This application seeks support for a team of statisticians, economists, clinicians, and mental health services researchers to collaborate on the development and application of discrete choice models for understanding treatment use and for causal inferences in experimental and naturalistic studies of mental illness. By studying how patients are matched with treatments in extant systems, researchers will gain greater insight into the determinants of quality of care.
The Specific Aims will involve the 1) extension of likelihood-based methods to estimate treatment effectiveness at the levels actually received using experimental data from two influential clinical trials (Schulberg, Block, Madonia et al., Acrh Gen Psychiatry 1996;53:913-9 & Rosenheck, Neale, Arch Gen Psychiatry 1998;55:459-66) and to compare these estimates with those based on conventional approaches, such as intention-to-treat, adequate, and completer principles, 2) development of new models of discrete choice to explain variation in treatment use based on patient, provider, and insurance characteristics for privately insured and Medicaid beneficiaries, and 3) application of these discrete choice models to explain variation in adherence with treatment recommendations and in treatment effectiveness for depression and for schizophrenia across a diverse array of practice settings. An Advisory Board comprised of leaders in statistics, economics, and psychiatry will convene annually to validate methods and ensure integration of techniques into mental health services research. The methodological advances from this research will enable mental health researchers and policy makers to better characterize usual care and to expand the inferences drawn from clinical trials.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH061434-02
Application #
6499366
Study Section
Special Emphasis Panel (ZMH1-SRV-C (01))
Program Officer
Hohmann, Ann A
Project Start
2001-02-01
Project End
2004-01-31
Budget Start
2002-02-01
Budget End
2003-01-31
Support Year
2
Fiscal Year
2002
Total Cost
$410,062
Indirect Cost
Name
Harvard University
Department
Administration
Type
Schools of Medicine
DUNS #
082359691
City
Boston
State
MA
Country
United States
Zip Code
02115
Busch, Alisa B; Neelon, Brian; Zelevinsky, Katya et al. (2012) Accurately predicting bipolar disorder mood outcomes: implications for the use of electronic databases. Med Care 50:311-9
O'Malley, A James; Frank, R G; Normand, S-L T (2011) Estimating cost-offsets of new medications: use of new antipsychotics and mental health costs for schizophrenia. Stat Med 30:1971-88
Teixeira-Pinto, Armando; Normand, Sharon-Lise (2011) MISSING DATA IN REGRESSION MODELS FOR NON-COMMENSURATE MULTIPLE OUTCOMES. Revstat Stat J 9:37-55
Neelon, Brian; O'Malley, A James; Normand, Sharon-Lise T (2011) A bayesian two-part latent class model for longitudinal medical expenditure data: assessing the impact of mental health and substance abuse parity. Biometrics 67:280-9
Fullerton, Catherine A; Busch, Alisa B; Frank, Richard G (2010) The rise and fall of gabapentin for bipolar disorder: a case study on off-label pharmaceutical diffusion. Med Care 48:372-9
Neelon, Brian H; O'Malley, A James; Normand, Sharon-Lise T (2010) A Bayesian model for repeated measures zero-inflated count data with application to outpatient psychiatric service use. Stat Modelling 10:421-439
Teixeira-Pinto, Armando; Normand, Sharon-Lise T (2009) Correlated bivariate continuous and binary outcomes: issues and applications. Stat Med 28:1753-73
Busch, Alisa B; Frank, Richard G; Sachs, Gary et al. (2009) Bipolar-I patient characteristics associated with differences in antimanic medication prescribing. Psychopharmacol Bull 42:35-49
Huskamp, Haiden A; Busch, Alisa B; Domino, Marisa E et al. (2009) Antidepressant reformulations: who uses them, and what are the benefits? Health Aff (Millwood) 28:734-45
Busch, Alisa B; Huskamp, Haiden A; Neelon, Brian et al. (2009) Longitudinal racial/ethnic disparities in antimanic medication use in bipolar-I disorder. Med Care 47:1217-28

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