Faculty of the Ph.D. Program in Health Policy and Clinical Practice

(not all inclusive of potential Ph.D. Advisors)

Please use this link for a listing of all faculty in our PhD Program with brief bios about their research interests, teaching duties, and approximately 10 recent publications (pdf format).

Denise L. Anthony, Ph.D.

John A. Baron, M.D., M.S., M.Sc.

Stephen J. Bartels, M.D., M.S.

Paul B. Batalden, M.D.

William C. Black, M.D.

Bernard F. Cole, Ph.D.

Madeline A. Dalton, Ph.D.

Robert E. Drake, M.D., Ph.D.

Eric J. Duell, Ph.D.

Elliott S. Fisher, M.D., M.P.H.

Ann Barry Flood, Ph.D.

David C. Goodman, M.D., M.S.

Pamela C. Jenkins, M.D., Ph.D.

Margaret R. Karagas, Ph.D.

Hilary A. Llewellyn-Thomas, Ph.D.

Jon D. Lurie, M.D., M.S.

Mark P. McGovern, Ph.D.

Gregory J. McHugo, Ph.D.

Todd A. MacKenzie, Ph.D.

Eugene C. Nelson, D.Sc., M.P.H.

Gerald T. O'Connor, Sc.D., Ph.D.

Stephen K. Plume, M.D.

Lisa M. Schwartz, M.D., M.S.

Jonathan S. Skinner, Ph.D.

Mark E. Splaine, M.D., M.S.

Douglas O. Staiger, Ph.D.

Harold M. Swartz, M.D., Ph.D., M.S.P.H.

Linda Titus-Ernstoff, Ph.D.

Anna N. A. Tosteson, Sc.D.

Tor Devin Tosteson, D.Sc.

John H. Wasson, M.D.

William B. Weeks, M.D., M.B.A.

James N. Weinstein, D.O., M.S.

H. Gilbert Welch, M.D., M.P.H.

John E. Wennberg, M.D., M.P.H.

Steven Woloshin, M.D., M.S.

Michael Zubkoff, Ph.D.

Denise L. Anthony, Ph.D.

Assistant Professor, Sociology; Adjunct Assistant Professor of Community and Family Medicine

B.A. in Sociology and International Studies from Indiana University of Pennsylvania, 1990

Ph.D. in Sociology from the University of Connecticut, 1997

Post-doctoral Fellow, Robert Wood Johnson Foundation Scholar in Health Policy, University of Michigan, 1997-1999

Website

Teaching roles at The Institute:

Ph.D. Program: Ph.D. Advisor; Lecturer

Research Interests: Collective Action Problems, Economic Sociology, Health Care and Health Policy, Organizations and Institutions

Representative Publications (related to the evaluative clinical sciences):

Broadhead, RS, Heckathorn DD, Grund , JPC, Stern LS, and Anthony DL. Drug Users Versus Outreach Workers in Combating AIDS Part I: Agency Problems in Traditional Outreach Interventions. The International Journal of Drug Policy. 1995;6(3):178-188.

Broadhead RS, Heckathorn DD, Grund JPC, Stern LS and Anthony DL. Drug Users Versus Outreach Workers in Combating AIDS Part II: Preliminary Results of a Peer-Driven Intervention. The International Journal of Drug Policy. 1995;6(4):274-288.

Anthony DL. Micro-Lending Institutions: Using Social Networks to Create Productive Capabilities. International Journal of Sociology and Social Policy (Special Issue on Economic Sociology).1997;17(7/8):156-178.

Broadhead RS, Heckathorn DD, Weakliem DL, Anthony DL, Madray H, Mills RJ, and Hughes J. Harnessing Peer Networks as an Instrument for AIDS Prevention: Results from a Peer-Driven Intervention. Public Health Reports. 1998;113 supplement 1:42-57.

Heckathorn DD, Broadhead RS, Anthony DL, and Weakliem DL. AIDS and Social Networks: Prevention Through Network Mobilization. Sociological Focus. 1999;32(2):159-179.

Anthony DL and Banaszak-Holl J. 2003. Organizational Variation in the Managed Care Industry in the 1990s. Research in the Sociology of Health Care. 2003;21.

Anthony, DL. Changing the nature of physician referral relationships in the US: the impact of managed care. Social Science and Medicine. 2003;56(10):2033-2044.

Anthony DL and Horne C. Gender and Cooperation: Explaining loan repayment in micro-credit borrowing groups. Social Psychology Quarterly. 2003;66(3):293-302.

Anthony DL. Cooperation in Micro-Credit Borrowing Groups: Identity, Sanctions and Reciprocity in the Production of Collective Goods. American Sociological Review. 2005;70:496-515.

Ye Z, Smith S, and Anthony DL. Trusted Paths for Browsers. ACM Journal (TISSEC) Transactions on Information and System Security, (In Press).

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John A. Baron, M.D., M.S., M.Sc.

Professor of Medicine (General Internal Medicine) and of Community and Family Medicine, Dartmouth Medical School

M.S. in Mathematical Statistics from Stanford University, 1968 (Ph.D. program interrupted by Selective Service)

M.D. from the University of Michigan, 1976

M.Sc. in Epidemiology from the University of London, 1981

Webpage

Teaching roles at The Institute:

Ph.D. Program: Ph.D. Advisor/Thesis Director; taught Advanced Topic Module in Epidemiology in ECS290 Doctoral Seminars

Research Interests: Dr. Baron has been active in epidemiological research since 1981, with interests in sex hormone-related diseases (e.g., osteoporosis, breast cancer, and prostate cancer), cigarette smoking, administrative data sets, clinical epidemiology, and cancer prevention. Major projects have focused on the investigation of orthopedic epidemiology using Medicare data, cancer prevention trials, and etiological epidemiology. Dr. Baron is of the Clinical Trials Center at Dartmouth.

Representative Publications (related to the evaluative clinical sciences):

Baron JA, Barrett J, Berger M. Incidence and costs to Medicare of fractures among Medicare beneficiaries aged equal or greater than 65 years - United States, July 1991 - June 1992. MMWR 45:877-883, 1996.

Baron JA, Gridley G, Weiderpass E, Nyren O, Linet M. Venous thromboembolism and cancer. Lancet. 1998;351:1077-80.

Michaelsson K, Baron JA, Farahmand BY, Johnell G, Magnusson C, Persson I, Ljunghall S. Hormone replacement therapy and hip fracture risk BMJ. 1998;316:1858-63.

Baron JA, Beach M, Mandel JS, Van Stolk RU, Haile RW, Rothstein R, Sandler, RS, Summers RW, Beck GJ, Frankl H, Bond JH, Snover DC, Pearson L, Greenberg ER, for the Polyp Prevention Study Group. A randomized trial of calcium supplementation to prevent colorectal adenomas. N Engl J Med. 1999;340:101-7.

Magnusson C, Baron JA, Correia N, Bergstrom R, Adami H, Persson I. Breast cancer risk following long-term oestrogen and oestrogen-progestin-replacement therapy. Int. J. Cancer. 1999;81:339-344.

Sorensen HT, Mellemkjaer L, Olsen JH, Baron JA. Prognosis of cancers associated with venous thromboembolism. N Engl J Med. 2000;343:1846-1850.

Baron JA, Cole BF, Sandler RS, Haile RW, Ahnen D, Bresalier B, McKeown-Eyssen G, Summers R. A Randomized Trial of Aspirin to Prevent Colorectal Adenomas. N Engl J Med. 2003;348:891-9.

Srensen HT,Mellemkjr L, Lauge Nielsen GL, Baron JA, Olsen JH, Karagas MR. Skin cancers and non-Hodgkin's lymphoma among users of systemic glucocorticoids: a population-based cohort study. J Natl Cancer Inst 2004; 96(9):709-711.

Wallace K. Baron JA. Cole BF. Sandler RS. Karagas MR. Beach MA. Haile RW. Burke CA. Pearson LH. Mandel JS. Rothstein R. Snover DC. Effect of calcium supplementation on the risk of large bowel polyps. J Natl Cancer Inst 2004; 96:921-5.

Wedren S. Lovmar L. Humphreys K. Magnusson C. Melhus H. Syvanen AC. Kindmark A. Landegren U. Fermer ML. Stiger F. Persson I. Baron J. Weiderpass E. Oestrogen receptor alpha gene haplotype and postmenopausal breast cancer risk: a case control study. Breast Cancer Research. 2004; 6(4):R437-49.

Katz JN, Barrett J, Mahomed NN, Baron JA, Wright J, Losina E. Association between hospital and surgeon procedure volume and the outcomes of total knee replacement. JBJS 2004; 86A 1909-16.

Losina E. Barrett J. Baron JA. Levy M. Phillips CB. Katz JN. Utilization of low-volume hospitals for total hip replacement. Arthritis & Rheumatism 2004; 51(5):836-42.

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Stephen J. Bartels, M.D., M.S.

Associate Professor of Psychiatry, Director: N.H.-Dartmouth Behavioral Health Policy Institute

B.A. in English from Amherst College, 1976

M.D., University of Virginia School of Medicine, 1980

Residency, Cambridge Hospital, Harvard Medical School 1981-1984

M.S. in Evaluative Clinical Sciences from Dartmouth College, 1997

Teaching roles at The Institute:

Ph.D.-Postdoc Program: Postdoctoral Mentor; Ph.D. Thesis Committee Member; Director of Module on Aging in Advanced Topics Doctoral Seminar

Masters: Lecturer in Health Policy

Research Interests: Geriatric health services research and health policy, integration of mental health services in primary care, quality improvement and outcome measurement for geriatric mental health services, mental health services in long-term care, prevention of alcohol and medication misuse in older adults, utilization and costs of mental health services and treatments for older persons, rehabilitation and health care for older persons with severe mental illness, care management and chronic illness.

Dr. Bartels is the recipient of a 5-year career award from the National Institute of Mental Health (NIMH) on geriatric mental health services research. He is currently conducting research on a variety of topics, including health care management and rehabilitation for older persons with serious mental disorders, integration of mental health and primary care, health policy and aging, Medicaid and Medicare costs of medical and psychiatric disorders in older adults, prevention of alcohol and medication misuse, quality of mental health services in long-term care, and evidence-based medicine.

Dr. Bartels served as the expert consultant to the Older Adult Subcommittee of the President's Commission on Mental Health and was responsible for writing the subcommittee report and recommendations. He has testified before congress and has participated in congressional briefings on aging and health policy, and on funding for research on mental disorders in older persons. He is a Past President of the American Association for Geriatric Psychiatry and recently served as the Founding Chair of the Geriatric Mental Health Foundation. He is currently the Scientific Co-Director for the Older Americans Substance Abuse and Mental Health Technical Assistance Center. Dr. Bartels was selected as the recipient of the Health Services Research Senior Career Award by the American Psychiatric Association in 2003, and was selected for the Mental Health and Aging Award by the American Society on Aging in 2005.

Representative Publications (related to the evaluative clinical sciences):

Bartels SJ, Horn SD, Smout RJ, Dums AR, Flaherty E, Jones JK, Monane M, Taler GA, Voss AC. Agitation and depression in frail nursing home elderly with dementia: Treatment characteristics and service use. American Journal of Geriatric Psychiatry. 2003;11(2):231-238.

Bartels SJ, Miles KM, Dums AR, Pratt SI. Community mental health service use by older adults with severe mental illness. Journal of Mental Health and Aging. 2003;9(2):127-139.

Bartels SJ, Miles KM, Dums AR, Levine KJ. Are nursing homes appropriate for older adults with severe mental illness? Conflicting consumer and clinician views and implications for the Olmstead decision. Journal of the American Geriatrics Society. 2003;51(11):1571-1579.

Bartels SJ. Improving the United States' system of care for older adults with mental illness: findings and recommendations for the President's New Freedom Commission on Mental Health. American Journal of Geriatric Psychiatry. 2003;11(5):486-497.

Bartels SJ, Clark RE, Peacock WJ, Dums AR, Pratt SI. Medicare and Medicaid costs for schizophrenia patients by age cohort compared with depression, dementia, and medically ill patients. American Journal of Geriatric Psychiatry. 2003;11(6):648-657.

Bartels SJ, Dums AR, Oxman TE, Schneider LS, Aren PA, Alexopoulos GS, Jeste DV. Evidence-based practices in geriatric mental health care: an overview of systematic reviews and meta-analyses. Psychiatric Clinics of North America. 2003;26(4):971-990.

Drake RE, Rosenberg SD, Teague GB, Bartels SJ, Torrey WC. Fundamental principles of evidence-based medicine applied to mental health care. Psychiatric Clinics of North America. 2003;26(4):811-820.

Bartels SJ, Coakley E, Zubritsky C, Ware JH, Miles KM, Aren PA, Chen H, Oslin DW, Llorente MD, Costantino G, Quijano L, McIntyre JS, Linkins KW, Oxman TE, Maxwell J, Levkoff SE, for the PRISM-E Investigators. Improving access to geriatric mental health services: a randomized trial comparing treatment engagement in integrated and enhanced referral care for depression, anxiety, and at-risk alcohol use. American Journal of Psychiatry. 2004;161:1455-1462.

