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Congratulations to recipients of dissertation grants and NRSA fellowships and their mentors/advisors

Congratulations to AHCPR's new dissertation and National Research Service Award (NRSA) postdoctoral fellowship awardees. We wish you well as you join the community of health services researchers and contribute knowledge that will help enhance the quality of health care in the future. We also acknowledge and thank all the mentors/advisors of these newly funded grants. You are providing invaluable leadership and guidance to these students/trainees.

They are:

Dissertation Projects

  • Jeffrey Brown, HS10016, Brandeis University, Stanley Wallack, Ph.D., mentor/advisor.
  • Mary Dellefield, HS10022, University of California, Los Angeles, School of Nursing, Anne K. Wuerker, Ph.D., M.S.N., mentor/advisor.
  • John Grabenstein, HS10021, University of North Carolina, Chapel Hill, Harry A. Guess, Ph.D., mentor/advisor.
  • Lynn Helseth, HS09994, University of Nebraska, Benjamin F. Crabtree, Ph.D., mentor/advisor.
  • Moira Inkelas, HS10008, RAND Corporation, Jose Escarce, M.D., Ph.D., mentor/advisor.
  • Allison Jeffrey, HS10036, Virginia Tech, George A. Clum, Ph.D., mentor/advisor.
  • Ellen Shaffer, HS10014, Johns Hopkins University, Donald M. Steinwachs, Ph.D., mentor/advisor.
  • Lynn Unruh, HS09991, University of Notre Dame, Charles Craypo, Ph.D., mentor/advisor.
  • Todd H. Wagner, HS09997, University of California, Berkeley, Teh-Wei Hu, Ph.D., mentor/advisor.
  • Sabrina T. Wong, HS10004, University of California, San Francisco, Catherine L. Gilliss, D.N.Sc., R.N., mentor/advisor.

NRSA Fellowships

  • Arleen Brown, M.D., HS00132, University of California, Los Angeles, Carol Mangione, M.D., mentor/advisor.
  • Naresh Punjabi, M.D., HS00129, Johns Hopkins University, Jonathan Samet, M.D., mentor/advisor.

Select for overview of AHCPR Research Training Grants.

AHCPR funds new projects

The following research projects, small project grants, conference grants, and National Research Service Awards have been funded recently by the Agency for Health Care Policy and Research. Readers are reminded that findings usually are not available until a project ends or is nearing completion.

Research Projects

Acupuncture treatment of depression during pregnancy
Project director: Rachel Manber, Ph.D.
Organization: University of Arizona, Tucson, AZ
Project number: AHCPR grant HS09988
Project period: 9/30/98 to 9/29/01
First year funding: $333,769

Assimilation of information to support decisions
Project director: Francois Sainfort, Ph.D.
Organization: University of Wisconsin
Madison, WI
Project number: AHCPR grant HS09975
Project period: 9/30/98 to 9/29/00
First year funding: $137,000

Combining different data sources to assess treatments
Project director: Christopher Schmid, Ph.D.
Organization: New England Medical Center
Boston, MA
Project number: AHCPR grant HS10064
Project period: 9/30/98 to 9/29/01
First year funding: $197,003

Comparison of treatment efficacy for prostate cancer
Project director: Peter C. Albertsen, M.D.
Organization: University of Connecticut
Farmington, CT
Project number: AHCPR grant HS09578
Project period: 9/30/98 to 9/29/03
First year funding: $273,779

Cost-effectiveness analysis of surgery in epilepsy
Project director: John T. Langfitt, Ph.D.
Organization: University of Rochester
Rochester, NY
Project number: AHCPR grant HS09986
Project period: 9/30/98 to 9/29/02
First year funding: $150,852

Evaluating the efficacy of acupuncture for back pain
Project director: Daniel C. Cherkin, Ph.D.
Organization: Group Health Cooperative of Puget
Sound, Seattle, WA
Project number: AHCPR grant HS09989
Project period: 9/30/98 to 9/29/01
First year funding: $317,040

