Evidence-based Practice Center
The Duke University Center for Clinical Health Policy Research (CCHPR) focuses on:
- Evaluating scientific evidence in order to determine best clinical practice.
- Determining current practice patterns.
- Designing pragmatic intervention programs to help change current practice into best practice.
With respect to evaluating evidence, CCHPR faculty led investigations into diagnostic testing for carotid artery
stenosis; efficacy of antiplatelet and anticoagulant agents for stroke prevention; evaluation of history and physical
exam for diagnosis of acute headache; and efficacy of drug, behavioral, and physical treatments for migraine and
tension-type headache. CCHPR faculty also evaluated current clinical practice using survey methods and medical
record abstraction in the areas of stroke prevention (carotid endarterectomy and anticoagulation). Currently,
CCHPR is coordinating a pragmatic intervention trial of organized anticoagulation management services to deliver
warfarin anticoagulation for stroke prevention: the Managing Anticoagulation Services Trial (MAST).
Health Economics Research, Inc. (HER) is a collaborating partner in the Evidence-based Practice Center
(EPC), bringing strength in examining claims databases for information on cost, utilization, and practice variation.
HER has experience on the Stroke Rehabilitation Clinical Practice Guideline (supported by the Agency for Health Care Policy and Research), and it collaborated
with CCHPR on the Stroke Prevention Patient Outcomes Research Team (PORT).
The core EPC staff from Duke University and HER have expertise in a full range of activities which includes
epidemiology, biostatistics, meta-analysis, decision analysis, cost and cost-effectiveness analysis, economic
analysis, health services research, health policy analysis, technical or scientific writing and editing, and in designing
and conducting literature searches.
The EPC team is particularly strong in methodological areas, and many individual members are clinically active and
have special areas of clinical expertise.
The current list of core EPC faculty and their areas of expertise and interests follows:
Paul Abrahamse, M.A., Duke, research assistant; Stuart Cohen, Ed.D., Wake Forest University, guideline
implementation; Santanu Datta, M.S., Duke, health economics; Ruth E. Goslin, MAT, Duke, medical writing and
editing; Rebecca N. Gray, D.Phil., Duke, research management, writing and editing; Victor Hasselblad, Ph.D.,
Duke, use of meta-analysis in support of clinical guidelines; Jane T. Kolimaga, M.A., Duke, research management;
David Lobach, M.D., Ph.D., M.S., Duke, medical informatics; David B. Matchar, M.D., Co-Director, Duke,
consensus development methods measurement of appropriateness of care and physician opinion decision analysis
cost-effectiveness analysis; Janet Mitchell, Ph.D.,HER, health economics, in particular, cost and health policy analysis related to
clinical guidelines and health programs.
In addition to the CCHPR and HER core faculty, formal relationships exist with senior faculty
throughout Duke University's Medical Center and academic departments to facilitate the timely availability
of clinical and research personnel. The expertise of this "extended faculty" includes adult health,
geriatrics, preventive medicine, women's health, mental health, and substance abuse.
For the first EPC evaluation of abnormal cervical cytology, additional collaborators providing clinical expertise are:
Lori Bastian, M.D., M.P.H., Durham Veterans Administration Medical Center, and the Duke Department of
General Internal Medicine; Evan Myers, M.D., M.P.H., Duke Department of Obstetrics and Gynecology, and
Kavita Nanda, M.D., Durham Veterans Administration Medical Center.
John W. Williams Jr., M.D.
Professor of Medicine & Psychiatry
Scientific Editor, NC Medical Journal
Duke University and Durham VA Medical Center
2424 Erwin Road
Suite 1105, Hock Plaza
Durham, NC 27705
Phone: (919) 668-0300
Fax: (919) 668-1300
Duke University and Health Economics Research, Inc., Evidence-based Practice Center. Profile, March 2008. Agency for Health Care Policy and Research, Rockville, MD. http://www.ahrq.gov/clinic/epc/dukeepc.htm