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Decision Support Tools for Advancing Healthcare in Aging

  • Shinyi Wu, PhD ,
  • Adrian Overton, MPA ,
  • Amar Das, MD, PhD

This special two-part seminar presents the latest work of two NIA Roybal centers on translational research in aging: the RAND Roybal Center for Health Policy Simulation and Stanford's Center on Advancing Decision Making in Aging (CADMA).

In the first presentation, held from 2 to 3:15 p.m., Dr. Shinyi Wu and Adrian Overton will discuss, Tools for Efficient Allocation of Fall-prevention Resources with a brief introduction to the RAND Roybal Center. In the second presentation, from 3:30 to 5 p.m., Dr. Amar Das will discuss e-Preference: A Tool for Incorporating Patient Preferences into Health Decision Aids.

For more information on these two presentations, see the abstracts and presenter biographies below. This special seminar is co-sponsored by CADMA and Stanford Medical Informatics.

Tools for Efficient Allocation of Fall-Prevention Resources

This seminar will present two decision-support tools for resource allocation developed in the RAND Roybal Center for Health Policy Simulation. The tools integrate multiple sources of information and evidence-based findings to support policy decision making on allocating resources to prevent falls among older people. One tool uses geographic information system (GIS) based mapping and spatial analysis to overlay demographic, epidemiologic, programmatic, and economic data. The GIS application allows visual identification of needs, gaps, and opportunities in geographic areas to enhance effectiveness of falls surveillance and prevention planning.

The other tool applies cost-effectiveness modeling that compares a list of evidence-based falls-prevention interventions. It enables policymakers to derive customized estimates of costs and benefits of alternative prevention strategies for their population-of-interest. These technically-driven but user-friendly tools can encourage better health investment decisions at various policy levels ranging from local to national as well as private and public.

This talk will be co-presented by Dr. Shinyi Wu and Adrian Overton. Dr. Wu (Ph.D., Industrial Engineering, University of Wisconsin - Madison) is a health services and policy researcher at the RAND Corporation and the Associate Director of the RAND Roybal Center for Health Policy Simulation. Her research interests extend across cost-effectiveness analysis, decision analysis, simulation modeling, and quality improvement. She has worked on healthcare issues related to physician-patient interactions, chronic disease care management, healthy aging evidence review, and evaluation of health information technology. Her health policy projects include lung cancer surveillance, HIV prevention planning, and evaluation of e-prescribing standards. She is the principal investigator of the Roybal Center project on fall-prevention resource allocation.

Adrian Overton (MPA, George Mason University) is a senior GIS Analyst at RAND. He has over 10 years of experience in applying geospatial technologies to a variety of policy research and planning related applications in the areas of health, urban and regional planning, and educational facilities planning. His most recent work has focused on neighborhood and built-environment effects on physical activity, and spatial decision-support tool development for allocating resources for intervention and prevention planning of disparities in health care.

e-Preference: A Tool for Incorporating Patient Preferences into Health Decision Aids

This seminar will present work on the translation of decision science methods into a novel software tool (called e-Preference) for building health decision aids (HDAs) that can increase the involvement of older adults in healthcare decisions. The widespread use of HDAs has been limited largely because they are implemented as stand-alone methods (using formats ranging from written brochures to multimedia), address one type of health problem, and are not readily accessible by patients outside of clinical settings. The e-reference software tool is based on formal decision-analytic models, uses patient-specific data stored in the electronic health record, and allows patient preferences to be collected via a Web portal. The tool also contains a knowledge-base component that allows experts to encode, modify and maintain the clinical knowledge used in modeling relevant clinical decisions, health states, and probabilistic relationships. The e-Preference technology can facilitate the use of HDAs at a time and place convenient to patients and physicians, and support dynamic adaptation for specific clinical care contexts. The implementation of the e-Preference software tool will be shown in its initial application to the decision of anticoagulation therapy for atrial fibrillation.

This talk will be presented by Dr. Amar Das. Dr. Das (M.D., Ph.D., Biomedical Informatics, Stanford University) is an Assistant Professor of Medicine and of Psychiatry and Behavioral Sciences at Stanford. His research interests have focused on decision-support systems and time-oriented databases in clinical computing since the early 1990s. Dr. Das has also undertaken work in clinical epidemiology at Columbia University, where he was study director of a large mental health screening. Dr. Das is the lead investigator of the e-Preference project, which is supported by the Roybal-funded Center on Advancing Decision Making in Aging at Stanford.