Clinical and Economic Evaluation
The Clinical and Economic Evaluation Program in the Mayo Clinic Kern Center for the Science of Health Care Delivery advances understanding of the clinical and economic effectiveness of diverse health care interventions, including care delivery models. The program team specializes in the comparative effectiveness research necessary to support the current practice and advance evidence-based implementation of practice transformation.
In today's health care landscape, measuring health outcomes alone is not enough to demonstrate the value of an intervention. Researchers also must prove that the expected benefits of a new medicine, diagnostic test or any other health intervention are worth the costs.
To do so, they conduct formal health economic evaluations, which are a group of analytic methods that quantify and compare the clinical effectiveness indicators — prevented disability, improved quality of life, and so on — and cost-effectiveness of medical interventions.
Areas of focus
- Comparative effectiveness research. The program team evaluates new therapies or other medical interventions, comparing them against the standard of care in terms of efficacy and safety outcomes.
- Economic evaluation. Program researchers and analysts identify and assess health care utilization and costs. They also use simulation modeling to conduct formal cost-effectiveness analyses.
- Methodological innovations. Team members possess both the knowledge and the skills required to develop and implement cutting-edge statistical, econometric and data science models. Deploying these advanced models helps minimize biases in observational comparative effectiveness research.
In addition to partnering with researchers from Mayo Clinic, the Clinical and Economic Evaluation Program has established relationships with external collaborators from academia and across the health care industry.
Examples of how the Clinical and Economic Evaluation Program enhances research across the continuum of health care include:
- Analyses using simulation models based solely on information from scholarly literature, publicly available data sources or both.
- Economic evaluations alongside prospective clinical trials.
- Retrospective validation and tokenization of prior randomized clinical trials.
- Retrospective and prospective observational studies.
Services provided by the Clinical and Economic Evaluation Program are typically available as a charge-out resource for researchers from all areas of health care and health care delivery, both within and external to Mayo Clinic.
Begin by reviewing the program's pre-consultation checklist. Then email Mayo Clinic's Clinical and Economic Evaluation Program at email@example.com to request a consultation.
Read about key projects below, or review publications on PubMed resulting from the team's efforts.
Cost Data Warehouse
The Cost Data Warehouse (must be logged in to the Mayo Clinic network) helps Mayo Clinic researchers standardize the way they identify, calculate and report costs of different practice innovations. It uses Medicare fee schedules and cost reports as a baseline. The underlying algorithm adjusts for inflation, making it continuously relevant down to the service-line level.
Using standardized costs prevents inadvertent release of business-sensitive information, while saving substantial effort for researchers who would otherwise need to create new data for each project.
Mayo Clinic has developed a teleneonatology program to bring neonatology expertise to the bedside of any newborn in need of critical care, regardless of birth location. This innovative program allows neonatologists to immediately advise care teams in community hospitals using a real-time audio-video telemedicine connection. The Clinical and Economic Evaluation Program contributed to this initiative by assessing its cost-effectiveness.
The teleneonatology program allows Mayo Clinic to bridge the gaps in care often found in rural or other underserved communities.
Many patients proceed to elective surgery with significant untreated anemia. This can raise the risk of the need for a blood transfusion from a donor, also called an allogeneic transfusion, during surgery. Such transfusions carry additional risks. Previously, Mayo Clinic did not have a formal program for preoperative anemia evaluation and treatment.
A multidisciplinary team from the Mayo Clinic Kern Center for the Science of Health Care Delivery worked with Mayo Clinic's Patient Blood Management Program team to pilot and evaluate a preoperative anemia clinic. This work included economic analysis by the Clinical and Economic Evaluation Program.
The pilot clinic evaluated, diagnosed and treated anemia in adult patients who were scheduled for elective cardiac surgery. Its goals were to correct anemia, reduce the use of perioperative transfusions and improve patient outcomes.
Patient-reported outcomes showed improved hemoglobin levels and satisfaction with the process, and the associated economic analysis indicated that the intervention is cost neutral. As a result, the pilot led to implementation across a variety of surgical specialities.
Telehealth cancer care
In another collaborative project, team members from the Clinical and Economic Evaluation Program are working to accelerate development, implementation and evaluation of virtual care, telehealth and artificial intelligence-enabled solutions for Mayo Clinic Comprehensive Cancer Center.
- Fisher DA, Saoud L, Hassmiller Lich K, Fendrick AM, Ozbay AB, Borah BJ, Matney M, Parton M, Limburg PJ. Impact of screening and follow-up colonoscopy adenoma sensitivity on colorectal cancer screening outcomes in the CRC-AIM microsimulation model. Cancer Medicine. 2021; doi:10.1002/cam4.3662.
- Longacre CF, Nyman JA, Visscher SL, Borah BJ, Cheville AL. Cost-effectiveness of the Collaborative Care to Preserve Performance in Cancer (COPE) trial tele-rehabilitation interventions for patients with advanced cancers. Cancer Medicine. 2020; doi:10.1002/cam4.2837.
- Piscitello A, Saoud L, Fendrick AM, Borah BJ, Hassmiller Lich K, Matney M, Ozbay AB, Parton M, Limburg PJ. Estimating the impact of differential adherence on the comparative effectiveness of stool-based colorectal cancer screening using the CRC-AIM microsimulation model. PLOS One. 2020; doi:10.1371/journal.pone.0244431.
- Pritchett JC, Borah BJ, Desai AP, Xie Z, Saliba AN, Leventakos K, Coffey JD, Pearson KK, Speicher LL, Orenstein R, Virk A, Ganesh R, Paludo J, Halfdanarson TR, Haddad TC. Association of a remote patient monitoring (RPM) program with reduced hospitalizations in cancer patients with COVID-19. JCO Oncology Practice. 2021; doi:10.1200/OP.21.00307.
- Bijan J. Borah, Ph.D.
- Robert D. and Patricia E. Kern Scientific Director for Clinical and Economic Evaluation
- Email: firstname.lastname@example.org