Hi Everyone

I received an NIH RC4 grant funded by the NIH Office of the Director and 
managed through the National Library of Medicine. The grant title is NEW 
OBSERVATIONAL DATA ANALYSIS METHODS FOR COMPARATIVE
EFFECTIVENESS RESEARCH.

I will be hiring asap 4 new researchers - 2 post-docs and 2 MS-level support 
staff - in statistics, biostatistics, clinical epidemiology, and/or computer 
science. I am sending this out now in case anyone is currently looking and 
would like to talk with me about this project. We will be starting the formal 
hiring announcement in the next week or two so this is an early heads up. Let 
me know asap if interested.

The abstract is below my contact information.
Thank you

Bill Shannon, PhD
Associate Prof. of Biostatistics in Medicine
Washington University School of Medicine
660 South Euclid Ave, Box 8005
St. Louis, MO 63110

[email protected]/314-454-8356<http://[email protected]/314-454-8356>

ABSTRACT

Comparative effectiveness research (CER) is designed to identify healthcare 
interventions having the best
patient outcomes to direct patients to receive the best treatment and to direct 
our healthcare dollars to where
they will be most productive. When comparing observational data to determine 
the best intervention, CER
requires that we apply risk or case-mix adjustment methods before examining 
outcomes of care. For
example, to compare survival in treatment or hospital for inpatient acute 
myocardial infarction (AMI) patients
using the proportion surviving may be misleading if the severity of disease is 
significantly different across
interventions or hospital. To make comparisons valid, risk adjustment must 
balance patient factors, such as
disease severity and co-morbidities, which result in different likelihood of 
death. A standard approach to risk
adjustment is to use measures of "observed-to-expected" rates, where expected 
outcome for patients are
estimated by an existing, often unknown and proprietary, regression model 
previously fit to a standard or
reference population of patient data said to be representative of all patients. 
The observed outcome is obtained
from the patient's discharge data. The goal of the risk adjustment is to 
determine if an intervention (or provider)
on average shows better, worse, or the same observed outcomes compared to 
expected outcomes.

We propose to develop and release an open-source HealthCare Rankings (HCR) 
case-mix adjustment
software package combining methods from observational data analysis, operations 
research, statistics, and
mathematics that have not been applied in combination previously in CER and 
health services research. The
HCR algorithm ranks two or more interventions or providers simultaneously based 
on direct comparison of
patient-level data. This algorithm avoids the need to have a reference database 
for observed-to-expected
comparisons. This proposal is a joint effort of investigators in the Washington 
University School of Medicine
(WUSM) Dept. of Medicine's Biostatistical Consulting Center and the BJC 
HealthCare Center for Clinical
Excellence (CCE). There are 11 hospitals in the BJC network with a 
comprehensive informatics system of
patient level clinical and administrative data available for developing and 
validating the HCR algorithm.

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