At MTPPI, we have long been interested in patient outcomes research as it seeks to understand the end results of particular health care practices and interventions. These end results include effects that people experience and care about, such as change in the ability to function or participate in daily activities. For individuals with chronic conditions—where cure is not always possible—end results include quality of life as well as mortality. By linking the care people get to the outcomes they experience, outcomes research has become the key to developing better ways to monitor and improve the quality of care. Nearly all of the research conducted by MTPPI gives considerable thought to relevant patient outcomes that matter to the patient, provider and society at large.
Comparative Effective Research
Comparative effectiveness research (CER) is a relatively new approach to conducting research and is designed to inform health-care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. MTPPI has collected evidence generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care. We conduct studies that generate new evidence of effectiveness or comparative effectiveness of a test, treatment, procedure, or health-care service. In our work in this area, we have realized that CER requires the development, expansion, and use of a variety of data sources and methods to conduct timely and relevant research and disseminate the results in a form that is quickly usable by clinicians, patients, policymakers, and health plans and other payers.
MTPPI has a strong focus on Health Services Research (HSR), a multidisciplinary scientific field that examines how people get access to health care practitioners and health care services, how much care costs, and what happens to patients as a result of this care. MTPPI studies in HSR investigate how financing systems, organizational structures and processes, medical technology, and personal behaviors affect access to health care, the quality and cost of health care, and quantity and quality of life. The primary goals of health services research conducted by MTPPI researchers are to identify the most effective ways to organize, manage, finance, and deliver high quality care; reduce medical errors; and improve patient safety. MTPPI health services researchers come from a variety of specializations, including economics, public health, medicine, biostatistics, management, engineering and law. While health services research is grounded in theory, its underlying aim is to perform research that can be applied by physicians, nurses, health managers and administrators, and other people who make decisions or deliver care in the health care system.
At MTPPI, we adhere to the very broad definition of Health technology assessment as a multi-disciplinary field of policy analysis that studies the medical, social, ethical, and economic implications of development, diffusion, and use of health technology. It has other definitions including "the systematic evaluation of the properties and effects of a health technology, addressing the direct and intended effects of this technology, as well as its indirect and unintended consequences, and aimed mainly at informing decision making regarding health technologies,” and "a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Our aim is to inform the formulation of safe, effective, health policies that are patient focused and seek to achieve best value. Despite its policy goals, HTA must always be firmly rooted in research and the scientific method". MTPPI uses HTA to provide a bridge between the world of research and the world of decision-making given that health policy decisions are becoming increasingly important as the opportunity costs from making wrong decisions continue to grow.
MTPPI researchers have focused their research efforts on chronic, expensive, recurrent medical conditions that require ongoing care and maintenance. Specifically, researchers have conducted research into chronic kidney disease, end-stage renal disease, diabetes, lupus, asthma, osteoporosis, and other conditions. We are familiar with the issues concerning patient health, quality of life and participation in daily activities as well as recognize the need for advanced statistical techniques in addressing questions related to chronic medical conditions.
MTPPI researchers have a longstanding focus on chronic renal failure (CKD) and end-stage renal disease (ESRD) dating back more than two decades. Researchers have led numerous research efforts funded by NIDDK, NIA, and AHRQ related to renal disease including: anemia management and survival; choice of dialysis modality; contributing role of diabetes and lupus in patient outcomes; access to renal transplantation; clinical sequelae and costs of immunosuppressive therapy; psychiatric illness in patients with end-stage renal disease; the relative risk and economic consequences of inpatient care among renal failure patients; and role of dialysis organizational status on patient quality of care and outcomes. Throughout this work, MTPPI researchers have extensively used the United States Renal Data System (USRDS) and Medicare 5% files, as well as Medicaid files, third party proprietary data, electronic health records, and other commercial databases. Researchers have considerable knowledge regarding their appropriate use as well as their limitations.