Foti ME, Merriman MP, Fletcher K, Bartels SJ, Van Citters AD. End-of-life treatment preferences of persons with severe mental illness. Psychiatric Services. 2005;56:585-591.

Bartels SJ, Miles KM, Van Citters AD, Forester B, Cohen MJ, Xie H. Improving mental health assessment and service planning practices for older adults: a controlled comparison study. Mental Health Services Research, (In press).

Bartels SJ, Van Citters AD. Community-based alternatives for older adults with serious mental illness: the Olmstead decision and deinstitutionalization of nursing homes. Ethics, Law, and Aging Review,(In press).

Bartels SJ, Miles KM, Oxman TE, Zimmerman S, Cori LA, Pomerantz AS, Cole BH, Van Citters AD, Mendolevicz N: Population-based screening for co-occurring alcohol use disorders, depressive symptoms, and suicidal ideation among older adults in a primary health care clinic. Journal of Dual Diagnosis, (In press).

Bartels SJ: Evidence-based medicine in older adults with mental disorders. Psychiatric Clinics of North America, (In press).

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Paul B. Batalden, M.D.

Professor of Pediatrics and of Community and Family Medicine, Dartmouth Medical School; Director, Health Care Improvement Leadership Development (HCILD), Dartmouth Institute ; Program Director, Dartmouth-Hitchcock Leadership Preventive Medicine Residency Program, Senior Vice President for Health Professional Development and Board member, Institute for Healthcare Improvement, Boston, Mass.

B.A., Augsburg College, 1963

M.D., University of Minnesota Medical School, 1967

Internship and Residency, Department of Pediatrics, University of Minnesota, 1967-1969

Teaching roles at The Institute:

Masters Degree: Academic Area Director, Health Care Improvement; Course Director, ECS 117 Continual Improvement of Healthcare: An Overview and Co-Director, ECS 124 The Design and Improvement of Clinical Microsystems

Ph.D. Program: Ph.D. Advisor/Thesis Director; Ph.D. Thesis Committee Member; Lecturer in Doctoral Seminars

Other teaching related to The Institute: Co-Director, National Office of Veterans Administration Quality Scholars Program; Program Director, Dartmouth-Hitchcock Leadership Preventive Medicine Residency

Research Interests: His major research interests include systems for managing the improvement of health and value of health care for clinical microsystems and systems for assessing the degree to which health care workers can learn and develop in their work setting.

Dr. Batalden has been a student of continual improvement of the quality of health care for over 25 years. During the past 2 decades, he has applied the work of W. Edwards Deming and others to the improvement of health care. As Director of Health Care Improvement Leadership Development, he leads the creation and delivery of educational opportunities for physicians, nurses, healthcare workers and healthcare administrators. He also works to accelerate the improvement of care for patients at the Dartmouth-Hitchcock Medical Center and the University of Bergen School of Medicine in Norway.

Representative Publications (related to the evaluative clinical sciences):

Batalden PB, Stoltz PK. A Framework for the Continual Improvement of Health Care. Journal on Quality Improvement. 1993;19(10):424-452.

Batalden PB, Mohr JJ, Nelson EC, Plume SK, Baker GR, Wasson JH, Stoltz PK, Splaine ME, Wisniewski JJ. Continually Improving the Health and Value of Health Care for a Population of Patients: The Panel Management Process. Quality Management in Health Care. 1997;5(3):41-51.

Nelson EC, Splaine ME, Batalden PB, Plume SK. Building Measurement and Data Collection into Medical Practice. Annals of Internal Medicine. 1998;128(6):460-466.

Nelson EC, Batalden PB, Mohr, JJ, Plume SK, Caldwell C, Goldberg HI, Kaluzny AD. Building a Quality Future. Frontiers of Health Services Management. 1998;15(1).

Nelson EC, Batalden PB, Ryer JC. Clinical Improvement Action Guide. JCAHO, Oak Brook Terrace, IL, 1998.

Batalden PB. How Shall We Prepare the Future Healthcare Professional? Frontiers of Health Services Management. 2001;18(2):39-42.

Mohr JJ, Batalden PB. Initiating the Improvement of the Safety of Care for Patients and Populations in the Clinical Microsystem. Quality & Safety in Health Care. 2002;11(1):45-50.

Batalden PB, Nelson EC, Mohr JJ, Godfrey MM, Huber TP, Kosnik L, Ashling K. Microsystem in Health Care: Part 5. How Leaders are Leading. Joint Commission Journal on Quality and Safety. 2003;29(6) 297-308.

Batalden PB, Nelson EC, Edwards WH, Godfrey MM, Mohr JJ. Microsystems in Health Care. Part 9: Developing Small Clinical Units to Attain Peak Performance. Joint Commission Journal on Quality and Safety. 2003;29(11):575-585.

Mohr JJ, Batalden PB, Barach P. Integrating patient safety into the clinical microsystem. Quality & Safety in Health Care. 2004;13 (Suppl II) ii34-ii38.

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William C. Black, M.D.

Professor of Radiology and of Community and Family Medicine, Dartmouth Medical School.

B.S. from University of Illinois, Urbana, IL, 1975

M.D. from the Medical College of Virginia, 1979

Residency in Diagnostic Radiology from University of Virginia Medical Center, 1983

Scholar, Radiological Society of North America Research and Education Fund, 1993

Teaching roles at The Institute:

Masters Degree: Guest lecturer on diagnostic testing and screening for disease

Ph.D. Program: Ph.D. Thesis Committee Member; teaches Advanced Topic Module in Diagnostic Testing in ECS290 Doctoral Seminars

Research Interests: Dr. Black is a practicing radiologist with expertise in the evaluation of screening and diagnostic testing. He has demonstrated how advances in diagnostic imaging distort the clinician's perception of the prevalence of disease, its natural history, and its response to medical intervention. He has also studied the public's perception of medical risks and benefits and shown that women 40-49 years of age substantially overestimate their risks of developing and dying from breast cancer. Black has also developed a mathematical method for estimating rates of disease progression from its stage distribution at autopsy and age-specific mortality rates. These estimates are important for making decisions about screening and diagnostic testing and understanding their effects. Currently, Dr. Black is a co-investigator on a proposed national multi-center randomized clinical trial of screening for lung cancer with helical CT. He serves on the monitoring committee of the National Cancer Institute Prostate, Lung, Colon and Ovary Screening Trial and the National Cancer Institute's PDQ committee for prevention and screening.

Representative Publications (related to the evaluative clinical sciences):

Black WC, Nease RF, Welch HG. Determining transition probabilities from mortality rates and autopsy findings. Med Decis Making. 1997;17:87-93.

Black WC. Advances in radiology and the real versus apparent effects of early diagnosis. Eur J Radiol. 1998;27:116-122.

Hersh AL, Black WC, Tosteson AN. Estimating the population impact of an intervention: a decision-analytic approach. Statistical Methods in Medical Research. 1999;8(4):311-30.

Black WC. Unexpected observations on tumor size and survival in Stage IA non-small cell lung cancer. Chest. 2000;117:1532-33.

Black WC. Overdiagnosis: an under recognized cause of confusion and harm in cancer screening [editorial; comment]. J Nalt Cancer Inst. 2000;92:1280-1282.

Black WC. Anatomic extent of disease: a critical variable in reports of diagnostic accuracy. Radiology. 2000;217:319-320.

Patz EF, Jr., Black WC, Goodman PC. CT Screening for Lung Cancer: Not Ready for Routine Practice. Radiology. 2001;221(3):587-91.

Black WC, Haggstrom DA, Welch HG. All-cause mortality in randomized trials of cancer screening. J Natl Cancer Inst. 2002;94:167-73.

Welch HG, Black WC. Are death within 1 month of cancer directed surgery attributed to cancer? J Natl Cancer Inst. 2002;94:1066-70.

Siegel A, Holtzman SR, Bettmann MA, Black WC. Clinicians' perceptions of the value of ventilation-perfusion scans. Clin Nucl Med. 2004;29(7):419-25.

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Bernard F. Cole, Ph.D.

Associate Professor of Community and Family Medicine (Biostatistics), Dartmouth Medical School;

B.A. in Mathematics from Boston University, 1985

M.A. in Mathematics from Boston University, 1986

Ph.D. in Mathematics from Boston University, 1992

Postdoctoral Research Fellow, Department of Biostatistics, Harvard School of Public Health and Dana-Farber Cancer Institute, 1992-1993

Webpage

Teaching roles at The Institute:

Masters Degree: See ECS245 below.

Ph.D. Program: Ph.D. Thesis Committee Member; Course Co-Director (w Todd MacKenzie), ECS 245: Advanced Statistics & Methods; Course Director, ECS 240/MATH30, Introduction to Linear Models; Co-Director (w Therese Stukel), Beyond Math 30.

Research Interests: Dr. Cole's central area of research is the development and application of statistical methods for incorporating quality-of-life considerations in the evaluation of cancer treatments. His on-going research in this area includes development of methods for incorporating longitudinal assessments of quality of life into survival analysis and models for non-ignorable missing data in this setting.

Representative Publications (related to the evaluative clinical sciences):

Cole BF, Gelber RD, Anderson KM. Parametric approaches to quality adjusted survival analysis. Biometrics. 1994;50:621-631.

Bonetti M, Cole BF, Gelber RD. A method-of-moments estimation procedure for categorical quality-of-life data with nonignorable missingness. Journal of the American Statistical Association. 1999;94:1025-1034.

Murray S, Cole BF. Variance and sample size calculations in quality-of-life adjusted survival analysis (Q-TWiST). Biometrics. 2000;56:173-182.

Cole BF, Gelber RD, Gelber S, Coates AS and Goldhirsch A. Polychemotherapy for early breast cancer: an overview of the randomised trials with quality-adjusted survival analysis. The Lancet. 2001;358:277-286.

Baron JA, Cole BF, Sandler RS, et al. A randomized trial of aspirin to prevent colorectal adenomas. New England Journal of Medicine 2003;348, 891-899.

Cole BF, Glantz MJ, Jaeckle KA, Chamberlain MC and Mackowiak JI. Quality-of-life-adjusted survival comparison of sustained-release cytosine arabinoside versus intrathecal methotrexate for treatment of solid tumor neoplastic meningitis. Cancer 2003;97:3053-3060.

Wallace K, Byers T, Morris JS, Cole BF, Greenberg ER, Baron JA, Gudino A, Spate V and Karagas MR. Prediagnostic serum selenium concentration and the risk of recurrent colorectal adenoma: a nested case-control study. Cancer Epidemiology, Biomarkers & Prevention 2003;12 464-467.

Ahles TA, Saykin AJ, Noll WW, Furstenberg CT, Guerin S, Cole B and Mott LA. The relationship of APOE genotype to neuropsychological performance in long-term cancer survivors treated with standard dose chemotherapy. Psycho-Oncology 2003;12, 612-619.

Vuola JM, Ristola MA, Cole B, Jrviluoma A, Tvaroha S, Rnkk T, Rautio O, Arbeit R.D. and von Reyn CF. Immunogenicity of an inactivated mycobacterial vaccine for the prevention of HIV-associated tuberculosis: a randomized, controlled trial. AIDS 2003;17, 2351-2355.

Harper DM, Longacre MR, Noll WW, Belloni DR and Cole BF. Factors affecting the detection rate of human papillomavirus. Annals of Family Medicine 2003;1, 221-227.

Cole BF, Gelber RD, Gelber S and Mukhopadhyay P. A quality-adjusted survival model (Q-TWiST) for advanced stage cancer. Journal of Biopharmaceutical Statistics 2004;14, 111-124.

Schwaab T, Tretter CPG, Gibson JJ, Cole BF, Schned AR, Harris R, Wallen EM, Fisher JL, Waugh MG, Truman D, Stempkowski LM, Crosby NA, Heaney JA and Ernstoff MS. Immunological effects of granulocyte-macrophage colony-stimulating factor and autologous tumor vaccine in patients with renal cell carcinoma. The Journal of Urology 2004;171, 1036-1042.

Wallace, K., Baron, J.A., Cole, B.F., Sandler, R.S., Karagas, M.R., Beach, M.A., Haile, R.W., Burke, C.A., Pearson, L.H., Mandel, J.S., Rothstein, R. and Snover, D.C. (2004). Effect of calcium supplementation on the risk of large bowel polyps. Journal of the National Cancer Institute 96, 921-925.

Cole BF, Bonetti M, Zaslavsky AM and Gelber RD. A multi-state Markov chain model for longitudinal, categorical quality-of-life data subject to nonignorable missingness. Statistics in Medicine 2005 (to appear).

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Madeline A. Dalton, Ph.D.