Evaluation of an adaptive patient data entry interface
Project director: David F. Lobach, M.D., Ph.D.
Organization: Duke University Medical Center
Durham, NC
Project number: AHCPR grant HS09706
Project period: 9/30/98 to 9/29/01
First year funding: $551,380

Geographic accessibility of health care in rural areas
Project director: Wilbert M. Gesler, Ph.D.
Organization: University of North Carolina
Chapel Hill, NC
Project number: AHCPR grant HS09624
Project period: 9/30/98 to 9/29/00
First year funding: $756,109

Impact of managed care organization policy on the quality of pediatric asthma care
Project director: Bruce Stuart, Ph.D.
Organization: University of Maryland
Baltimore, MD
Project number: AHCPR grant HS09950
Project period: 9/30/98 to 9/29/01
First year funding: $393,559

Improving primary care of African Americans with non-insulin-dependent diabetes mellitus
Project director: Lawrence S. Phillips, M.D.
Organization: Emory University
Atlanta, GA
Project number: AHCPR grant HS09722
Project period: 9/30/98 to 9/29/02
First year funding: $619,635

Maine lumbar spine study
Project director: Robert B. Keller, M.D.
Organization: Maine Medical Assessment
Foundation, Manchester, ME
Project number: AHCPR grant HS09804
Project period: 9/30/98 to 9/29/01
First year funding: $153,759

MAJIC, making advances against jaundice in infant care
Project director: R. Heather Palmer, M.D.
Organization: Harvard School of Public Health
Boston, MA
Project number: AHCPR grant HS09782
Project period: 5/1/98 to 4/30/03
First year funding: $92,305

Multi-method assessment of Medicaid managed care
Project director: Howard Waitzkin, M.D., Ph.D.
Organization: University of New Mexico
Albuquerque, NM
Project number: AHCPR grant HS09703
Project period: 9/30/98 to 9/29/01
First year funding: $479,855

Outcomes of increasing self-monitoring in an HMO
Project director: Stephen Soumerai, Sc.D.
Organization: Harvard Pilgrim Health Care
Brookline, MA
Project number: AHCPR grant HS10063
Project period: 9/30/98 to 9/29/01
First year funding: $275,863

Study of functional outcome after trauma in adolescents
Project director: Troy L. Holbrook, Ph.D.
Organization: University of California
San Diego, CA
Project number: AHCPR grant HS09707
Project period: 9/30/98 to 9/29/03
First year funding: $185,046

Surgical treatment outcomes project for dysfunctional uterine bleeding
Project director: Kay Dickersin, Ph.D.
Organization: Brown University
Providence, RI
Project number: AHCPR grant HS9506
Project period: 9/30/98 to 9/29/01
First year funding: $1,696,213

Use of quality report cards by patients, physicians, and managed care organizations
Project director: Dana B. Mukamel, Ph.D.
Organization: University of Rochester
Rochester, NY
Project number: AHCPR grant HS9803
Project period: 9/30/98 to 9/29/00
First year funding: $131,582

Using cancer registries to assess quality of cancer care
Project director: John Ayanian, M.D.
Organization: Harvard Medical School
Boston, MA
Project number: AHCPR grant HS09869
Project period: 9/30/98 to 9/29/01
First year funding: $414,323

Small Project Grants

Developing culturally and linguistically appropriate prenatal care
Project director: Virginia Gonzales, Ed.D.
Organization: University of Washington
Seattle, WA
Project number: AHCPR grant HS09836
Project period: 9/30/98 to 9/29/99
Funding: $62,057

Dissemination of a quit smoking program: 1-year followup
Project director: Clara Manfredi, Ph.D.
Organization: University of Illinois
Chicago, IL
Project number: AHCPR grant HS09837
Project period: 9/30/98 to 9/29/99
Funding: $84,526

Effectiveness of the NHLBI guide on childhood asthma
Project director: Philip V. Scribano, D.O.
Organization: Connecticut Children's Medical
Center, Hartford, CT
Project number: AHCPR grant HS09825
Project period: 9/30/98 to 9/29/00
First year funding: $37,167

