Rodney A. Hayward, M.D.
Professor, Department of Internal Medicine and Department of Health Management and Policy, University of Michigan School of Public Health; Director, VA Center for Practice Management and Outcomes Research; Co-Director, RWJ Clinical Scholars Program

Epidemiological Malpractice: How Biomedical "Experts" Systematically MisInform Healthcare Policy"

September 8, 2006
12:00-1:30 PM
Colonial Penn Center Auditorium

Abstract Paper
Slides

Biosketch:
Rod Hayward is the Director of the VA Ann Arbor Health Services Research & Development (HSR&D) Center of Excellence, and is a Professor of Public Health and Internal Medicine at the University of Michigan. He received his training in health services research and policy as a Robert Wood Johnson Clinical Scholar at UCLA and at the RAND Corporation, Santa Monica. His current and past work includes studies examining measurement of quality, costs and health status, environmental and educational factors affecting physician practice patterns, quality improvement, and physician decision making. An overarching theme of his work focuses on encouraging improvements in healthcare quality and efficiency through more sophisticated benefit structures and market incentives. He is perhaps best known for his work on statistical nuances in risk/benefit stratification, in assessing preventable adverse events and in performance profiling, but much of his recent work has focused on fundamental discrepancies between the epidemiological literature and current healthcare market incentives.


Abstract:
Many proponents of the evidence-based medicine (EBM) movement proposed that relying more heavily on randomized clinical trials would result in more efficient and effective medical care. However, 15 years into this seemingly successful "revolution" we find healthcare costs continuing to spiral out-of-control and little to no association with how much is spent on healthcare and health outcomes.

In this talk, Rod Hayward will argue that there is a fundamental problem that must be addressed if we are to make substantial progress in improving the efficiency of healthcare -- we need to improve the accuracy of the epidemiological evidence that helps inform healthcare policy. In particular, the conventional analysis and reporting of RCT's is designed to over-estimate the benefits and under-estimate the costs of medical interventions. Using evidence from recent national guidelines, FDA decisions and national performance standards (such as new NCQA standards), he will demonstrate how biomedical "experts" are systematically misinforming the national healthcare policy debate. He will discuss policy changes that could substantially improve the accuracy of the scientific information that influences healthcare policy.


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