Research Associate Professor, Department of Pediatrics, Dartmouth Medical School; Director, the Hood Center for Children and Families, DHMC

B.A. in Biology from Alfred University, 1983

M.S. from School of Nutrition Science and Policy, Tufts University, 1988

Ph.D. from School of Nutrition Science and Policy, Tufts University, 1994

Teaching roles at The Institute:

Ph.D. Program: Ph.D. Advisor; Lecturer in Advanced Topic Module on Epidemiology in Doctoral Seminars

Research Interests: For the past 10 years, Dr. Dalton's research has focused on the social and environmental risk factors for tobacco use. Her studies span from early childhood to adulthood and address issues ranging from attitudinal development about smoking to cessation treatments. Currently, Dr. Dalton is Principal Investigator for two NCI-funded studies examining the influence of parents and media on adolescent smoking behavior. Working with a multi-disciplinary team, Dr. Dalton seeks to establish the mechanisms for media effects on adolescent smoking; to evaluate the public health implications of depicting tobacco use in movies; and to design family and community interventions to reduce adolescent risk of smoking. Recently, Dr. Dalton has extended her research to address issues related to adolescent obesity. As part of this new initiative, Dr. Dalton and colleagues have received funding from NIEHS to examine the influence of individual, family and community level factors on adolescent dietary practices and physical activity. This five-year study involves a longitudinal cohort of 2500 adolescents and their parents from New Hampshire and Vermont.

Representative Publications (related to the evaluative clinical sciences):

Dalton MA, Sargent JD, Stukel TA. Utility of a risk assessment questionnaire in identifying children at high risk for lead exposure. Arch Pediatr Adolesc Med 1996;150:197-202.

Dalton MA, Sargent JD, O'Connor GT, Olmstead EM, Klein RZ. Calcium and phosphorus supplementation of iron-fortified infant formula: no effect on iron status of healthy full-term infants. Am J Clin Nutr 1997;65:921-926.

Sargent JD, Tickle JJ, Beach ML, Dalton MA, Ahrens B, Heatherton TF. Brand appearances in contemporary cinema films and contribution to global marketing of cigarettes. Lancet 2001;357:29-32.

Sargent JD, Beach ML, Dalton MA, Mott LA, Tickle JJ, Ahrens MB, Heatherton TF. Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study. BMJ 2001;323:1394-1397. Unabridged version available at this link

Dalton MA, Ahrens MB, Sargent JD, Beach ML, Tickle JJ, Heatherton TF. Relation between parental restrictions on movies and adolescent use of tobacco and alcohol. Eff Clin Pract 2002;5(1):1-10.

Sargent JD, Dalton MA, Beach ML, Mott LA, Tickle JJ, Ahrens MB, Heatherton TF. Viewing tobacco use in movies: does it shape attitudes that mediate adolescent smoking? Am J Prev Med 2002;22(3):137-145.

Dalton MA, Tickle JJ, Sargent JD, Beach ML, Ahrens MB, Heatherton TF. The incidence and context of tobacco use in popular movies from 1988-1997. Prev Med 2002;34(5):516-523.

Dalton MA, Sargent JD, Beach ML, Titus-Ernstoff L, Gibson JJ, Ahrens MB, Tickle JJ, Heatherton TF. Effect of viewing smoking in movies on adolescent smoking initiation: a cohort study. Lancet 2003;362:281-285. URL

Sargent JD, Dalton MA, Heatherton TF, Beach ML. Modifying exposure to movie smoking: a novel approach to preventing adolescent smoking. Arch Pediatr Adolesc Med 2003;157:643-648.

Sargent JD, Beach ML, Dalton MA, Titus-Ernstoff L, Gibson JJ, Tickle JJ, Heatherton TF. Effect of parental R-rated movie restriction on adolescent smoking initiation: a prospective study. Pediatrics 2004;114(7):149-156.

Dalton MA, Bernhardt AM, Gibson JJ, Sargent JD, Beach ML, Adachi-Mejia AM, Titus-Ernstoff L, Heatherton TF. 'Honey, have some smokes,'' Preschoolers use cigarettes and alcohol while role playing as adults. Archives of Pediatrics & Adolescent Medicine, in press, 2005.

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Robert E. Drake, M.D., Ph.D.

Andrew Thomson Professor of Psychiatry and Professor of Community and Family Medicine, Dartmouth Medical School; Director, new Hampshire-Dartmouth Psychiatric Research Center

B.A., in Biology from Princeton University, 1971

Ph.D., in Developmental and Clinical Psychology from Duke University, 1977

M.D., from Duke University, 1978

Website

Teaching roles at The Institute:

Ph.D. Program: Ph.D. Advisor/Thesis Director, Ph.D. Thesis Committee Member

Research Interests: In addition to working actively as a clinician in community mental health centers for over 20 years, Dr. Drake has been developing and evaluating innovative community programs for persons with severe mental disorders. He is well known for his work in rehabilitation and health services research. His seven books and over 280 published papers cover diverse aspects of adjustment and quality of life among persons with severe mental disorders and those in their support systems.

Representative Publications (related to the evaluative clinical sciences):

Mueser, K.T., Torrey, W.C., Lynde, D., Singer, P., & Drake, R.E. Implementing evidence-based practices for people with severe mental illness. Behavior Modification. 2003;27(3):387-411.

Sacks, J.Y., Drake, R.E., Williams, V.F., Banks, S.M., & Herrell, J.M. Utility of the Time-Line Follow-Back to assess substance use among homeless adults. The Journal of Nervous and Mental Disease. 2003;191(3):145-153.

Xie, H., McHugo, G.J., Sengupta, A., & Drake, R.E. Using discrete-time survival analysis to examine patterns of remission from substance use disorder among persons with severe mental illness. Mental Health Services Research. 2003;5(1):55-64.

Drake, R.E., Morse, G., Brunette, M.F., Torrey, W.C. The evolving U.S. service model for patients with severe mental illness and co-occurring substance use disorder. Acta Neuropsychiatrica 16:1-5, 2004.

Mueser, K.T., Clark, R.E., Haines, M., Drake, R.E., McHugo, G.J., Bond, G.R., Essock, S.M., Becker, D.R., Wolfe, R., Swain, K. The Hartford study of supported employment for severe mental illness: Employment and non-vocational outcomes. Journal of Consulting and Clinical Psychology 72:479-490, 2004.

Tremblay, T., Smith, J., Xie, H., Drake, R. The impact of specialized benefits counseling services on Social Security Administration disability beneficiaries in Vermont. Journal of Rehabilitation 70(2):5-11, 2004.

Drake, R.E., Mueser, K.T., Brunette, M.F., McHugo, G.J. Review of treatments for persons with severe mental illness and co-occurring substance use disorder. Psychiatric Rehabilitation Journal 27:360-374, 2004.

Drake, R.E. Dual diagnosis. Psychiatry 3(10):60-63, 2004.

Latimer, E., Bush, P., Becker, D., Drake, R., Bond, G. The costs of high-fidelity supported employment programs for people with severe mental illness. Psychiatric Services 55:401-406, 2004.

Xie, H., McHugo, G., Drake, R., Sengupta, A., Clark, R.E. Using mixed-effects mixed-distribution model to analyze repeated measures data with excess zeros. Mental Health Services Research 6:239-247, 2004.

Drake, R.E., Latimer, E., Leff, S., McHugo, G.J., Burns, B.J. What is evidence? Child and Adolescent Psychiatric Clinics of North America 13:717-728, 2004.

Drake, R.E., Xie, H., McHugo, G.J., Shumway, M. Thee-year outcomes of patients with severe bipolar disorder and co-occurring substance use disorders. Biological Psychiatry 56:749-756, 2004.

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Eric J. Duell, Ph.D.

Assistant Professor of Community and Family Medicine, Dartmouth Medical School.

B.A. in Microbiology from University of California, San Diego, 1988

M.S. in Environmental Health Sciences from University of California, Los Angeles, 1992

Ph.D. in Epidemiology from University of North Carolina, Chapel Hill, 1999

Postdoctoral Research Fellow/Associate, Department of Genetics and Complex Diseases (formerly Cancer Cell Biology), Harvard School of Public Health, 1999-2001

Webpage

Teaching roles at The Institute:

Masters Degree: Guest lecturer, Environmental and Occupational Health

Ph.D. Program: Ph.D. Advisor.

Other Teaching: Lecturer: in Biostatistics and Epidemiology; Graduate Toxicology.

Research Interests: Dr. Duell's central area of research is in cancer susceptibility, environmental and molecular epidemiology, and spatial epidemiology. Dr. Duell studies cancer susceptibility by investigating the interaction of inherited genetic variation with environmental exposures. He is currently studying susceptibility to pancreatic cancer in the context of exposure-related DNA damage and repair pathways. In the areas of spatial and environmental epidemiology, Dr. Duell is using Geographic Information Systems (GIS) to investigate the spatial distribution of non-melanoma skin cancer (and other human cancers) in relation to indoor radon concentrations in New Hampshire. His research utilizes the New Hampshire state cancer registry and GIS methods to study spatial relations between a variety of environmental and social factors and human cancer. Dr. Duell is also a member of the cancer epidemiology and chemoprevention working group of the Norris Cotton Cancer Center.

Representative Publications (related to the evaluative clinical sciences):

Millikan R, De Voto E, Duell EJ, Tse C-K, Savitz DA, Beach J, Edmiston S, Jackson S and Newman B. DDE, PCBs and Breast Cancer among African-American and White Women in North Carolina. Cancer Epidemiol Biomarkers Prevention. 2000;9:1233-40.

Korte JE, Hertz-Picciotto I, Schultz M, Ball LM, Duell EJ. The Contribution of Benzene to Smoking-Induced Leukemias. Environmental Health Perspectives. 2000;108:333-339.

Duell EJ, Millikan R, Savitz DA, Newman B, Smith JC, Schell MJ, and Sandler DP. A Population-based Case-Control Study of Farming and Breast Cancer in North Carolina. Epidemiology. 2000;11:523-531.

Duell EJ, Wiencke JK, Cheng T-J, Varkonyi A, Zuo ZF, Ashok TDS, Mark EJ, Wain JC, Christiani DC, and Kelsey KT. Polymorphisms in the DNA Repair Genes XRCC1 and ERCC2 and Biomarkers of DNA Damage in Human Blood Mononuclear Cells. Carcinogenesis. 2000;21:965-971.

Duell EJ, Millikan R, Schell M, Savitz DA, Schell MJ, Newman B, Tse C-K, and Sandler DP. Reproducibility of Reported Farming Activities and Pesticide Use among Breast Cancer Cases and Controls: A Comparison of Two Modes of Data Collection. Annals of Epidemiology. 2001;11:178-85.

Duell EJ, Millikan R, Pittman GP, Winkel S, Lunn RM, Tse C-K, Eaton A, Mohrenweiser HW, Newman B, and Bell DA. Polymorphisms in the DNA Repair Gene XRCC1 and Breast Cancer. Cancer Epidemiol Biomarkers Prevention. 2001;10:217-22.

Duell EJ, Holly EA, Liu M, Bracci PM, Wiencke JK, and Kelsey KT. A Population-Based, Case-Control Study of Polymorphisms in Carcinogen-Metabolizing Genes, Smoking, and Pancreatic Adenocarcinoma Risk. J Natl Cancer Inst. 2002;94(4):297-306.

Duell EJ, Holly EA, Bracci PM, Wiencke JK, and Kelsey KT. A Population-Based Study of the Arg399Gln Polymorphism in XRCC1 and Risk of Pancreatic Adenocarcinoma. Cancer Res. 2002;62:4630-6.

Duell EJ and Holly EA. A Polymorphism in CYP17, Reproductive Factors, and Pancreatic Cancer Risk. Proceedings of the American Association for Cancer Research. Toronto, Canada 2003 (Abstract no. 2612)

Duell EJ, Holly EA, Burk RD, and Kelsey KT. Inflammation, Genetic Polymorphisms in Pro-Inflammatory Genes RANTES, CCR5, and TNF-α, and Risk of Pancreatic Cancer. Proceedings of the American Association for Cancer Research. Orlando, Florida March 2004 (Abstract no. 1118)

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Elliott S. Fisher, M.D., M.P.H.

