Evidence Development & Decision Science

The systematic production and application of medical knowledge to clinical practice. LDI Senior Fellows analyze the process by which data affect coverage and clinical decisions, and conducts comparative effectiveness and cost effectiveness studies.

Comparative Effectiveness of Proton vs Photon Therapy as Part of Concurrent Chemoradiotherapy for Locally Advanced Cancer

Dec. 26, 2019

Brian C. Baumann, Nandita Mitra, Joanna G. Harton, Ying Xiao, Andrzej P. Wojcieszynski, Peter E. Gabriel, Haoyu Zhong, Huaizhi Geng, Abigail Doucette, Jenny Wei, Peter J. O’Dwyer, Justin E. Bekelman, James M. Metz

Abstract [from journal]

Importance: Concurrent chemoradiotherapy is the standard-of-care curative treatment for many cancers but is associated with substantial morbidity. Concurrent chemoradiotherapy administered with proton therapy might reduce toxicity and achieve comparable cancer control outcomes compared with conventional photon radiotherapy by reducing the radiation dose to normal tissues.

Objective: To assess whether proton therapy in the setting of concurrent chemoradiotherapy is associated with fewer 90-day unplanned...

Association of a Targeted Population Health Management Intervention with Hospital Admissions and Bed-Days for Medicaid-Enrolled Children

David M. Rubin, MD, MSCE
Dec. 2, 2019

David M. Rubin, Chén C. Kenyon, Douglas Strane, Elizabeth Brooks, Genevieve P. Kanter,  Xianqun Luan, Tyra Bryant-Stephens, Roberto Rodriguez, Emily F. Gregory,  Leigh Wilson, Annique Hogan, Noelle Stack,...

Abstract [from journal]

Importance: As the proportion of children with Medicaid coverage increases, many pediatric health systems are searching for effective strategies to improve management of this high-risk population and reduce the need for inpatient resources.

Objective: To estimate the association of a targeted population health management intervention for children eligible for Medicaid with changes in monthly hospital admissions and bed-days.

Design, Setting, and Participants: This quality...

Implementing Regulatory Broad Consent Under the Revised Common Rule: Clarifying Key Points and the Need for Evidence

Jul. 12, 2019

Holly Fernandez Lynch, Leslie E. Wolf, Mark Barnes

Abstract [from journal]

The revised Common Rule includes a new option for the conduct of secondary research with identifiable data and biospecimens: regulatory broad consent. Motivated by concerns regarding autonomy and trust in the research enterprise, regulators had initially proposed broad consent in a manner that would have rendered it the exclusive approach to secondary research with all biospecimens, regardless of identifiability. Based on public comments from both researchers and patients concerned that this approach would hinder important medical advances, however,

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