Research Programs
Program in Health Outcomes
The program in Health Outcomes is led by Dr. Elting. Epidemiologic studies of the outcomes of treatments and care strategies in large representative populations are the cornerstone of the program. Racial, ethnic and socioeconomic disparities in outcomes are an important focus of this program. Cost of illness studies typically are conducted alongside epidemiologic studies to develop clinical models of the resources used and costs accrued during cancer treatments. The generality of these models is tested in population-based studies from large national datasets.
Current projects include the following:
- Development of a clinical model of the cost of bladder cancer
- Clinical and economic outcomes of oral mucositis among recipients of head and neck radiotherapy
- Cost of managing myelodysplastic syndromes
- Disparities in access to mammography facilities in the Gulf Coast and breast cancer outcomes
Program in Health Economics in Cancer
The program in Health Economics in Cancer uses economic theories and applied econometric methods to study the impact of cancer on the health care system as well as the economic well-being of cancer patients. Three primary focuses are described below:
Economic burden of cancer and cancer treatments
Patients who undergo chemotherapy often experience side effects, such as chemotherapy-induced anemia, nausea/vomiting or febrile neutropenia. Even after cancer treatments, many survivors continue to report experiencing conditions such as pain, fatigue or lymphedema.
Current projects include the following:
- Studies examining the economic burden of breast cancer-related lymphedema among the working-age population
- Studies estimating the direct and indirect costs of chemotherapy-induced nausea and vomiting
- Studies exploring the short-term and long-term labor market outcomes among cancer survivors
Economic evaluations – applications and methodologies
Economic evaluation is a subfield under health economics, and includes cost-effectiveness analyses, cost benefit analyses, cost minimization analyses and budget impact analyses, among others. Our research in this area includes both applying methods of economic evaluations to assess the economic value of various interventions related to cancer and exploring methodological issues in these methods.
Current projects include the following:
- Studies examining the use of Bayesian approaches in cost-effectiveness analysis, budget impact models and post-marketing surveillance
- Studies examining the impact of generic-drug entry and other future changes on studies of economic evaluations
- Studies exploring the use of economic evaluations to guide resource allocation decisions for the National Health Insurance (NHI) program in Taiwan
Studies of health disparities
Our research in health disparities focuses on examining possible disparities in the use of preventive and/or curative services among minorities and on exploring methodological issues in the measurement of disparity.
Current projects include the following:
- Studies exploring the relationship between health literacy and cancer screening behavior
- Studies comparing the screening patterns between U. S.- and foreign-born individuals
- Studies examining the impact of Medicare policies on the disparities in racial/ethnic groups
Program in Medical Decision Making
The program in Medical Decision Making is led by Dr. Cantor. The main emphasis of the program is on the prescriptive analysis of clinical oncology problems, using the tools of clinical decision analysis and cost-effectiveness analysis. Descriptive studies seek to explain decision-making behavior; these have included utility assessment and preference elicitation. Methodological advances in medical decision making, particularly in the areas of diagnostic testing and cost-effectiveness analysis, have been developed through the study of applied clinical problems.
Current projects include the following:
- Cost-effectiveness analysis of strategies for the screening, diagnosis and management of cervical intraepithelial neoplasia
- Patient and spouse preferences on screening for prostate cancer
- Utility assessment for cancer pain health states
- Cost-effectiveness analysis of smoking cessation intervention
- Cost-effectiveness analysis of interferon-alpha in high-risk melanoma patients
- Zones of indifference in health policy space for Monte Carlo simulation
- Ethics and medical decision making
Program in Cancer Policy in Texas
The program in Cancer Policy in Texas is led by Dr. Elting. Studies of access to cancer prevention, screening and treatment in Texas residents are complemented by studies of the outcomes and costs of those treatments.
Current projects include the following:
- Relationship between hospital staffing and outcomes of cancer surgeries in Texas
- Disparities in access to centers of cancer surgery excellence and outcomes of surgery among Texans
- Access to mammography facilities in Texas and breast cancer outcomes
Oncology Health Services Research Databank
The Oncology Health Services Research Databank was developed by Dr. Elting to facilitate population-based research in oncology using large databases. The databank includes statewide, national and international datasets enhanced for use in oncology by the addition of commonly used cancer diagnosis, comorbidity and complication indicators. Hospital claims datasets also have been enhanced by the addition of patient zip code level socioeconomic data from the 2000 U. S. census and, through newly created crosswalk files, to hospital staffing and facility information from the Centers for Medicare and Medicaid Services. Most Texas datasets have been geocoded and a geographic information system is available for analysis of geographic barriers and disparities in access to oncology healthcare services. Access to this resource is open to all qualified investigators.