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.

How to Pay for Proton Therapy in Cancer Clinical Trials

Jul. 20, 2018

It’s a classic Catch-22: many insurers will not cover expensive proton therapy for some cancers because there’s little proof that it’s more beneficial or less harmful than standard treatment; meanwhile, patients cannot enroll in the clinical trials to test its comparative effectiveness because their insurers won’t cover the therapy. In a commentary in the Journal of Clinical Oncology, LDI Senior Fellow Justin Bekelman and colleagues point out the dilemma and suggest a way forward.

Complexity of the Relationships of Pain, Posttraumatic Stress, and Depression in Combat-Injured Populations: An Integrative Review to Inform Evidence-Based Practice

Jun. 27, 2018

Nicholas A. Giordano, Christine Bader, Therese S. Richmond, Rosemary C. Polomano 

ABSTRACT [FROM JOURNAL]

Background: Understanding the complex interrelationships between combat injuries, physical health, and mental health symptoms is critical to addressing the healthcare needs of wounded military personnel and veterans. The relationship between injury characteristics, pain, posttraumatic stress disorder (PTSD), and depression among combat-injured military personnel is unique to modern conflicts and understudied in the nursing literature.

Aim: This integrative review synthesizes clinical presentations and relationships...

The Value of Value Frameworks

Oct. 26, 2017

“Value” is more than a buzzword. In response to rising costs, payers, physicians, and patients have turned to value assessment frameworks to inform treatment plans and design sustainable budgets. However, the usefulness and potential of these tools remain murky. LDI’s 50th anniversary symposium convened a panel to elucidate key questions for the future of value frameworks—what does value mean to different stakeholders in the health care system? How should payers, doctors, and patients appraise the value of the care they receive?

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