Below are examples of current research programs MTPPI is participating in
Causal Inference Toolkit
Our causal inference researchers continue to enhance the CERBOT platform and toolkit. CERBOT is the leading collaboration tool for researchers conducting comparative effectiveness research on observational data sets. Users are guided through the process of articulating a research question in terms of a hypothetical randomized trial (the target trial) and then specifying an emulated target trial using observational data.
Software implementations into large healthcare systems can improve care delivery by providing enhanced insights and efficiencies, but they also have the potential to introduce unintended consequences into the IT environment. MTPPI is developing a framework of best practices, strategies and solutions that health systems can use to successfully integrate statistical analysis tools into existing technology stacks.
COVID-19 and the Uninsured
Our researchers are working with clinicians at the UT Southwestern health system to use innovative causal modeling (parametric g-formula and marginal structural models) methods to analyze the entire course of a patient's COVID-19 illness. Patient status will include insurance coverage, admission to a ED, admission to a hospital, use of a ventilator, discharge and risk of subsequent hospital re-admission.
Vascular Access Controversies
Vascular access (VA) is essential to delivering life-sustaining treatments ESRD patients. While the preferred method is an arteriovenous fistula (AVF), it is often complicated by failure to mature as well as the later development of stenosis and/or thrombosis. MTPPI is working with the University of Alabama at Birmingham to compare the clinical outcomes of different VA strategies and procedures in an elderly population of patients.
Effect of Bundled Payments
The CMS implementation of the bundled payment reimbursement structure for ESRD patients had a profound effect on the delivery of patient services. While the reforms were designed to curtail spending growth while incentivizing quality of care, the impact on the efficiency of services was unknown at the time of implementation. This retrospective study aims to answer that question.
Liver Cancer Surveillance
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. HCC occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection. MTPPI is working with the Palo Alto VA system to understand disparities in HCC surveillance, which describes the various methods used to detect the disease at an early stage and increase the chances of access to curative treatment.