Impact of dispatching nontraditional EMS resources
Project director: Terri Ann Schmidt, M.D.
Organization: Oregon Health Sciences University
Portland, OR
Project number: AHCPR grant HS09835
Project period: 9/30/98 to 9/29/99
Funding: $74,485

Measurement of homeless patients' satisfaction with care
Project director: Carol L. Macnee, Ph.D.
Organization: East Tennessee State University
Johnson City, TN
Project number: AHCPR grant HS09834
Project period: 9/30/98 to 9/29/99
Funding: $50,165

Medical decisions and advance care planning in the nursing home
Project director: Jiska Cohen-Mansfield, Ph.D.
Organization: Hebrew Home of Greater
Washington, Rockville, MD
Project number: AHCPR grant HS09833
Project period: 9/30/98 to 9/29/99
Funding: $81,000

More disease: How major a factor in higher utilization?
Project director: Michael Shwartz, Ph.D.
Organization: Boston University
Boston, MA
Project number: AHCPR grant HS09832
Project period: 9/30/98 to 9/29/99
Funding: $64,385

Nursing home outcomes as quality indicators
Project director: Mark A. Rudberg, M.D.
Organization: University of Chicago
Chicago, IL
Project number: AHCPR grant HS09827
Project period: 9/30/98 to 9/29/99
Funding: $75,406

Pilot feasibility study for heart failure surveillance
Project director: Robert J. Goldberg
Organization: University of Massachusetts
Worcester, MA
Project number: AHCPR grant HS09830
Project period: 9/30/98 to 3/31/00
Funding: $77,367

Predictors of quality care in California nursing homes
Project director: Mary E. Dellefield, M.S.
Organization: University of California
Los Angeles, CA
Project number: AHCPR grant HS10022
Project period: 9/30/98 to 3/31/99
First year funding: $14,431

Validation of a disease-specific health status instrument
Project director: Michael G. Stewart, M.D.
Organization: Baylor College of Medicine
Houston, TX
Project number: AHCPR grant HS09829
Project period: 9/30/98 to 9/29/00
First year funding: $39,960

Conference Grants

Enhancing patient safety and reducing errors conference
Project director: Martin J. Hatlie, J.D.
Organization: National Patient Safety Foundation
Chicago, IL
Project number: AHCPR grant HS09840
Project period: 9/30/98 to 9/29/99
Funding: $49,900

Improving health outcomes in diverse populations
Project director: Barbara Tilley, Ph.D.
Organization: Case Western Reserve University
Detroit, MI
Project number: AHCPR grant HS09824
Project period: 9/1/98 to 2/28/99
Funding: $43,500

Key aspects of preventing and managing chronic illness
Project director: Sandra G. Funk, Ph.D.
Organization: University of North Carolina
Chapel Hill, NC
Project number: AHCPR grant HS09839
Project period: 9/30/98 to 9/29/99
Funding: $25,000

Making analysis more relevant to decisionmakers
Project director: Sanford J. Schwartz, M.D.
Organization: University of Pennsylvania
Philadelphia, PA
Project number: AHCPR grant HS09841
Project period: 9/22/98 to 9/21/99
Funding: $31,000

Seventh conference of health survey methods
Project director: Diane P. O'Rourke, M.A.
Organization: University of Illinois
Chicago, IL
Project number: AHCPR grant HS09842
Project period: 9/30/98 to 9/29/99
First year funding: $49,600

National Research Service Awards

NRSA institutional training grant
Project director: Peter P. Budetti, J.D., M.D.
Organization: Northwestern University
Evanston, IL
Project number: AHCPR grant HS00078
Project period: 7/1/98 to 6/30/03
First year funding: $125,943

Unmet needs in Medicare beneficiaries with diabetes
Project director: Arleen F. Brown, M.D.
Organization: University of California
Los Angeles, CA
Project number: NRSA fellowship F32 HS00132;
Carol Mangione, M.D., sponsor
Project period: 3-year fellowship
First year funding: $35,476

Validation of a screening instrument for sleep apnea
Project director: Naresh M. Punjabi, M.D.
Organization: Johns Hopkins University
Baltimore, MD
Project number:: NRSA fellowship F32 HS00129;
Jonathan Samet, M.D., sponsor
Project period: 1-year fellowship
Funding: $37,012

AHSR issues call for abstracts

The Association for Health Services Research (AHSR) has issued a call for abstracts for papers, posters, and panels to be presented at its 16th annual meeting, June 27-29, 1999, in Chicago, IL. The deadline for submissions is January 15, 1999, and selections and notifications will be made by March 24, 1999.

