For the past twenty-nine years, I have followed my passion as a general internist and a decision scientist, first as an active member of the Division of Clinical Decision Making at the New England Medical Center (1984-1999) and more recently as Director of the Center for Clinical Effectiveness in the Institute for the Study of Health at the University of Cincinnati Medical Center (1999 – present). As both a researcher and a clinician, this environment has supported my interests in combining both clinical and theoretic applications of decision analysis to the care of individual patients and to broader issues of health policy. In particular my methodological interests have included the development of patient-specific decision support tools, cost-effectiveness analysis, and the continued study and development of new decision analytic methods.
In terms of decision analytic application areas, my interests also extend to more generic issues of health policy planning and cost-effectiveness analyses, attempting to use quantitative methods to help make decisions about the allocation of increasingly scarce health care resources. I also have maintained a special interest in the decision analytic issues surrounding anticoagulation therapy within a variety of clinical situations, including atrial fibrillation, venous thromboembolism, and thrombophilic states.
Within our institution in particular and the profession in general, I am also deeply committed to pursuing the continued development and application of computational and information technologies to the practice of medicine and medical education. I believe that the challenges we encounter as both clinicians treating individual patients and as administrators managing and leading systems of care, provide the most fertile soil for interesting research and innovative problem solving. The model we are striving to create in our Center for Clinical Effectiveness is one that balances a portfolio of research projects that on the one hand address the operational and strategic needs of our own institution, but also utilize these real-world challenges and investigations as the nidus for more scholarly work.