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R. Scott Braithwaite, M.D., M.Sc.
Associate Professor of Internal Medicine
New York University School of Medicine
Scott.braithwaite@nyumc.org
2007-2010 Cohort
Project Title:  "Can We Tailor Clinical Guidelines to the Comorbidity Profiles of Patients?"




About the Project:

This project asked the question, how do physicians adapt clinical guidelines to patients with shortened life expectancies due to comorbidities, in order to ensure that they are not harmed?  Using the concept of "payoff time", the project aimed to apply a new method of tailoring clinical guidelines to comorbidities, to other USPTF guidelines and comorbidities, and test the method’s feasibility at the point of care using the Veterans Affairs Medical System electronic medical records.

Biosketch:

R. Scott Braithwaite, M.D., M.Sc., F.A.C.P. is Chief of the newly created Section of Value and Comparative Effectiveness in the Division of General Internal Medicine at NYU School of Medicine. Dr. Braithwaite received his Bachelor’s Degree in Physics from the Massachusetts Institute of Technology, received his M.D. degree from the State University of New York at Stony Brook, and trained in Internal Medicine at the University of Washington. He completed a research fellowship in Decision Analysis and Medical Decision Making at Tufts University, and received a Masters Degree in Clinical Research at the University of Pittsburgh. He is active in the Society for Medical Decision Making, currently serving as Trustee, and chairing the scientific review committee in previous years. Dr. Braithwaite occupies an exciting niche at the intersection of health services research and the decision sciences. Simply put, he uses a variety of research tools to estimate the benefit that health care is delivering so we can get more "bang" from our health care "buck." This is a particularly important concern for the United States health care system, which spends far more money on health care per-capita than any other country, yet delivers benefits that are often modest and unevenly distributed.

His research project for the Physician Faculty Scholars Program was entitled "Tailoring Clinical Guidelines to Comorbidity," and addressed the problem that clinical guidelines (e.g., cancer screening tests) are increasingly applied across the entire patient spectrum including those who are unlikely to benefit because of serious co-existing illnesses. Dr. Braithwaite sought to develop objective decision rules that will help providers and payers know when to adapt clinical guidelines, and has the potential both to improve health care quality and to reduce unnecessary resource expenditures.

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