David Bruce Matchar, MD

Professor of Medicine
Director of the Center for Clinical Health Policy Research
Professor of Pathology
Affiliate, Duke Global Health Institute
Campus mail Box 102811, DUMC, Durham, NC 27705
Phone (656) 516-2584
Email address david.matchar@duke-nus.edu.sg

My research relates to clinical practice improvement - from the development of clinical policies to their implementation in real world clinical settings. Most recently my major content focus has been cerebrovascular disease. Other major clinical areas in which I work include the range of disabling neurological conditions, cardiovascular disease, and cancer prevention.
Notable features of my work are: (1) reliance on analytic strategies such as meta-analysis, simulation, decision analysis and cost-effectiveness analysis; (2) a balancing of methodological rigor the needs of medical professionals; and (3) dependence on interdisciplinary groups of experts.
This approach is best illustrated by the Stroke Prevention Patient Outcome Research Team (PORT), for which I served as principal investigator. Funded by the AHCPR, the PORT involved 35 investigators at 13 institutions. The Stroke PORT has been highly productive and has led to a stroke prevention project funded as a public/private partnership by the AHCPR and DuPont Pharma, the Managing Anticoagulation Services Trial (MAST). MAST is a practice improvement trial in 6 managed care organizations, focussing on optimizing anticoagulation for individuals with atrial fibrillation.
I serve as consultant in the general area of analytic strategies for clinical policy development, as well as for specific projects related to stroke (e.g., acute stroke treatment, management of atrial fibrillation, and use of carotid endarterectomy.) I have worked with AHCPR (now AHRQ), ACP, AHA, AAN, Robert Wood Johnson Foundation, NSA, WHO, and several pharmaceutical companies.
Key Words: clinical policy, disease management, stroke, decision analysis, clinical guidelines

Education and Training

  • M.D., University of Maryland, College Park, 1980

Publications

Duminy, Lize, Nirmali Ruth Sivapragasam, David Bruce Matchar, Abhijit Visaria, John Pastor Ansah, Carl Rudolf Blankart, and Lukas Schoenenberger. “Validation and application of a needs-based segmentation tool for cross-country comparisons.” Health Serv Res 56 Suppl 3 (December 2021): 1394–1404. https://doi.org/10.1111/1475-6773.13873.

PMID
34755337
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Jimenez, G., D. Matchar, G. C. H. Koh, S. Tyagi, R. M. J. J. Van Der Kleij, N. H. Chavannes, and J. Car. “Revisiting the four core functions (4Cs) of primary care: Operational definitions and complexities.” Primary Health Care Research and Development 22 (November 10, 2021). https://doi.org/10.1017/S1463423621000669.

Full Text

Chong, Wayne F. W., Leong Hwee Ng, Ringo M-H Ho, Gerald C. H. Koh, Helen Hoenig, David B. Matchar, Philip Yap, et al. “Stroke Rehabilitation Use and Caregiver Psychosocial Health Profiles in Singapore: A Latent Profile Transition Analysis.” J Am Med Dir Assoc 22, no. 11 (November 2021): 2350-2357.e2. https://doi.org/10.1016/j.jamda.2021.02.036.

PMID
33812841
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Yoon, Sungwon, Hendra Goh, Si Ming Fung, Shihui Tang, David Matchar, Geoffrey S. Ginsburg, Lori A. Orlando, Joanne Ngeow, and Rebekah Ryanne Wu. “Experience and Perceptions of a Family Health History Risk Assessment Tool among Multi-Ethnic Asian Breast Cancer Patients.” J Pers Med 11, no. 10 (October 19, 2021). https://doi.org/10.3390/jpm11101046.

PMID
34683187
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Yan, Xiaoxi, David B. Matchar, Nirmali Sivapragasam, John P. Ansah, Aastha Goel, and Bibhas Chakraborty. “Sequential Multiple Assignment Randomized Trial (SMART) to identify optimal sequences of telemedicine interventions for improving initiation of insulin therapy: A simulation study.” Bmc Med Res Methodol 21, no. 1 (September 30, 2021): 200. https://doi.org/10.1186/s12874-021-01395-7.

PMID
34592951
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Tan, Chorh Chuan, Carolyn S. P. Lam, David B. Matchar, Yoong Kang Zee, and John E. L. Wong. “Singapore's health-care system: key features, challenges, and shifts.” Lancet 398, no. 10305 (September 18, 2021): 1091–1104. https://doi.org/10.1016/S0140-6736(21)00252-X.

PMID
34481560
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Matchar, David Bruce, Sherry Hsueh Yi Young, Rita Sim, Christine Jia Ying Yu, Xiaoxi Yan, Deidre Anne De Silva, and Bibhas Chakraborty. “Incentives for Uptake of and Adherence to Outpatient Stroke Rehabilitation Services: A 3-Arm Randomized Controlled Trial.” Arch Phys Med Rehabil, September 10, 2021. https://doi.org/10.1016/j.apmr.2021.08.013.

PMID
34516998
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Seow-En, Isaac, Aik Yong Chok, David Bruce Matchar, Sungwon Yoon, Dawn Qingqing Chong, and Emile Kwong-Wei Tan. “Long-term quality of life, sexual health and gastrointestinal function following colorectal cancer resection in an Asian cohort.” Colorectal Dis 23, no. 9 (September 2021): 2348–60. https://doi.org/10.1111/codi.15768.

PMID
34097342
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Ng, Ted Kheng Siang, David Bruce Matchar, Timothy V. Pyrkov, Peter O. Fedichev, Angelique Wei-Ming Chan, and Brian Kennedy. “Association between housing type and accelerated biological aging in different sexes: moderating effects of health behaviors.” Aging (Albany Ny) 13, no. 16 (August 29, 2021): 20029–49. https://doi.org/10.18632/aging.203447.

PMID
34456185
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Xie, Feng, Marcus Eng Hock Ong, Johannes Nathaniel Min Hui Liew, Kenneth Boon Kiat Tan, Andrew Fu Wah Ho, Gayathri Devi Nadarajan, Lian Leng Low, et al. “Development and Assessment of an Interpretable Machine Learning Triage Tool for Estimating Mortality After Emergency Admissions.” Jama Netw Open 4, no. 8 (August 2, 2021): e2118467. https://doi.org/10.1001/jamanetworkopen.2021.18467.

PMID
34448870
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