Dr. Noyes proposes to develop the skills necessary to become an independent researcher in the field of cost-effectiveness analysis and health policy evaluation in geriatric disease. The candidate's undergraduate training in biomedical physics and PhD training in neurophysiology confirm her commitment to research as well as her strong analytical capabilities. To strengthen her knowledge in health care policy, outcomes evaluation, statistical analysis, and data management, the candidate will complete the proposed didactic coursework and participate in a series of clinical skills workshops and seminars. The candidate will spend the main part of the five-year grant period conducting proposed research. The candidate's long-term plan is to improve efficiency of the health care system by incorporating cost-effectiveness analysis into health care policy and decision making, in particular, related to Parkinson's disease (PD) and geriatric depression. The study will address short-comings of the methods currently used to evaluate outcomes in PD and will use patient's quality of life as the effectiveness measure. It is hypothesized that 1) levodopa is more cost-effective than pramipexole in the treatment of early PD; 2) elderly chronically ill patients use more health services than do general Medicare beneficiaries; and 3) disability and long-term care are the main sources of expenses associated with chronic geriatric disease. The project's specific aims are to conduct a cost-effectiveness analysis of early PD therapy with pramipexole compared to levodopa, to assess the pattern of health care utilization in Medicare beneficiaries with PD, and to develop a Parkinson's disease health policy pilot model. The cost-effectiveness will be assessed based on 4 years of data collected from a clinical-economic trial in PD. The patterns of health services utilization of Medicare patients will de examined using the Medicare Current Beneficiary Survey. Supplemental data on costs will be collected from published literature and Medicare fee schedules. The study design will include cost-effectiveness analysis, decision analytical modeling, sensitivity analysis, and Bayesian statistics. The results of this study can serve as a foundation for developing clinical guidelines for PD, provide information for resource allocation with respect to long term institutional and informal care, and to improve public health policy associated with chronic diseases and aging. Supervision for this project will be provided by a multidisciplinary team at the University of Rochester whose members are experienced in fostering the development of clinical researchers. The model and analytical approaches acquired by the candidate during her training will be used later to develop a decision analytical model describing geriatric depression.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
1K01AG020980-01
Application #
6506629
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Haaga, John G
Project Start
2002-09-01
Project End
2007-08-31
Budget Start
2002-09-01
Budget End
2003-08-31
Support Year
1
Fiscal Year
2002
Total Cost
$103,724
Indirect Cost
Name
University of Rochester
Department
Public Health & Prev Medicine
Type
Schools of Dentistry
DUNS #
208469486
City
Rochester
State
NY
Country
United States
Zip Code
14627
Noyes, Katia; Liu, Hangsheng; Lyness, Jeffrey M et al. (2011) Medicare beneficiaries with depression: comparing diagnoses in claims data with the results of screening. Psychiatr Serv 62:1159-66
Madeb, Ralph; Golijanin, Dragan; Noyes, Katia et al. (2009) Treatment of nonmuscle invading bladder cancer: do physicians in the United States practice evidence based medicine? The use and economic implications of intravesical chemotherapy after transurethral resection of bladder tumors. Cancer 115:2660-70
Ruan, Shuolun; Noyes, Katia; Bazarian, Jeffrey J (2009) The economic impact of S-100B as a pre-head CT screening test on emergency department management of adult patients with mild traumatic brain injury. J Neurotrauma 26:1655-64
O'Connor, Alec B; Noyes, Katia; Holloway, Robert G (2008) A cost-utility comparison of four first-line medications in painful diabetic neuropathy. Pharmacoeconomics 26:1045-64
Noyes, Katia; Liu, Hangsheng; Temkin-Greener, Helena (2008) Medicare capitation model, functional status, and multiple comorbidities: model accuracy. Am J Manag Care 14:679-90
Noyes, Katia; Dick, Andrew W; Holloway, Robert G (2007) The implications of using US-specific EQ-5D preference weights for cost-effectiveness evaluation. Med Decis Making 27:327-34
Dorsey, E R; Thompson, J P; Noyes, K et al. (2007) Quantifying the risks and benefits of natalizumab in relapsing multiple sclerosis. Neurology 68:1524-8
Noyes, Katia; Corona, Ethan; Zwanziger, Jack et al. (2007) Health-related quality of life consequences of implantable cardioverter defibrillators: results from MADIT II. Med Care 45:377-85
Noyes, Katia; Liu, Hangsheng; Holloway, Robert et al. (2007) Accuracy of Medicare claims data in identifying Parkinsonism cases: comparison with the Medicare current beneficiary survey. Mov Disord 22:509-14
Noyes, Katia; Liu, Hangsheng; Temkin-Greener, Helena (2006) Cost of caring for Medicare beneficiaries with Parkinson's disease: impact of the CMS-HCC risk-adjustment model. Dis Manag 9:339-48

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