Professor of Medicine and Community and Family Medicine, Dartmouth Medical School

B.A. in East Asian Studies from Harvard College, 1974

M.D., from Harvard Medical School, 1981

M.P.H., from the University of Washington, 1985

Senior Fellow, Robert Wood Johnson Clinical Scholars Program, University of Washington, 1983-1985

Residency, University of Washington, Primary Care Internal Medicine, 1982-1983

Internship, University of Washington, Primary Care Internal Medicine, 1981-1982

Teaching roles at The Institute:

Masters Degree: Academic Area Co-Director, Health Policy; Course Director, ECS 100 Introduction to the Evaluative Clinical Sciences

Ph.D. Program: Ph.D. Advisor/Thesis Director; Ph.D. Thesis Committee Member

Other teaching related to The Institute: Co-director VA/Institute Outcomes Research Fellowship

Research Interests: Dr. Fisher is a general internist at the Department of Veterans Affairs Medical Center in White River Junction, Vermont. He has served on numerous national committees and member of the National Advisory Council of the Agency for Healthcare Research and Quality. Dr. Fisher's interests lie in three areas. First, he has worked to clarify the limitations of administrative databases and develop methods to overcome them. Second, he has developed approaches to resource allocation based upon the principles of benchmarking, first as a means of addressing inequities in the levels of hospital resources across communities in Oregon and more recently as applied to the U.S. physician supply. Most recently, he has focused on the health implications of the uneven distribution of health care resources. Little is known about the impact of these differences on health outcomes. His current research, funded by the Robert Wood Johnson Foundation, examines the potential adverse consequences of increasing capacity in health care.

Representative Publications (related to the evaluative clinical sciences):

Fisher ES, Welch HG. Avoiding the unintended consequences of growth in medical care: how might more be worse? JAMA. 1999;281:446-53.

Teno JM, Fisher E, Hamel MB, et al. Decision-making and outcomes of prolonged ICU stays in seriously ill patients. J Am Geriatr Soc. 2000;48:S70-4.

Fisher ES, Wennberg JE, Stukel TA, et al. Associations among hospital capacity, utilization, and mortality of US Medicare beneficiaries, controlling for sociodemographic factors. Health Serv Res. 2000;34(6):1351-62.

Virnig BA, Kind S, McBean M, Fisher ES. Geographic variation in hospice use prior to death. J Am Geriatr Soc. 2000;48(9):1117-25.

Goodman DC. Fisher ES. Little GA, Stukel TA. Chang CH. The uneven landscape of newborn intensive care services: variation in the neonatology workforce. Effective Clinical Practice. 2001;4(4):143-9.

Goodman DC. Fisher ES. Little GA. Stukel TA. Chang CH. Are neonatal intensive care resources located according to need? Regional variation in neonatologists, beds, and low birth weight newborns. Pediatrics. 2001;108(2):426-31.

Bazos DA. Weeks WB. Fisher ES. DeBlois HA. Hamilton E. Young MJ. The development of a survey instrument for community health improvement. Health Services Research. 2001;36(4):773-92.

Goodman DC, Fisher ES, Little GA, Stukel TA, Chang CH, Schoendorf KS. The Relationship Between the Availability of Neonatal Intensive Care and Neonatal Mortality. N Engl J Med. 2002;346(20):1538-44.

Fisher ES, Wennberg DE, Stukel DA, Gottlieb D, Lucas FL, Pinder E. The implications of regional variations in Medicare spending: Part 1. Utilization of services and the quality of care. Ann Intern Med. 2003;138:273-287.

Fisher ES, Wennberg DE, Stukel DA, Gottlieb D, Lucas FL, Pinder E. The implications of regional variations in Medicare spending: Part 2. Health outcomes and satisfaction with care. Ann Intern Med. 2003;138:288-298.

Fisher ES Medical care--is more always better? N Engl J Med 2003;349(17):1665-1667.

Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ Variations in the Longitudinal Efficiency of Academic Medical Centers. Health Affairs Web Exclusive 2004;VAR:90-97.

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Ann Barry Flood, Ph.D.

Professor of Community and Family Medicine, Dartmouth Medical School and Sociology, Dartmouth College; Chair, Ph.D. Program and NRSA Postdoctoral Programs; and Director, Policy Studies, Dartmouth Institute ; Co-Editor-in-Chief, Health Services Research, Official Journal of the AcademyHealth, Blackwell Pub.

B.A. in Mathematics and Sociology from University of Kansas, 1965

M.A. in Sociology from Stanford University, 1968

Ph.D. in Sociology from Stanford University, 1977

NIMH Postdoctoral Fellow in Organizations at Stanford University, 1977-1979

Robert Wood Johnson Health Policy Fellow at the Institute of Medicine and US Senate Finance Committee, 1988-9

Teaching roles at The Institute:

Masters Degree: Academic Area Co-Director: Health Policy; Course Director, ECS 101 Health Policy: Organizational and Delivery System Issues and Problems; Former Course Director, ECS 120 Patient Health Behavior and Decision-Making

Ph.D. Program: Chair of Ph.D. Program; Ph.D. Advisor/Thesis Director; Ph.D. Thesis Committee Member; Course Director, ECS290- Doctoral Seminars: Modules in Advanced Topics and in Research Ethics and Skills

Other teaching related to The Institute: Chair, NRSA Postdoctoral Program; Co-Director, Institutional NRSA Training Grant from AHRQ; Co-Director of Course at College Hum3: Scientific Controversies in Medicine.

Research Interests: Dr. Flood's area of expertise involves the theoretical and policy implications regarding professional and organizational factors which influence the outcomes of health care. Besides using outcomes to evaluate quality of care, she investigates the effects of financial incentives and managed care techniques on clinical decision-making and resource use and how clinical organizations respond to insurance incentives. She participated in 'The Institutional Differences Study'', a major study of quality of surgical care in US hospitals sponsored by the National Academy of Sciences (ref 1). This work helped spawn a major line of inquiry about the relationship between the volume of cases performed and better outcomes (ref 2). Her work on the Prostate Disease PORT grant continued a focus on surgical outcomes and the role of patient preferences in choosing treatment. Her recent work involves attempts to improve shared decision making under uncertainty, examining the decision to undergo periodic screening for prostate cancer. She was also the principal investigator on a study funded by the AHCPR, Commonwealth, and the Robert Wood Johnson Foundation to investigate factors which effect physicians' practice decisions, their treatment of HMO and fee-for-service patients, and their reactions to some major administration changes in financial incentives introduced into their group practice. This study used billing records to compare styles of generalists and specialists in using outpatient resources to treat episodes of seven common illnesses and their reactions to insurance-based incentives.

Her interests in health policy and Making A Difference derive from the nature of her research projects and from her experience as a Robert Wood Johnson Health Policy Fellow serving on the staff of the US Senate Finance Committee in 1989 and from her role as Co-Editor-in-Chief of Health Services Research, the official journal of AcademyHealth which was named as an outstanding journal in health services research in a recent study reported in Medical Care Research and Review.

Representative Publications (related to the evaluative clinical sciences):

Flood, AB and Scott, WR. Hospital Structure and Performance. Baltimore, MD: Johns Hopkins University Press, 1987.

Flood AB, Scott WR, Ewy W, et al. Does Practice Make Perfect? I: The Relation Between Hospital Volume and Outcomes for Selected Diagnostic Categories. Medical Care, 22(2):98 114, and Part II: The Relation Between Volume and Outcomes and Other Hospital Characteristics. Medical Care 1984;22(2):98-114 and 115 124, [with an accompanying editorial by A. Donabedian, 'Volume, Quality, and the Regionalization of Health Care Services.'' Medical Care, 1984;22(2):95-97].

Flood AB, Fennell ML. Through the lenses of organizational sociology: The role of organizational theory and research in conceptualizing and examining our health care system. J Health and Social Behavior, 1995;36:154-69. [awarded the 1997 Eliot Freidson Award for Best Paper in Medical Sociology by the American Sociological Association]

Flood AB, Wennberg JE, Nease RF, Fowler, FJ, Ding J, Hynes LM & Members of the Prostate PORT. 'The Importance of Patient Preference in the Decision to Screen for Prostate Cancer.'' J General Internal Medicine, 1996;11:342-349. [with an accompanying guest editorial: Deber, Raisa B 'Shared decision making in the real world.'' J General Internal Medicine, 1996;11: 377-78.

Flood AB, Fremont AM, Jin K, et al. How do HMOs achieve their savings? The effectiveness of one organization's strategies. Health Services Research, 1998; 33(1): 79-99.

Flood AB, Bott DM, Goodrick E. The Promise and Pitfalls of Explicitly Rewarding Physicians Based on Patient Insurance. The Journal of Ambulatory Care Management, 2000; 23(1):55-70.

Harris, Russell P.; Flood, Ann Barry; Berge Viktor; and Coates, Ralph J. Screening for Prostate Cancer: Sharing the Decision. A web-based presentation sponsored by the CDC. link [last accessed September 30, 2003].

Radosevich, DM, Partin, Melissa R.; Nugent, Sean; Nelson, David; Flood, Ann Barry; Holtzman, Jeremy, Dillon, Nancy; Haas, Michelle, Wilt, TJ. Measuring patient knowledge of the risks and benefits of prostate cancer screening Patient Educational and Counseling. 2004; 54(2).

Partin MR, Wilt T, Nelson D, Radosevich D, Nugent S, Flood AB, Dillon N, Holtzman J. A Randomized Trial Examining the Effect of Two Prostate Cancer Screening Educational Interventions on Patient Knowledge, Preferences, and Behaviors. J Gen Int Med. 2004;19:835-842.

Flood AB, Luft HS. Recognizing excellence and translating health services research to policy. Health Serv Res 2004;39:431-432.

O'Connor AM, Llewellyn-Thomas HA, Flood AB. Modifying unwarranted variations in preference sensitive care: The role of shared decision making in using patients' decision aids. Health Affairs web exclusive 2004.

Flood AB. External Peer Review at HSR. Health Serv Res 2004;39(5):1235-50.

Flood AB, Zinn, J, Scott WR. Organizational performance: Managing for efficiency and effectiveness. In Essentials of Health Care Management. Fifth ed. Shortell, Stephen M. and Arnold Kaluzny (editors). Albany, NY: Delmar Pub., forthcoming.

Flood, AB. 'Special Issues involving Human Subjects Protection in Health Services Research.'' Chapter 10-6. in Robert J. Amdur, Elizabeth A. Bankert (ed). Institutional Review Board Management and Function. Second Ed. Sudbury, MA: Jones and Bartlett Publishers, forthcoming.

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David C. Goodman, M.D., M.S.

Professor of Pediatrics and of Community and Family Medicine, Dartmouth Medical School; Attending Physician, Dartmouth-Hitchcock Clinical; Chief, Allergy/Immunology at Dartmouth-Hitchcock Medical Center

B.A. in Biochemistry from the University of Vermont, 1977

M.D. from SUNY, Upstate Medical Center, 1981

M.S. in Evaluative Clinical Sciences from Dartmouth College, 1995

Residency, The John Hopkins Hospital, Pediatrics, 1981-1984

Teaching roles at The Institute:

Masters Degree: Course Director, ECS 146/147: Advanced Methods in Health Services Research

Ph.D. Program: Ph.D. Advisor/Thesis Director; lecturer, ECS290-Doctoral Seminars

Other teaching related to The Institute: Mentor, NRSA Postdoctoral Fellows; Seminar leader Pediatric Evaluative Clinical Sciences

Research Interests: Dr. Goodman divides his time between the pediatric teaching services at Dartmouth-Hitchcock Medical Center and the Dartmouth Institute. His current research interests include developing novel methods of measuring primary care resources; evaluating the relationship between regional variation in clinician supply and population outcomes; and the epidemiology of asthma medical care in children.

Representative Publications (related to the evaluative clinical sciences):

Kronick R, Goodman DC, Wennberg J, Wagner E. The Marketplace in Health Care Reform: The Demographic Limitations of Managed Competition. New England Journal of Medicine. 1993;328:148-152.

Goodman DC, Fisher ES, Gittelsohn A, Chang C, Fleming C. Why Are Children Hospitalized? The Role of Non-Clinical Factors in Pediatric Hospitalizations. Pediatrics. 1994;93:896-902.

Goodman DC, Fisher ES, Bubolz TA, Mohr JE, Poage JF, Wennberg JE. Benchmarking the U.S. Physician Workforce: An Alternative to Needs or Demand Based Planning. JAMA. 1996; 276:1811-1817.

Goodman DC, Fisher ES, Stukel TA, Chang C. The Distance to Community Medical Care and the Likelihood of Hospitalization: Is Closer Always Better? American Journal of Public Health. 1997;87:1144-1150.

Goodman DC, Stukel TA, Chang C. Trends in Pediatric Asthma Hospitalization Rates: Regional and Socio-economic Differences Pediatrics. 1998;101:208-213.

Goodman DC, Lozano P, Stukel TA, Chang C, Hecht J. Has Asthma Medication Use in Children Become More Frequent, More Appropriate, or Both? Pediatrics 1999;104:187-194.

Goodman DC, Fisher ES, Little GA, Stukel TA, Chang C, Schoendorf KS. The Relation Between the Availability of Neonatal Intensive Care and Neonatal Mortality. The New England Journal of Medicine 2002; 346: 1538-1544.

Thompson LA, Goodman DC, Little GA .Is More Neonatal Intensive Care Always Better? Insights From a Cross-National Comparison of Reproductive Care, Pediatrics.2002; 109:1036-1043.