Abstracts in response to the call for papers should focus on one of the following ten themes:

  • Access to care.
  • Health coverage.
  • Lessons from abroad.
  • Long-term care.
  • Managed care and markets.
  • Medicare.
  • Organization/management.
  • Quality/outcomes.
  • Social determinants.
  • Workforce/training.

From the abstracts submitted on each theme, one to three 90-minute sessions will be formed with three papers presented in each session.

Panel proposals are not theme-related, and researchers may collaborate with colleagues to submit a proposal on any health services research topic for consideration for a full 90-minute session. The call for posters also is not theme-related. Two poster sessions with noncompeting activities will be scheduled.

All abstract submissions undergo a blind peer review. All abstracts selected for a session or poster presentation will be included in the abstract book and on AHSR's Web site.

Visit AHSR's Web site at for more information, including detailed instructions on abstract submission. You can also contact Diane Rowland, Sc.D., Conference Chair, AHSR, 1130 Connecticut Avenue, N.W., Suite 700, Washington, DC 20036; phone (202) 223-2477.

Deadline extended to February 1 for methodology abstracts

The Seventh Conference on Health Survey Research Methods, sponsored by the Agency for Health Care Policy and Research, is planned for fall 1999. The organizers of the conference have extended the call for abstracts from December 4, 1998, to February 1, 1999. They are particularly interested in abstracts for both original studies and overview papers that discuss new and innovative survey research methods and their application to health-related issues.

Select for more information or call (217) 333-4273.

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Research Briefs

Alonso, J., Black, C., Norregaard, J-C, and others (1998). "Cross-cultural differences in the reporting of global functional capacity: An example of cataract patients." (HS07085). Medical Care 36(6), pp. 868-878.

International comparisons of patient-based health outcomes should not rely on single-item indicators until there is convincing evidence of their cross-cultural equivalence, concludes this study. The authors used the International Study of Outcomes of Cataract Surgery to examine the validity of using a single-item global measure of vision-related functional capacity across international settings. They used a universally accepted clinical measure of visual impairment (visual acuity) assessed by the patient's ophthalmologist and self-assessment of visual function in first-time cataract surgery patients in the United States, Canada, Denmark, and Spain. Patients from Canada and Spain with similar visual acuity were less likely to report a great deal of trouble with their vision than comparable Danish and U.S. patients. This international variation was not explained by clinical or sociodemographic factors, possibly because of cultural differences. No such differences were found among the U.S. patients from three sites.

Barak, N., Margolis, C.Z., and Gottlieb, L.K. (1998, September). "Text-to-algorithm conversion to facilitate comparison of competing clinical guidelines." Medical Decision Making 18, pp. 304-310.

A central problem in developing methods for comparing competing guidelines to pinpoint differences between those that address the same clinical condition is that most guidelines are written in prose. The goal of this study was to test the usefulness and reliability of text-to-algorithm conversion in comparing measles immunization guidelines published in 1989 and 1994. The researchers detected five categories of differences: recommendations, excluded elements, logical inconsistencies, nonspecific phrases, and approaches to contraindications. On a scale of 1 to 10 (where identical = 10), the guidelines published in 1989 were 6.01 and those published in 1994 were 5.54. In addition, text-to-algorithm conversions performed by three different people on the 1989 guidelines were compared and found similar. The authors conclude that text-to-algorithm conversion is an important step in facilitating comparison of competing guidelines.

Freiman, M.P. (1998, October). "The demand for health care among racial/ethnic sub-populations." Health Services Research 33(4), pp. 867-890.

