Community Engagement in the Stanford Cancer Institute. Focusing on racial and socioeconomic disparities in chronic disease treatment outcomes, Dr. Adams' interdisciplinary research seeks to evaluate the impact of changes in drug coverage policy on access to essential medications, understand the drivers of disparities in treatment adherence among insured populations, and test strategies for maximizing the benefits of treatment outcomes while minimizing harms through informed decision-making. Prior to joining Stanford School of Medicine, Dr. Adams was Associate Director for Health Care Delivery and Policy and a Research Scientist at the Kaiser Permanente Division of Research, as well as a Professor at the Bernard J. Tyson Kaiser Permanente School of Medicine. From 2000 to 2008, she was an Assistant Professor in the Department of Population Medicine (formerly Ambulatory Care and Prevention) at Harvard Medical School and Harvard Pilgrim Health care. She received her PhD in Health Policy and an MPP in Social Policy from Harvard University. She is Vice Chair of the Board of Directors for AcademyHealth and a former recipient of the John M. Eisenberg Excellence in Mentoring Award from Agency for Healthcare Research and Quality and an invited lecturer on racial disparities in health care in the 2014/2015 National Institute of Mental Health Director’s Innovation Speaker Series.

Professor, Epidemiology and Population Health
Professor, Health Policy
Professor, Pediatrics (by courtesy)
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Stanford Medicine Innovation Professor
alyce_profile_2022.jpg PhD, MPP

Alyce Adams is a Professor of Health Policy and of Epidemiology and Population Health in the Stanford School of Medicine; Associate Chair, Partnership and Community Engagement for the Department of Health Policy; and Associate Director for Health Equity and Community Engagement in the Stanford Cancer Institute. Focusing on racial and socioeconomic disparities in chronic disease treatment outcomes, Dr. Adams' interdisciplinary research seeks to evaluate the impact of changes in drug coverage policy on access to essential medications, understand the drivers of disparities in treatment adherence among insured populations, and test strategies for maximizing the benefits of treatment outcomes while minimizing harms through informed decision-making. Prior to joining Stanford School of Medicine, Dr. Adams was Associate Director for Health Care Delivery and Policy and a Research Scientist at the Kaiser Permanente Division of Research, as well as a Professor at the Bernard J. Tyson Kaiser Permanente School of Medicine. From 2000 to 2008, she was an Assistant Professor in the Department of Population Medicine (formerly Ambulatory Care and Prevention) at Harvard Medical School and Harvard Pilgrim Health care. She received her PhD in Health Policy and an MPP in Social Policy from Harvard University. She is Vice Chair of the Board of Directors for AcademyHealth and a former recipient of the John M. Eisenberg Excellence in Mentoring Award from Agency for Healthcare Research and Quality and an invited lecturer on racial disparities in health care in the 2014/2015 National Institute of Mental Health Director’s Innovation Speaker Series.

Professor, Epidemiology and Population Health
Professor, Health Policy
Professor, Pediatrics (by courtesy)
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This study investigates the marginal value of information in the context of health signals that people receive after checkups. Although underlying health status is similar for individuals just below and above a clinical threshold, treatments differ according to the checkup signals they receive. For the general population, whereas health warnings about diabetes increase healthcare utilization, health outcomes do not improve. However, among high-risk individuals, outcomes do improve, and improved health is worth its cost. These results indicate that the marginal value of health information depends on setting appropriate thresholds for health warnings and targeting individuals most likely to benefit from follow-up medical care.

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1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Journal of Public Economics
Authors
Karen Eggleston
Toshiaki Iizuka
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Title: Research in Progress: Doug Owens - Development of the New USPSTF Guidelines on Screening for Lung Cancer and Colorectal Cancer

Brief Abstract: 

Discuss the development of the two new draft guidelines from the U.S. Preventive Services Task Force.  Screening for lung cancer and colorectal cancer are two of the most complex and important cancer screening guidelines in the USPSTF portfolio.  Describing the methods the USPSTF uses, including the evidence reviews and modeling that helped us create these new recommendations.

 

Zoom Meeting 

Register in advance for this meeting: 
https://stanford.zoom.us/meeting/register/tJcuf-2sqzkoE93jEPn9deZKTTBJoze-2d6u 

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Encina Commons, Room 201 
615 Crothers Way Stanford, CA 94305-6006 

Executive Assistant: Soomin Li, soominli@stanford.edu
Phone: (650) 725-9911

(650) 723-0933 (650) 723-1919
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Henry J. Kaiser, Jr. Professor
Professor, Health Policy
Senior Fellow, Freeman Spogli Institute for International Studies
Professor, Management Science & Engineering (by courtesy)
doug-headshot_tight.jpeg MD, MS

Douglas K. Owens is the Henry J. Kaiser, Jr. Professor, Chair of the Department of Health Policy in the Stanford University School of Medicine and Director of the Center for Health Policy (CHP) in the Freeman Spogli Institute for International Studies (FSI). He is a general internist, a Professor of Management Science and Engineering (by courtesy), at Stanford University; and a Senior Fellow at the Freeman Spogli Institute for International Studies.

Owens' research includes the application of decision theory to clinical and health policy problems; clinical decision making; methods for developing clinical guidelines; decision support; comparative effectiveness; modeling substance use and infectious diseases; cardiovascular disease; patient-centered decision making; assessing the value of health care services, including cost-effectiveness analysis; quality of care; and evidence synthesis.

Owens chaired the Clinical Guidelines Committee of the American College of Physicians for four years. The guideline committee develops clinical guidelines that are used widely and are published regularly in the Annals of Internal Medicine. He was a member and then Vice-Chair and Chair of the U.S. Preventive Services Task Force, which develops national guidelines on preventive care, including guidelines for screening for breast, colorectal, prostate, and lung cancer. He has helped lead the development of more than 50 national guidelines on treatment and prevention. He also was a member of the Second Panel on Cost Effectiveness in Health and Medicine, which developed guidelines for the conduct of cost-effectiveness analyses.

Owens also directed the Stanford-UCSF Evidence-based Practice Center. He co-directs the Stanford Health Services Research Program, and previously directed the VA Physician Fellowship in Health Services Research, and the VA Postdoctoral Informatics Fellowship Program.

Owens received a BS and an MS from Stanford University, and an MD from the University of California-San Francisco. He completed a residency in internal medicine at the University of Pennsylvania and a fellowship in health research and policy at Stanford. Owens is a past-President of the Society for Medical Decision Making. He received the VA Undersecretary’s Award for Outstanding Achievement in Health Services Research, and the Eisenberg Award for Leadership in Medical Decision Making from the Society for Medical Decision Making. Owens also received a MERIT award from the National Institutes on Drug Abuse to study HIV, HCV, and the opioid epidemic. He was elected to the American Society for Clinical Investigation (ASCI) and the Association of American Physicians (AAP.)

Chair, Department of Health Policy, School of Medicine
Director, Center for Health Policy, Freeman Spogli Institute for International Studies
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