Goodman DC, Mick S, Bott DM, Chang CH, Carretta H, Marth N. Primary Care Service Areas: A New Tool for the Evaluation of Primary Care Services, Health Services Research, 2003;38:187-309.

Jennings R, Thompson L, Townsend C, Stashwick C, Goodman DC. The Relation Between Pediatric Residency Program Size and Inpatient Illness Severity and Diversity, Archives of Pediatric and Adolescent Medicine. 2003;157:676-680.

Birkmeyer JD, Siewers AE, Martha N, Goodman DC. Regionalizing High Risk Surgery: How Far Would Patients Have to Travel? JAMA. 2003;290:2703-2708.

Goodman DC Do we need more physicians? The answer is to be found in a reexamination of physician productivity. Health Affairs 2004; W4: 67-69.

Goodman DC Twenty Year Trends in the Regional Variation of the Physician Workforce. Health Aff (Millwood). 2004;Web Exclusive:VAR 90-97 Oct 7.

Guagliardo MF, Jablonski KA, Joseph JG, Goodman DC. Do pediatric hospitalizations have a unique geography? BMC Health Services Research 2004; 4:2.

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Pamela C. Jenkins, M.D., Ph.D.

Assistant Professor of Pediatrics and Community and Family Medicine, Dartmouth Medical School

B.S. E. in Mechanical Engineering and Materials Science from Duke University, 1983

M.D. University of North Carolina, Chapel Hill, 1992.

Residency, Dartmouth Hitchcock Medical Center, Pediatrics, 1992-1995

M.S. in Evaluative Clinical Sciences from Dartmouth College, 1996

Ph.D. in Evaluative Clinical Sciences from Dartmouth College, 1999

Teaching roles at The Institute:

Ph.D. Program: Ph.D. Advisor; lecturer, ECS290-Doctoral Seminars

Research Interests: Pam Jenkins is conducting a multi-institutional research project in pediatric cardiology which compares outcomes for a particularly lethal congenital heart disease called hypoplastic left heart syndrome. Her work involves examining the outcomes and risks associated with treatment alternatives for this disease using survival analysis, risk factor analysis, and decision analysis, and by comparing functional health outcomes between the two surgical treatment strategies. New work includes examining longer term growth parameters and morbidities for these children; surveying physicians and families about health status in these kids; and validating the prior risk factor analysis at other pediatric cardiac surgical centers.

Representative Publications (related to the evaluative clinical sciences):

Jenkins P, Dickison A, Flanagan M. Cardiac inflammatory pseudotumor: rapid appearance in an infant with congenital heart disease. Pediatric Cardiology 1996;17:399-401.

Jenkins PC, Flanagan MF, Jenkins KJ, Sargent JD, Canter CE, Chinnock RE, Vincent RN, Tosteson ANA, O'Connor GT. Risk factors for mortality in transplantation and staged surgery for hypoplastic left heart syndrome. Circulation 1999;100:I-670 (abstract).

Jenkins PC, Flanagan MF, Jenkins KJ, Sargent JD, Canter CE, Chinnock RE, Vincent RN, Tosteson ANA, O'Connor GT. Survival analysis of transplantation versus staged surgery in hypoplastic left heart syndrome. Circulation 1999;100:I-672 (abstract).

Mendeloff EN, Bailey MS, Jenkins PC, Canter CE, Huddleston CB. Staged reconstruction versus orthotopic heart transplant for hypoplastic left heart syndrome: a10-year experience. Pediatr Research, Nov-Dec 2000. In Press. (abstract).

Jenkins PC, Tosteson ANA , Flanagan MF, Sargent JD, O'Connor GT, Canter CE, Chinnock RE, Jenkins KJ, Vincent RN. Decision analysis comparing treatment strategies for hypoplastic left heart syndrome. J Am Coll Cardiol 2000;35Suppl 2:502A. (abstract).

Jenkins PC, Tosteson ANA , Flanagan MF, Sargent JD, O'Connor GT, Canter CE, Chinnock RE, Jenkins KJ, Vincent RN. Decision analysis comparing treatment strategies for hypoplastic left heart syndrome. Pediatr Research 2000;47Suppl:44A. (abstract).

Jenkins PC, Flanagan MF, Jenkins KJ, Sargent JD, Canter CE, Chinnock RE, Vincent RN, Tosteson ANA, O'Connor GT. Survival analysis and risk factors for mortality in transplantation and staged surgery for hypoplastic left heart syndrome. J Am Coll Cardiol 2000;36:1178-85.

Jenkins PC, Flanagan MF, Sargent JD, Canter CE, Chinnock RE, Jenkins KJ, Vincent RN, O'Connor GT, Tosteson ANA. A comparison of treatment strategies for hypoplastic left heart syndrome using decision analysis. J Am Coll Cardiol. 2000;38(4)1181-7.

Jenkins PC, Flanagan MF, Jenkins KJ, Sargent JD, Canter CE, Chinnock RE, Vincent RN, O'Connor GT. Morbidities and somatic growth in patients with hypoplastic left heart syndrome. Pediatr cardiol 2004 Jan-Feb; 25(1): 3-10.

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Margaret R. Karagas, Ph.D.

Professor Section of Biostatistics and Epidemiology of Community and Family Medicine, Dartmouth Medical School, Director of Biostatistics and Epidemiology

B.S. in Biology from Newcomb College of Tulane University, 1980

M.S. in Health Sciences/Epidemiology from California State University, Northridge, 1983

Ph.D. in Epidemiology from the University of Washington School, 1990

Webpage

Teaching roles at The Institute:

Masters Program: Co-Director, Environmental and Occupational Medicine

Ph.D. Program: Ph.D. Advisor/Thesis Director; Ph.D. Thesis Committee Member; lecturer, Advanced Topic Module in Epidemiology, ECS290-Doctoral Seminars

Research Interests: Professor Karagas's research includes several epidemiologic studies focusing on the biologic mechanisms and prevention of human cancers. Among these are investigations to determine the incidence rates of basal cell and squamous cell skin cancer and to assess the extent of any increase over the past 15 years. Another aspect of this research is a population-based case-control study of these malignancies designed to quantify the risks associated with various patterns of sun exposure, ingestion of arsenic-containing drinking water, and emerging exposures such as tanning lamps. The research has recently been extended to study the effects of arsenic on bladder cancer and to conduct chemical analyses of household drinking water supplies. She also is conducting an international study of melanoma in women to assess the risks associated with female sex-steroids, reproductive history, alcohol and body weight.

Representative Publications (related to the evaluative clinical sciences):

Karagas MR, Le XC, Morris S, Blum J, Lu X, Spate V, Carey M, Stannard V, Klaue B and Tosteson TD. Markers of low level arsenic exposure for evaluating human cancer risks in a U.S. Population. Int J Occup Med and Environ Health 2001; 14:171-5.

Karagas MR, Stannard V, Mott LA, Slattery MG, Spencer SKI, Weinstock MA. Use of tanning lamps and the risk of basal cell and squamous cell carcinoma of the skin. Journal of the National Cancer Institute 2002; 93 (3).

Andrew AS, Karagas MR, Schned A, Hamilton JW. Decreased expression of DNA repair genes ERCC1, XPF, and XPB, but not XPG or XPA among individuals exposed to arsenic in drinking water. Int J Cancer 2003; 104: 263-268

Tosteson TD, Buzas JS, Demikenko E, Karagas MR. Power and sample size calculations for generalized regression models with covariate measurement error. Stat Med 2003; 22: 1069-1092

Henrik Toft Sorensen, HT, Olsen JH, Nielsen GL, Mellemkjor, Baron JA, Karagas MR. Risk of skin cancers and malignant lymphomas among users of systemic glucocorticoids: a population-based cohort study. J Nat Cancer Inst 2004; 96: 709-711.

Kelsey KT, Hirao T, Schned AR, Hirao S, Ashok T, Nelson HH, Andrew A, Karagas MR. A population-based study of immunohistochemical detection of p53 alteration in bladder cancer. Br J Cancer 2004; 90: 1572-1576.

Karagas MR, Tosteson TD, Morris JS, Heaney J, Demidenko E, Mott Le, Schned A. Incidence of transitional cell carcinoma of the bladder and arsenic exposure in New Hampshire. Cancer Causes Control 2004; 15:465-472.

Carroll RJ, Ruppert D, Crainiceanu CM Tosteson TD, Karagas MR. Nonlinear and non-parametric regression and instrumental variables. J Am Stat Assoc 2004; 99 (467): 736-750.

Jacobs ET, Jiang R, Alberts DS, Greenberg ER, Gunter EW, Karagas MR, Lanza E, Ratnasinghe L, Reid ME, Schatzkin A, Smith-Warner SA, Wallace K, Martinez ME. Selenium and Colorectal Adenoma: Results of a Pooled Analysis. J Nat Cancer Inst 2004; 96: 1669-75.

Peters SC, Blum JD, Karagas MR, Chamberlain CP. Sources and exposure of the New Hampshire population to arsenic in drinking water. Chemical Geology (in press)

Wallace K, Karagas MR, Cole BF, Beach MA, Pearson L, Baron JA. The Association of physical activity and body mass index on the risk of large bowel polyps. Cancer Epidemiol Biomarkers Prev (in press).

Kelsey KT, Hirao T, Schned AR, Hirao S, Ashok T, Nelson HH, Andrew A, Karagas MR. P53 Alteration in bladder cancer in a population-based study. Br J Cancer (in press)

Karagas MR, Zens MS, Stukel TA, Dykes J, Swerdlow AJ, Rosso S, Osterlind A, Mack T, Kirkpatrick C, Holly E, Green A, Gallagher R, Elwood M, Armstrong B. Pregnancy history and incidence of melanoma in women: a combined analysis. Cancer Causes Control (in press).

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Hilary A. Llewellyn-Thomas, Ph.D.

Professor of Community and Family Medicine, Dartmouth Medical School; Director, Studies in Health Care Decision Making.

B.Sc. in Nursing, University of Toronto, 1968

M.Sc. in Community Health Nursing, University of Toronto, 1977

Ph.D. from The Institute of Medical Science, Faculty of Medicine, University of Toronto, 1983

National Health Research Scholar in the National Health Research and Development Program, Health and Welfare Canada, 1989-99

Web page

Teaching roles at The Institute:

Masters Degree: Academic Area Co-Director, Health Care Decision Making; Course Director, ECS 120 Studying Patients' Decisions.

Ph.D. Program: Ph.D. Advisor; Ph.D. Thesis Committee Member; Co-director of ECS290 Workshop on Critical Appraisal and Research Design; Director, ECS290 Advanced Topic Module on Patient Decision Making

Research Interests: Dr. Llewellyn-Thomas's research focuses on the issues involved in incorporating patients' perspectives into health care. Specific areas include patients' attitudes toward experienced and anticipated health states; preferences for treatment alternatives and involvement in treatment decisions; attitudes toward the time involved in waiting for, undergoing, and recovering from treatment; understanding of the risk/benefit probabilities involved in different treatment options; the concepts of decisional conflict and decision support as a clinical skill; and the evaluation of the effectiveness of interventions designed to support shared decision making.

Her research projects include:

Developing and testing ways to measure concepts such as:

+patients' required risk reduction for lifelong preventive medication;

+patients' opinions about minimal clinically important differences in clinical trials;

+patients' attitudes towards their position in wait queues for therapy; and

+consumers' attitudes about geographic variations in preference-sensitive care.

The treatment protocols of interest include those for musculoskeletal disorders, cancer, cardiovascular disease, problems in mental health, and new vaccine technologies.

Developing and testing ways to assess the effectiveness of providing decision support for individuals who want to be involved in making health care decisions in which there is no single 'best'' action. Funded by the Foundation for Informed Medical Decision Making, these projects focus on different ways of:

+providing patients with information,

+helping them to clarify the relative personal importance of the risks and benefits associated with various treatment options, and

+helping them to make informed, preference-based choices that then can be effectively communicated to their health care providers.

Determining the opinions of physicians about patient involvement in shared decision making in 'close call'' situations, and about the feasibility, usefulness, and preferred ways of disseminating effective decision aids for patients.

Representative Publications (related to the evaluative clinical sciences):

Llewellyn-Thomas HA. Presidential Address -- Patients' health care decision making: A framework for descriptive and experimental investigations. Medical Decision Making 1995;15(2):101-106.

Llewellyn-Thomas HA, Williams JI, Levy L, Naylor CD. Benign prostatic hyperplasia (BPH): Using a trade-off technique to assess patients' treatment preferences. Medical Decision Making 1996;16(3):162-172.

Palda VA, Llewellyn-Thomas HA, MacKenzie RG, Pritchard KI, Naylor CD. Breast cancer patients' attitudes about rationing postlumpectomy radiation therapy: Applicability of the probability trade-off method to policy-making. Journal of Clinical Oncology 1997; 15(10): 3192-3200.