Hispanics tend to spend less on health care compared with blacks and whites, who spend about the same. Ethnic differences in health care use and expenditures are due to more than race alone. A complex set of interactions between the health care system and people of different racial/ethnic backgrounds drives these differences, according to Marc P. Freiman, Ph.D., formerly of the Agency for Health Care Policy and Research. For example, HMOs have a greater positive impact on the use of health care for blacks and Hispanics than for whites. Dr. Freiman notes that more detailed institutional analyses are needed to reveal which specific factors associated with HMOs help overcome the barriers to care faced by members of these two minority groups. Geographic area also plays a role; this analysis revealed that Hispanics living in the West spend more on health care than Hispanics living in other areas of the country, perhaps because they have greater access to care in the West, where significantly more Hispanics live. Whites generally responded more to price and demand-related variables such as the physician fee index and average county income. These findings are based on data from the 1987 National Medical Expenditure Survey, a nationally representative sample of the U.S. population. Reprints (AHCPR Publication No. 99-R006) are available from the AHCPR Publications Clearinghouse.

McIlvain, H., Crabtree, B., Medder, J., and others (1998, July). "Using practice genograms to understand and describe practice configurations." (HS08776). Family Medicine 30(7), pp. 490-496.

The proliferation of clinical practice guidelines, decreased numbers of small, independent practices, and growth of managed care are pressuring physicians to change and adjust to change. However, the same interventions to promote change don't work for all physicians or practices. These authors developed a tool, loosely based on the family genogram (a diagram used to map family relationships and interactions), that can be used to identify patterns of interaction within a practice, which in turn may suggest avenues for positive change. Using this model, the researchers developed a practice genogram to keep track of the individuals involved in eight Nebraska family practices and their formal and informal relationships with each other. They found that practice genograms provided a more dynamic, relational model than the organizational chart and promoted identification of relationship strengths and weaknesses within a practice. The researchers conclude that use of the practice genogram enhanced data gathering, increased understanding of the complexity of practices as adaptive systems, and increased understanding of current and potential approaches to changing practices.

Normand, S-L. T., McNeil, B.J., Peterson, L., and Palmer, R.H. (1998). "Eliciting expert opinion using the Delphi technique: Identifying performance indicators for cardiovascular disease." (HS09487). International Journal for Quality in Health Care 10(3), pp. 247-260.

In attempts to define quality of care in medicine, opinion is typically elicited from panels of experts regarding the appropriateness or importance of medical treatment for well-defined clinical conditions. This method was pioneered in the 1950s and 1960s by RAND Corporation as a means of forecasting developments in technology, but it has been criticized because of its failure to include a consumer perspective.

The article described here presents a refinement of the RAND methodology. It describes how to use the panel process to elicit information from diverse panels of experts and consumers and combine the data in order to create a standard or performance measure of care. The authors used the data from five distinct panels convened as part of the Harvard Q-SPAN-CD study, a nationally funded project whose goal is to identify a set of cardiovascular-related performance measures. They combined the opinions of "experts" representing five perspectives: consumers, purchasers, regulators, and physicians within participating health plans, as well as physicians independent of the participating health plans.

Spector, W.D., and Mukamel, D.B. (1998). "Using outcomes to make inferences about nursing home quality." Evaluation and the Health Professions 21(3), pp. 291-315.

William D. Spector, Ph.D., of the Agency for Health Care Policy and Research's Center for Organizational and Delivery Studies, and Dana B. Mukamel, Ph.D., of the University of Rochester, discuss why it is difficult to develop facility-level outcome measures that can be used to evaluate and compare the quality of care in nursing homes. They place outcomes measures in the context of historical policy and review important conceptual and methodological issues associated with outcome-based quality assessment. They also discuss such topics as the difficulty of isolating the facility effect when studying nursing home outcomes and the implications of using different estimation approaches. The authors recommend the integration of research with outcome-based quality assurance systems to allow ongoing evaluation and quality improvement in nursing homes. Reprints (AHCPR Publication No. 98-R083) are available from the AHCPR Publications Clearinghouse.

AHCPR Publication No. 99-0010
Current as of December 1998

The information on this page is archived and provided for reference purposes only.


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