Currently, my work extends the findings of randomized controlled trials of coronary artery disease treatment (efficacy) to the general application of these treatments in the overall population (effectiveness). The two major sources of data concerning medical effectiveness involve large insurance claims analysis files, and secondary data from randomized controlled trials. We have converted the Medicare Provider Analysis and Review File, a file that contains the hospital claims for 95% of elderly Americans, into a longitudinal record describing patient care involving a variety of coronary artery disease procedures and diagnoses between 1987 and 1994. The second source of data involves detailed resources information following interventions in randomized controlled trials. With these two sources of data, we are replicating the findings of ongoing randomized trials comparing coronary angioplasty and bypas surgery for the elderly population, and extending the findings of such trials to determine their economic and health policy implications. I also use these sources to examine current health policy issues, such as the effect of physician induced demand in a fee for service system on the use procedures.
Education and Training
- Fellow in Cardiology, Medicine, Duke University, 1989 - 1992
- Medical Resident, Medicine, Duke University, 1986 - 1989
- M.D., Ohio State University, 1986