Llewellyn-Thomas HA, Arshinoff R, Bell M, Williams JI, Naylor CD. In the queue for total joint replacement: patients' perspectives on waiting times. Journal of Evaluation in Clinical Practice 1998;4(1):63-74.

Llewellyn-Thomas HA, Thiel EC, Paterson JM, Naylor CD. In the queue for coronary artery bypass grafting: patients' perceptions of risk and `maximal acceptable waiting time'. Journal of Health Services Research and Policy 1999; 4 (2):65-72.

O'Connor AM, Rostom A, Fiset V, Tetroe J, Entwhisle V, Llewellyn-Thomas H, Holmes-Rovner M, Barry M, Jones J. Decision aids for patients facing health treatment or screening decisions: a Cochrane Systematic Review. British Medical Journal 1999; 319: 731-734.

Morgan MW, Deber RB, Llewellyn-Thomas HA, Gladstone P, Cusimano RJ, O'Rourke K, Tomlinson G, Detsky AS. Randomized, controlled trial of an interactive videodisc decision aid for patients with ischemic heart disease. Journal of General Internal Medicine Oct. 2000;15(10): 685-693. Accompanying editorial by Richard A. Deyo, p. 749.

Holmes-Rovner M, Llewellyn-Thomas HA, Elwyn G. Moving to the mainstream. In: G. Elwyn A. Edwards A, editors. Evidence-Based Patient Choice: Inevitable or Impossible? Oxford: Oxford University Press, 2001.

Llewellyn-Thomas HA, Arshinoff R, Bell M, Williams JI, Naylor CD, & The Ontario Hip and Knee Replacement Project Team. Healthy-years equivalents (HYEs) in major joint replacement: can patients provide meaningful responses? International Journal of Technology Assessment in Health Care 2002;18 (3): 467-484.

Llewellyn-Thomas HA, Paterson JM, Carter JA, Basinski A, Myers MG, Hardacre GD, Dunn EV, D'Agostino RB, Naylor CD. Primary prevention drug therapy: Can it meet patients' requirements for reduced risk? Medical Decision Making 2002; 22:326-339.

Del Giudice ME, Swaka CA, Pritchard KI, Llewellyn-Thomas HA, Trudeau ME, Lewis J, Franssen E. Hormone replacement therapy after treatment for breast cancer: physicians' attitudes towards randomised trials. Breast Cancer Research and Treatment 2003; 79(2):213-23.

Bordeleau L, Szalai J, Ennis M, Leszcz M, Speca M, Sela R, Doll R, Chochinov HM, Navarro M, Arnold A, Pritchard KI, Bezjak A, Llewellyn-Thomas HA, Sawka CA, Goodwin PJ. Quality of life in a randomized trial of group psychosocial support in metastatic breast cancer: overall effects of the intervention and an exploration of missing data. Journal of Clinical Oncology. 2003; 21(10): 1944-1951.

O'Connor AM, Llewellyn-Thomas HA, Flood AB. Modifying unwarranted variations in health care: the role of shared decision making using patients' decision aids. Health Affairs Web Exclusive, Oct 7, 2004 VAR 63-72.

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Jon D. Lurie, M.D., M.S.

Assistant Professor of Medicine, and of Community and Family Medicine, Dartmouth Medical School

B.S. E in Geological Engineering from Princeton University, 1985

M.D. from Stanford University School of Medicine, 1992

M.S. in Evaluative Clinical Sciences from Dartmouth College, 1997

Residency in Internal Medicine, Dartmouth Hitchcock Medical Center, 1992-6

Postdoctoral Research Training: VA-Institute Outcomes Research Fellow, 1996-8

First Award, NIH 2002-

Teaching roles at The Institute:

Masters Degree: Course Director for ECS 80 - Introduction to Clinical Medicine

Research Interests: Dr. Lurie is general internist at Dartmouth Hitchcock Medical Center. He is a Physician Investigator for the Spine Patient Outcomes Research Trial (SPORT) - a 5 - year, multi-center, randomized clinical trial designed to compare surgery to non-surgical therapy for patients with herniated intervertebral discs, spinal stenosis, and degenerative spondylolisthesis. His principal research interests are in the use and evaluation of diagnostic testing, particularly in patients with low back pain. He has also done work on fecal occult blood testing for colorectal cancer screening and the diagnostic use of blood cultures. In addition, Dr. Lurie contributes to the Dartmouth Atlas of Health Care, looking at physician workforce issues and modeling the effect of policy changes on the workforce.

Representative Publications (related to the evaluative clinical sciences):

Lurie JD, Gerber PD, Sox HC. Clinical Problem Solving: A pain in the back. N Engl J Med 2000; 343: 723 - 728.

Lurie JD. A Review of Generic Health-Status Measures in Patients with Low Back Pain. Spine 2000; 25: 3125-3129.

Lurie JD, Weinstein JN. Geographic Variation and Shared Decision Making: Implications for the Orthopaedic Workforce. Clinical Orthopedics and Related Research 2001; 385:68-75.

Lurie JD, Goodman DC, Wennberg JE. Benchmarking the Future Generalist Workforce. Effective Clinical Practice 2002; 5: 58-66.

Birkmeyer NJO, Weinstein JN, Tosteston ANA, Tosteson TD, Skinner JS, Lurie, JD, Deyo RA, Wennberg JE. Design of the Spine Patient Outcomes Research Trial (SPORT). Spine 2002; 27(12):1361-72.

Hanscom B; Lurie JD, Homa K; Weinstein JN. Computerized Questionnaires and the Quality of Survey Data. Spine 2002;27:1797-1801

Lurie JD, Birkmeyer NJO, Weinstein JN. Rates of Advanced Spinal Imaging and Spine Surgery. Spine 2003; 28(6): 616-620.

Walsh TL, Hanscom B, Lurie JD, Weinstein JN. Is a Condition-Specific Instrument for Patients with Low Back Pain/Leg Symptoms Really Necessary? The responsiveness of the Oswestry Disability Index and the SF36. Spine 2003; 28(6): 607-615.

Walsh TL, Hanscom B, Lurie JD, Weinstein JN. Is a Condition-Specific Instrument for Patients with Low Back Pain/Leg Symptoms Really Necessry? The responsiveness of the Oswestry Disability Index and the SF36. Spine 2003; 28(6):607-615.

Lurie JD, Birkmeyer NJO, Weinstein JN. Rates of Advanced Spinal Imaging and Spine Surgery, Spine 2003; 28(6):616-620.

Ankle fractures in the elderly: Geographic variations in frequency, gender, race and treatment. Koval KJ, Lurie JD, Zhou W, Weinstein JN. Journal of Trauma 2005(in Press)

McDonough CM, Grove MR, Tosteson TD, Lurie JD, Hilibrand AS, Tosteson AN. Comparison of Preference Classification Systems among Patients with Herniated Discs and Spinal Stenosis. Journal of Qual Life Res 2005(in Press).

Shipman SA, Lurie JD, Goodman DC. The General Pediatrician: An Endangered Species, Specialty in Surplus, or Both? Pediatrics 2004;113:435-442.

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Mark P. McGovern, Ph.D.

Associate Professor of Psychiatry and of Community and Family Medicine, Dartmouth Medical School, Faculty, Research Scientist, Addiction Consultant, Department of Psychiatry, Dartmouth Medical School, New Hampshire-Dartmouth Psychiatric Research Center, State of New Hampshire Division of Alcohol and Drug Abuse, Lebanon and Concord, New Hampshire

B.A. in Psychology from LaSalle College, 1977

Ph.D. in Clinical Psychology from Temple University, 1985

Residency in Clinical Psychology from Northwestern University Medical School, 1984

Teaching roles at The Institute:

Ph.D.Program: Ph.D. Advisor

Research Interests: Dr. McGovern specializes in the treatment of substance use disorders and practices through the Department of Psychiatry at Dartmouth Hitchcock Medical Center. He has studied and published widely in the area of addiction treatment services research. He has conducted projects in a variety of settings including inner city detoxification programs, community mental health centers, state psychiatric hospitals, academic medical centers, office-based practices, private specialty treatment programs and state addiction treatment delivery systems. Dr. McGovern has worked extensively with special populations including impaired health care professionals, and he has worked with the National Football League's Program for Substance Abuse since its inception in 1995. He has also conducted training and research in the assessment and treatment of the dual-diagnosis patient in both psychiatric and addiction treatment systems. In July of 2004, he received a 5-year career development award from the National Institute on Drug Abuse. His interests are in co-occurring disorders in addiction treatment programs, treatment system improvement with evidence-based practices, and greater specificity in the care of persons suffering from substance use problems.

Representative Publications (related to the evaluative clinical sciences):

McGovern MP, Angres DH Triaging the impaired physician: Patient-treatment matching by specificity and intensity. Epikrisis, 1998;9(6):1-2.

Beedle D, McGovern MP Diagnosis and treatment of psychiatric comorbidity in alcoholics and drug addicts. Psychiatric Annals, 1998;28(12):705-708.

McGovern MP, Groberski MJ, Gryll SL Training in substance use disorders assessment and intervention: Design and implementation of a model within a traditional mental health clinic. Professional Psychology: Research and Practice, 1999;30(4):200-204.

McGovern MP, Angres DH, Leon S. Characteristics of physicians presenting for assessment at a behavioral health center. Journal of Addictive Diseases,2000;19(2):59-73.

Angres DH, McGovern MP, Rawal P, Shaw M Psychiatric comorbidity and physicians with substance use disorders: Clinical characteristics, treatment experiences, and post-treatment functioning. Addictive Disorders & Their Treatment, 2002;1(3):89-98.

McGovern MP, Angres DH, Shaw M, Rawal P. Gender of physicians with substance use disorders: Clinical characteristics, treatment utilization, and post-treatment functioning. Substance Use and Misuse, 2003;38(7):993-1001.

McGovern MP, Carroll KM. Evidence-based practices for substance use disorders. Psychiatric Clinics of North America, 2003;26:991-1010.

McGovern MP, Fox TS, Xie H, Drake RE. A survey of clinical practices and readiness to adopt evidence-based practices: Dissemination research in an addiction treatment system. Journal of Substance Abuse Treatment, 2004;26:305-312.

McGovern MP, Wrisley BR, Drake RE Substance use relapse and it prevention: Implications for persons with co-occurring substance use and psychiatric disorders.Psychiatric Services, 2005 (in press).

Drake RE, Wallach M, McGovern MP Preventing relapses to substance use disorder among clients with severe mental illnesses: What do we know and what do we do next? Psychiatric Services, 2005 (in press).

Crouse E, Drake KM, McGovern MP Co-existing substance use and Axis II Personality disorders. In A. Baker, R. Velleman (Eds.). Clinical handbook of co-existing mental health and drug and alcohol problems. London UK: Brunner Rouledge, 2005 (in press).

Easton C, Neavins T, McGovern MP, Carroll KM Behavioral treatments for substance use disorders. In K Silk, P Tyrer (Eds.). Handbook on Effective Treatments in Psychiatry. Cambridge UK: Cambridge University Press, 2005 (in press).

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Gregory J. McHugo, Ph.D.

Associate Professor of Community and Family Medicine, Dartmouth Medical School, Associate Director for Psychophysiological Research, National Center for PTSD, V.A. Medical Center, White River Junction, VT

B.A. in Psychology from University of Vermont, 1970

M.A. in Psychology from Dartmouth College, 1976

Ph.D. in Psychology from Dartmouth College, 1979

Teaching roles at The Institute:

Ph.D. Program: Co- Ph.D. Advisor

Other Teaching: Training Seminar in Mental Health Services Research, Dartmouth Med. School, NH-Dartmouth PRC

Research Interests: Gregory McHugo, Ph.D., is an experimental psychologist and evaluation methodologist. He has been engaged in both basic and applied research at Dartmouth for over 30 years. Since coming to the PRC in 1990, McHugo has been involved in all phases of design, implementation, and analysis of numerous large scale, randomized controlled trials. As chief methodologist at the PRC, he has been responsible for selection and development of measurement instruments, training of interviewers and project directors, design of data systems, and planning and coordination of statistical analyses. McHugo has also designed and provided training in mental health services research for young investigators at the PRC. Currently, McHugo is coordinating a mixed methods, multi-site study of the implementation of evidence-based practices for people with serious mental illness.As an independent investigator, McHugo has developed a program of research in collaboration with Maxine Harris and Roger Fallot to evaluate the effectiveness of trauma interventions for people with serious mental illness and a history of interpersonal abuse. In addition, McHugo spends part of his time at the National Center for PTSD (at the nearby Vermont VA Hospital), where he has studied the efficacy of cognitive-behavioral therapy for women with PTSD due to childhood sexual abuse. McHugo provides methodological consultation and supervision at the NCPTSD, and he is responsible for psychophysiological assessment.

Representative Publications (related to the evaluative clinical sciences):

Drake R E, & McHugo G J. Taking issue - Large data sets can be dangerous. Psychiatric Services, 2003;54:113.

McHugo G J, & Drake R E. Finding and evaluating the evidence: A critical step in evidence-based medicine. Psychiatric Clinics of North America, 2003;26(4):821-831.

Drake R E, Xie H, McHugo G J, & Shumway M. Three-year outcomes of long-term patients with co-occurring bipolar and substance use disorders. Journal of Biological Psychiatry, 2004;56:749-756.

Xie H, McHugo G, Sengupta A, Clark R, & Drake R. A method for analyzing longitudinal outcomes with many zeros. Mental Health Services Research, 2004;6:239-246.

McHugo G J, Bebout R R, Harris M, Cleghorn S, Herring G, Xie H, Becker D, & Drake R E. A randomized controlled trial of integrated versus parallel housing services for homeless adults with severe mental illness. Schizophrenia Bulletin, 2004;30:969-982.

McHugo,G.J, Kammerer N, Jackson E, Markoff L, Gatz M, Larson M J, Mazelis R, & Hennigan K. Women, Co-Occurring Disorders, and Violence Study: Evaluation design and study population. Journal of Substance Abuse Treatment, 2005;28:91-107.

McHugo G J, Caspi Y, Kammerer N, Mazelis R, Jackson E, Russell L, Clark C, Liebschutz J, Kimerling R. The assessment of trauma history in women with co-occurring mental health and substance use disorders and a history of interpersonal violence. Journal of Behavioral Health Services and Research, 2005;32:113-127.

Xie H, McHugo G J, Helmstetter B S, & Drake R E. Three-year recovery outcomes for long-term patients with co-occurring schizophrenic and substance use disorders. Schizophrenia Research, 2005;75:337-348.

McDonagh-Coyle A, Friedman M J, McHugo G J, Ford J, Sengupta A, Mueser K T, Demment K, Fournier D, Schnurr P, & Descamps M. Randomized trial of cognitive behavioral therapy for chronic PTSD in adult female childhood sexual abuse survivors. Journal of Consulting and Clinical Psychology (in press).

Essock S, Mueser K, Drake R E, Covell N, McHugo G J, Frisman L, Kontos N, Jackson C, Townsend L, & Swain K Assertive community treatment versus standard case management for clients receiving integrated treatment for co-occurring sever mental illness and substance use disorders. Psychiatric Services (in press).

Xie H, McHugo G J, Fox M B, & Drake R E. Substance abuse relapses in a 10-year prospective follow-up of clients with co-occurring severe mental and substance use disorders. Psychiatric Services (in press).

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Todd A. MacKenzie, Ph.D.

Assistant Professor of Medicine

B.Sc. in Statistics from Dalhousie University, Halifax, 1990

M.Sc in Statistics from McGill University, Montreal, 1993

Ph.D in Statistics from McGill University, Montreal, 1997

Teaching roles at The Institute:

Masters Degree: Advanced Statistical Methods ECS 245

Ph.D. Program: Ph.D. Advisor; Ph.D. Thesis Committee Member

Research Interests: His expertise is in survival analysis including flexible estimation of the hazard ratio, left-truncation, interval censoring, and the ability of markers to replace information lost to right censoring in clinical trials. His clinical interests include diabetes, glucose and insulin, and the effect of common dietary items such as alcohol, caffeine and tea.

Representative Publication (related to the evaluative clinical sciences)

Kempe A, Luberti A, Belman S,Hertz A, Sherman H, Amin D, Dempsey C, Chandramouli U, and MacKenzie T. Outcomes Associated with Pediatric After-Hours Care by Call Centers--A Multicenter Study, Ambulatory Pediatrics 2003;3(4):211-7.

Hoffenberg EJ, MacKenzie T, Barriga KJ, Eisenbarth GS, Bao F, Erlich H, Haas JE, Sokol RJ, Taki I, Norris J, and Rewers M. A Prospective Study of the Incidence of Childhood Celiac Disease, Journal of Pediatrics 2003;143(3):308-314.

Burch JM, Sokol RJ, Narkewicz MR, Reichlin M, Frank .B, MacKenzie T, and Lee LA. Autoantibodies in mothers of children with neonatal liver disease. Journal of Pediatric Gastroenterology and Nutrition, 2003;37(3):262-7.

Wathen J, MacKenzie T. and Bothner J. Utility of Serum Electrolytes in the Emergency Department Management of Pediatric Dehydration, Pediatrics, 2004;114(5):1227-34.

Chase HP, MacKenzie T, Burdick J, Fiallo-Scharer R, Walravens P, Klingensmith G and Rewers M Redefining the Clinical Remission Period in Children with Type 1 Diabetes, Pediatric Diabetes 2004;5(1):16-9.

Hokanson J, MacKenzie T, Kinney G, Snell-Bergeon JK, Dabelea D, Ehrlich J, Eckel RH, and Rewers M. Evaluating changes in coronary artery calcium: An analytical method that accounts for inter-scan variability, American Journal of Roentgenology 2004;182(5):1327-32.

Duong M, MacKenzie T and Malenka D. N-acetylcysteine Prophylaxis Significantly Reduces the Risk of Radiocontrast-Induced Nephropathy: Comprehensive Meta-Analysis, Catheterization and Cardiovascular Intervention, 2005;64:471-489.

Liu E, MacKenzie T and Sokol R. Characterization of acute liver failure and development of a continuous risk of death staging system in children, 2005 accepted by Journal of Hepatology.

Dexiang Gao, Gary K, Grunwald JS, Rumsfeld L S, MacKenzie T and Shroyer, LA Time-Varying Risk Factors For Long-Term Mortality Following Coronary Artery Bypass Graft Surgery, accepted by ATS.

Carney PA, Goodrich ME, Weiss JE, MacKenzie T, Poplack SP, Wells WA, Titus-Ernstoff L. Utilization of Mammography in NH. Cancer, 2005 (In Press).

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Eugene C. Nelson, D.Sc., M.P.H.

Professor of Community and Family Medicine, Dartmouth Medical School; Director, Quality Education, Measurement and Research at Dartmouth-Hitchcock Medical Center; Adjunct Professor, Division of Hearing and Speech Sciences Vanderbilt University School of Medicine; Member, Board of Trustees for Health Outcomes Institute; Senior Advisor and Measurement Captain for Idealized Design of Clinical Office Practice, a national demonstration sponsored by the Institute for Healthcare Improvement; Board President, The Greenwood School.

A.B. in Sociology from Dartmouth College, 1970

M.P.H. in Medical Care Planning and Administration from Yale Medical School, 1973

D.Sc. in Health Services Administration and Health Education from Harvard School of Public Health, 1977

Teaching roles at The Institute:

Masters Degree: Co-Director for ECS 124 - The Design and Improvement of Clinical Microsystems.

Ph.D. Program: Ph.D. Advisor/Thesis Director; Ph.D. Thesis Committee Member

Research Interests: His recent work has focused on quality improvement and performance measurement, health services research and program evaluation. He has served as a consultant in these areas for organizations such as the National Institutes of Health, American College of Physicians, American College of Obstetrics and Gynecology, American Medical Association, Vanderbilt University, and the RAND Corporation. He served as a member of the Institute of Medicine Committee on the Future of United States Healthcare Quality. He is on the Editorial Board for Journal of Evaluation in Clinical Practice and for Quality Management in Health Care.

Representative Publication (related to the evaluative clinical sciences)

Nelson EC, Splaine ME, Batalden PB, Plume SK: 'Building Measurement and Data Collection into Medical Practice'' Annals of Internal Medicine, 1998;128 (6): 460-466.

Nelson EC, Splaine ME, Batalden PB, Plume SK: 'Measuring Clinical Outcomes at the Front Line,'' The Handbook for Managing Change in Healthcare, 1998;9:225-247.

Nelson EC, Mihevc N, Gentry M, Kehne D, Levine A, Batalden PB, Plume SK: 'Measuring Health Care System Quality and Performance,'' The Handbook for Managing Change in Health Care, 1998;10:249-262.

Nelson EC, Batalden PB, Mohr JJ, Plume SK: 'Building a Quality Future'' Frontiers of Health Services Management, 15 (1):3:32, Fall 1998.

Hess AM, Nelson EC, Johnson DJ, Wasson JH: 'Building an Idealized Measurement System to Improve Clinical Office Practice Performance'' Managed Care Quarterly, 1999;7 (3): 22-34.

Weinstein JN, Brown PW, Hanscom B, Walsh T, Nelson EC: Designing an Ambulatory Clinical Practice for Outcomes Improvement: From Vision to Reality - The Spine Center at Dartmouth-Hitchcock, Year One. Quality Management in Health Care, 2000;8(2):1-20.

Nelson EC, Splaine ME, Godfrey MM, Kahn V, Hess AR, Batalden PB, Plume SK: Using Data to Improve Medical Practice by Measuring Processes and Outcomes of Care. Joint Commission Journal on Quality Improvement, 2000;26(12)667-685.

Nelson EC, Batalden PB, Huber TP et al: Microsystems in Health Care: Part 1. Learning from High-Performing Front-Line Clinical Units. Joint Commission Journal on Quality Improvement, 2002;28(9) 472-493.

Nelson EC, Batalden PB, Huber TP et al: Microsystems in Health Care: Part 2. Creating a Rich Information Environment. Joint Commission Journal on Quality and Safety, 2003;29(1) 5-15.

Godfrey MM, Nelson EC, Wasson JH et al: Microsystems in Health Care: Part 3. Planning Patient-Centered Services. Joint Commission Journal on Quality and Safety. 2003;29(4) 159-170.

Nelson EC, Batalden PB, Homa K, Godfrey MM, Campbell C, Headrick LA, Huber TP, Mohr JJ, Wasson JH: Data and Measurement in Clinical Microsystems: Part 2. Creating a Rich Information Environment Joint Commission Journal on Quality and Safety 2003; 29(1):5-15.

Godfrey MM, Nelson EC, Wasson JH, Mohr JJ, Batalden PB: Microsystems in Health Care: Part 3. Planning Patient-Centered Services Joint Commission Journal on Quality and Safety 2003;29(4):159-70.

Huber TP, Godfrey MM, Nelson EC, Mohr JJ, Campbell C, Batalden PB: Microsystems in Health Care: Part 8. Developing People and Improving Work Life: What Frontline Staff Told Us Joint Commission Journal on Quality and Safety 2003; 29(10):512-22.

Batalden PB, Nelson EC, Edwards WH, Godfrey MM, Mohr JJ: Microsystems in Health Care: Part 9. Developing Small Clinical Units to Attain Peak Performance. Joint Commission Journal on Quality and Safety 2003; 29(11):575-85.

Nelson EC, Gentry MA, Mook KH, Spritzer KL, Higgins JH, Hays RD How Many Patients Are Needed to Provide Reliable Evaluations of Individual Clinicians? Medical Care. 2004;42(3).

Nelson EC, Splaine ME, Plume SK, Batalden P Good Measurement for Good Improvement Work. Quality Management in Health Care. 2004;13(1).

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Gerald T. O'Connor, Sc.D., Ph.D.

Professor of Medicine and of Community and Family Medicine, Dartmouth Medical School; Director of Education Programs, Center for the Evaluative Clinical Sciences, Chief of Clinical Research, Department of Medicine, Dartmouth-Hitchcock Medical Center.

B.S. in Biological Science, Columbia University, New York, NY, 1967

M.A. Public Health Education, Goddard College, Plainfield, VT, 1977

Ph.D. in Health Services, Union Institute, Cincinnati, OH, 1980

Sc.D. in Epidemiology from Boston University School of Public Health, 1987

Post-doctoral Fellowship training in cardiovascular epidemiology at the Channing Laboratory, Harvard Medical School, Boston, MA. 1984-87

Teaching roles at The Institute:

Masters Degree: Academic Area Director, Epidemiology and Statistics, Course Director, ECS 140 Epidemiology/Biostatistics I and ECS 140 Epidemiology/Biostatistics II

Ph.D. Program: Ph.D. Advisor/Thesis Director; Ph.D. Thesis Committee Member

Other teaching related to The Institute: Director of Education Programs, Dartmouth Institute; Director of Masters of Science Program

Research Interests: His primary interest is the use of epidemiologic techniques to improve clinical and patient decision-making and to accelerate the improvement of clinical care. Dr. O'Connor is the Principal Investigator of two regional research groups. The Northern New England Cardiovascular Study Group, a regional voluntary consortium to provide information about the management of cardiovascular disease in Maine, New Hampshire and Vermont was organized in 1987 and is ongoing. The Northern New England Cystic Fibrosis Consortium, first funded in 1997, uses epidemiologic techniques to study the measurement, organization, and improvement of clinical care for patients with cystic fibrosis.

Representative Publications (related to the evaluative clinical sciences):

O'Connor GT, Plume SK, Olmstead EM, Coffin LH, Morton JR, Maloney CT, Nowicki ER, Tryzelaar JF, Hernandez F, Adrian L, Casey KJ, Soule DN, Marrin CAS, Nugent WC, Charlesworth DC, Clough R, Katz S, Leavitt BJ, Wennberg JE, for the Northern New England Cardiovascular Disease Study Group. A regional prospective study of in-hospital mortality associated with coronary artery bypass grafting. The Northern New England Cardiovascular Disease Study Group (see comments). JAMA 1991;266:803-9.

O'Connor GT, Morton JR, Diehl MJ, Olmstead EM, Coffin LH, Levy DG, Maloney CT, Plume SK, Nugent W, Malenka DJ, Hernandez F, Clough R, Birkmeyer J, Marrin CAS, Leavitt BJ. Differences between men and women in hospital mortality associated with coronary artery bypass graft surgery. The Northern New England Cardiovascular Disease Study Group. Circulation 1993;88:2104-10.

Charlesworth DC, Maloney GT, O'Connor GT, Marrin CAS, Morton JR, Leavitt BJ, Clough R. Patient and Disease Factors and the Incidence of Cerebrovascular Accident Associated With Coronary-Artery Bypass Graft (GABG). Circulation 1995; 92:3091.

O'Connor GT, Plume SK, Olmstead EM, Morton JR, Maloney CT, Nugent WC, Hernandez F, Jr., Clough R, Leavitt BJ, Coffin LH, Marrin CA, Wennberg D, Birkmeyer JD, Charlesworth DC, Malenka DJ, Quinton HB, Kasper JF. A regional intervention to improve the hospital mortality associated with coronary artery bypass graft surgery. The Northern New England Cardiovascular Disease Study Group (see comments). JAMA 1996; 275:841-6.

O'Connor GT, Birkmeyer JD, Dacey LJ, Quinton HB, Marrin CA, Birkmeyer NJ, Morton JR, Leavitt BJ, Maloney CT, Hernandez F, Clough RA, Nugent WC, Olmstead EM, Charlesworth DC, Plume SK. Results of a regional study of modes of death associated with coronary artery bypass grafting. Northern New England Cardiovascular Disease Study Group. Aann Thorac Surg 1998; 66:1323-8.

Moscucci M, O'Connor GT, Ellis SG, Malenka DJ, Sievers J, Bates ER, Muller DWM, Werns SW, Kline Rogers E, Karavite D, Eagle KA. Validation of risk adjustment models for in-hospital percutaneous transluminal coronary angioplasty mortality on an independent data set. Journal of the American College of Cardiology, Sep 1999, 34:3:692-69-7.

O'Connor GT, Malenka DJ, Quinton H, Robb JF, Kellett MA, Jr., Shubrooks S, Bradley WA, Hearne MJ, Watkins MW, Wennberg DE, Hettleman B, O'Rourke DJ, McGrath PD< Ryan T, Jr., VerLee P. Multivariate prediction of in-hospital mortality after percutaneous coronary interventions in 1994-1996. Northern New England Cardiovascular Disease Study Group. J Amer Coll Cardio 1999; 34:681-91.

Dacey LJ, Munoz JJ, Johnson ER, Leavitt BJ, Maloney CT, Morton JR< Olmstead EM, Birkmeyer JD, O'Connor GT. Effect of preoperative aspirin use on mortality in coronary artery bypass grafting patients. Northern New England Cardiovascular Disease Study Group. Ann Thorac Surg 2000; 70:1986-90.

Surgenor SD, O'Connor GT, Lahey SJ, Quinn R, Charlesworth DC, Cacey LJ, Clough RA, Leavitt BJ, Dofoe GR, Fillinger M, Nugent WC. Predicting the risk of death from heart failure after coronary artery bypass graft surgery. Anesth Analg 2001; 92:596-601.

Clough RA, Leavitt BJ, Morton JR, Plume SK, Hernandez F, Nugent W, Lahey SR, Ross CS, O'Connor GT. The effect of comorbid illness on mortality outcomes in cardiac surgery. Arch Surg 2002; 137:428-32; 432-3.

O'Connor GT, Quinton HB, Kneeland T, Kahn R, Lever T, Maddock J, Robichaud P, Detzer M, Swartz DR. Median household income and mortality rate in cystic fibrosis Pediatrics 2003;11(4): e333-9.

Baskett RJF, O'Connor GT, Hirsch GM, Ghali WA, Sabadosa K, Morton JR, Ross CS, Hernandez F, Nugent Jr. WC, Lahey SJ, Sisto DA, Dacey LJ, Klemperer JD, Helm Jr RE, Maitland A. A multicenter comparison of intraaortic balloon pump utilization in isolated coronary artery bypass graft surgery. Ann Thorac Surg 2003; 76:1988-92.

Speroff T, O'Connor GT. Study designs for PDSA quality improvement research. Manage Health Care 2004; 13(1):17-92.

Nowicki ER, Birkmeyer NJO, Weintraub RW, Leavitt BJ, Sanders JH, Dacey LJ, Clough RE, Quinn RD, Charlesworth DC, Sisto DA, Uhlig PN, Olmstead EM, O'Connor GT. Multivariable predictions of in-hospital mortality associated with aortic and mitral valve surgery in Northern New England. Ann Thorac Surg 2004; 77:1966-1977.

Groom RC, Likosky DS, Forest RJ, O'Connor GT, Morton JR, Ross CS, Clark C, Kramer R. A model for cardiopulmonary bypass redesign. Perfusion 2004; 19:257-261.

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Stephen K. Plume, M.D.

FACS, Professor of Surgery and of Community and Family Medicine, Dartmouth Medical School

B.A. Harvard University, 1964

M.D. University of Rochester, 1969

Internship in Surgery, Strong Memorial Hospital, Cambridge, MA, 1969-1970

Residency in Surgery, University of Rochester, Rochester, NY, 1970-1975

Fellow in Cardiovascular and Thoracic Surgery, University of Toronto, 1975-1977

Cardiothoracic Surgeon, DHMC and Concord Hospital

Teaching roles at The Institute:

Masters Degree: Lecturer in Healthcare Improvement Leadership Development and Statistical Process Control

Research Interests: Dr. Plume's long-standing interest in understanding and improving systems of care and an increasing awareness of outcomes research led to the founding, with Gerald O'Connor, of the Northern New England Cardiovascular Disease Study Group. Experience gained from participating in this multi-center, multi-disciplinary effort to understand and reduce variation in cardiac surgery practices and outcomes proved useful in the effort to focus and coordinate a large, geographically dispersed multispecialty group practice.

Dr. Plume served as President of Dartmouth-Hitchcock Clinic from 1990 to 2000, after serving as Chief of Cardiothoracic Surgery at Dartmouth-Hitchcock Medical Center from 1979 to 1990. In addition to clinical, research and leadership responsibilities, Dr. Plume has served as consultant to institutions wishing to improve clinical services, and to others wishing to understand alternatives for organizing group practices.

Representative Publications (related to the evaluative clinical sciences):

Batalden PB, Mohr JJ, Nelson EC, Plume SK, Baker GR, Wasson JH, Stoltz PK, Splaine ME, Wisniewski JJ. Continually Improving the Health and Value of Health Care for a Population of Patients: The Panel Management Process. Quality Management in Health Care, 1997;5(3): 41-51.

Johnson LC, Batalden PB, Corindia JT, Marrin CAS, Nelson EC, Plume SK. Clinical Process Cost Analysis: A Promising Tool for Clinical Improvement. Quality Management in Health Care, 1997;5(3):

52-62.

Carey JS, Dziuban SW, Aron KV, Cimochowski GE, Plume SK, Grover FL. Quality Improvement Programs in Thoracic Surgery. Bulletin of the American College of Surgeons 1998;83:24-29.

Nelson EC, Splaine ME, Batalden PB, Plume SK. Building Measurement and Data Collection into Medical Practice. Ann Int Med, 1998;128(6):460-466.

Nelson EC, Batalden PB, Mohr JJ, Plume SK. Building a Quality Future. Frontiers of Health Services Management 1998;15(1): 3-32.

Nelson EC, Splaine ME, Godfrey MM, Kahn V, Hess AM, Batalden P, Plume SK. Using Data to Improve Medical Practice by Measuring Processes and Outcomes of Care. Journal of Quality Improvement, 2000;26 (12):667-685.

Nelson EC, Splaine ME, Godfrey MM, Kahn V, Hess AM, Batalden P, Plume SK. Using Data to Improve Medical Practice by Measuring Processes and Outcomes of Care Journal of Quality Improvement, 2000;26(12):667-685.

Plume, SK. A Healthcare Systems Leadership Perspective on Organizational Challenges Posed by Genomics. Frontiers of Health Services Management, 2001;17(3):29-33.

Plume SK, O'Connor GT, Olmstead EM. Changes in patients undergoing coronary artery bypass grafting: 1987-1990, updated in 2000. Ann Thorac Surg, 2001;72(1): 314-315.

Clough RA, Leavitt BJ, Morton JR, Plume SK, Hernandez F, Nugent W, Lahey SR, Ross CS, O'Connor GT. The effect of comorbid illness on mortality outcomes in cardiac surgery. Arch Surg 137(428-32):432-3.

Nelson EC [4] , Splaine ME [5] , Plume SK [6] , Batalden P [7] . Good measurement for good improvement work. Qual Manag Health Care. 2004 Jan-Mar;13(1):1-16.

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Lisa M. Schwartz, M.D., M.S.

Associate Professor of Medicine (General Internal Medicine) and Community and Family Medicine, Dartmouth Medical School

B.A. from the State University of New York, 1985

M.D. from the New York University, 1989

M.S. in Evaluative Clinical Sciences from Dartmouth College, 1996

VA-Institute Fellow in General Internal Medicine at Dartmouth College, 1994-97

Internal Medicine Residency, Bellevue/NYC Medical Center, 1989-1992

VA HSR&D Career Development Awardee (current)

Teaching roles at The Institute:

Master Degree: Co-Course Director, ECS 122 Survey Research Methods and Principles

Other Teaching roles at The Institute: Mentor for the VA-Institute Post Doctoral Fellowship Program

Research Interests: Dr. Schwartz's research focuses on learning how to help patients weigh the harms and benefits of medical care. In order to foster informed decision making, basic work needs to be done to learn what patients understand about disease risks and treatment harms, costs and benefits, and how to better inform patients about these issues. Her work in collaboration with Dr. Steven Woloshin addresses largely unexplored areas, particularly how best to communicate quantitative information and how to measure perceptions of the harms and benefits of treatment

To date, her work has focused on the following issues:

- Assessing patients comprehension of quantitative information and the extent to which low numeracy (basic facility in working with numbers) interferes with risk communication

- Assessing women's perceptions of the benefits and harms of screening mammography

- Developing methods to help clinicians and patients talk about disease risk and treatment benefit

- Analyzing problems with health messages

Representative Publications (related to the evaluative clinical sciences):

Schwartz LM, Woloshin S, Black WC, Welch HG. The role of numeracy in understanding the benefit of screening mammography. Ann Intern Med 1997;127: 966-972.

Schwartz LM, Woloshin S, Welch HG. Misunderstandings about the effect of race and sex on physicians' referrals for cardiac catheterization. N Engl J Med 1999; 341:279-283.

Schwartz LM, Woloshin S, Welch HG. Risk communication in clinical practice: Putting cancer in context. Monogr Natl Cancer Inst 1999; 25:124-33.

Welch HG, Schwartz LM, Woloshin S. Are changing five year survival rates evidence of progress against cancer? JAMA 2000; 283:2975-2984.

Schwartz LM, Woloshin S, Sox HC, Fischhoff B, Welch HG. US Women's attitudes to false positive mammography results and detection of ductal carcinoma in situ: cross sectional survey. BMJ 2000; 320:1635-1640.

Schwartz LM, Woloshin S. msJAMA-Marketing medicine to the public: A reader's guide. JAMA 2002; 287:774-5.

Schwartz LM, Woloshin S, Baczek L. Media coverage of scientific meetings: Too much, too soon? JAMA 2002;287:2859-63.

Schwartz LM, Woloshin, S. News media coverage of screening mammography for women in their forties and tamoxifen for primary prevention of breast cancer. JAMA 2002;287:3136-3142.

Schwartz LM, Woloshin S. On the prevention and treatment of exaggeration. J Gen Intern Med 2003; 18: 153-4.

Sirovich BE, Schwartz LM, Woloshin S. Screening men for prostate and colorectal cancer in the United States: does practice reflect the evidence? JAMA 2003; 289(11):141-20.

Caudill-Slosberg MA, Schwartz LM, Woloshin S. Office visits and analgesic prescriptions for musculoskeletal pain in US: 1980 vs. 2000 Pain 2004; 109(3):514-519.

Schwartz LM, Woloshin, Fowler FJ, Jr, Welch HG. Enthusiasm for cancer screening in the United States. JAMA 2004; 291(1):71-78.

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Jonathan S. Skinner, Ph.D.