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Summer 2013

Events at CHPR:

CHPR Open House
June 20, 2013
4:00pm to 6:00pm

Outcomes Research
Brown Bag Discussions

Every 2nd and 4th Mondays
Noon to 1:00pm

Other CHPR Events:

CHPR Health Services Research Seminar
Every Wednesday
Noon to 1:00pm
Location varies: Contact Coleen Cameron at to receive updates.


New Funding:

Quality, Safety and Comparative Effectiveness Research Training Program (T32)
Funding Agency: AHRQ
Funding Amount: $2,001,732
Co-PIs: Joy Melnikow, MD, MPH and Patrick S. Romano, MD, MPH

Sacramento Taking Action Against Nicotine Dependence on Community College Campuses
Funding Agency: UCOP
Funding Amount: $239,860
PI: Elisa Tong, MD, MA

Development of Ambulatory Care Outcome Measures
Funding Agency: CMS (Subcontract with Yale University)
Funding Amount: $18.920
PI: Patrick S. Romano, MD, MPH

Innovation Evaluation Center
Funding Agency: UCOP
Funding Amount: $92,940
PI: Patrick S. Romano, MD, MPH

N-of-1 Trials Using mHealth in Chronic Pain
Funding Agency: NIH
Funding Amount: $3,905,813
PI: Richard L. Kravitz, MD, MSPH

Use of administrative data to develop and validate a set of nurse sensitive measures in patients with stroke
Funding Agency: Neuroscience Nursing Foundation
Funding Amount: $10,000
PI: Patricia Zrelak, Ph.D., C.N.R.N., C.N.A.A., B.C.

Acting to Reduce Variations in Utilization: Advance Care Planning for Heart Failure
Funding Agency: CHF/UCLA
Funding Amount: $42,181
PI: Patrick S. Romano, MD, MPH

Provider Training to Support Patient Self-efficacy for Depression Care
Funding Agency: NIH
Funding Amount: $698,602
PI: Anthony F. Jerant, MD

Promoting Patient-centered Counseling to Reduce Inappropriate Diagnostic Tests
Funding Agency: PCORI
Funding Amount: $687,729
PI: Joshua Fenton, MD, MPH

Exploring Disparities: Urinary incontinence Treatment Seeking in Mid-life Women
Funding Agency: NIH
Funding Amount: $418,168
PI: Elaine Waetjen, MD



Center for Healthcare Policy and Research to Hold Open House on June 20, 2013

The CHPR will be holding its second Open House on June 20, 2013, between 4:00 and 6:00pm.

If you are interested in learning more about the Center and the work that we do, this is your opportunity.

Join us for hors d'oeuvres and beverages, and a tour of our newly expanded department. To learn more, or to RSVP to this exclusive event, please visit the registration page, located HERE.


T32 Outcomes Research Fellowship to be Led by Melnikow, Romano

The CHPR has received an award notice for $2 million in funding from the US Agency for Healthcare Research and Quality (AHRQ) for the purpose of training postdoctoral fellows in outcomes research.

The program, called the Quality, Safety, and Comparative Effectiveness Research Training Program (QSCERT), will fund the training of three fellows per year, over a five-year period and will be led by CHPR Director Joy Melnikow (left) and CHPR Investigator and Executive Committee Member Patrick Romano.

Applications have been received for the first recruiting period and are currently under review.


CHPR Expands to Accommodate $8.3M in New Funding

UC Davis researchers affiliated with the Center for Healthcare Policy and Research (CHPR) have recently been awarded new funding for multiple projects totaling more than $8M.

All project proposals were prepared by the CHPR in conjunction with the Principal Investigators and their research collaborators, and all are being administered and housed at the Center for Healthcare Policy and research.

To accommodate new projects, the CHPR has expanded to the first floor of the Grange Building, located at 2103 Stockton Blvd, in Sacramento. Also hosted at the Grange is a research project entitled "Cognition and Nutrition Across Adulthood," headed by Lisa Miller of the UC Davis Department of Human Development.


Outcomes Research Brown Bag Sessions

The Center has recently begun hosting brown bag sessions on patient-centered outcomes research. The sessions take place every second and fourth Monday at noon in the downstairs conference room at the Grange building (see map).

If you have an interest in learning more about patient-centered outcomes research or want to discuss a research idea, you are welcome to attend these sessions, led by CHPR Director Joy Melnikow and Daniel J. Tancredi.

If you would like to be added to our outcomes research special interest mailing list, please contact Laura Sterner at The mailing list receives announcements of upcoming sessions and other occasional mailings of possible general interest to researchers.

Conference: Surgical and Trauma Outcomes Research: Current Status and Future Directions

The UC Davis Center for Healthcare Policy and Research, Department of Surgery and Department of Emergency Medicine jointly sponsored a conference in focusing on the current and future trends in surgical and trauma outcomes research.

The conference featured nationally recognized speakers and was well attended, with positive evaluations from the attendees.

Guest presentations at the conference included :

"Trauma Care: From Practice to Policy"
Avery B. Nathens, MD, PhD
Surgeon in Chief, Professor of Surgery
University of Toronto
Canada Research Chair, Systems of Trauma Care

"Making Trauma Data Actionable"
N. Clay Mann, PhD, MS

Professor of Pediatrics, Associate Adjunct Professor of Family and Preventive Medicine
University of Utah School of Medicine
Director of Research, Intermountain Injury Control Research Center

"Outcome Disparities in Trauma Care: Who, Why, When?"
Edward E. Cornwell III, MD, FACS, FCCM

Surgeon-in-Chief, Howard University Hospital
Chair of the Department of Surgery
Howard University College of Medicine

"Surgical Outcomes Research: A View From Outside Trauma"
Justin B. Dimick, MD, MPH

Associate Professor of Surgery
Chief, Division of Minimally Invasive Surgery
University of Michigan Department of Surgery

Presentation slides are available at


Health Differences Explain Most Differences in Geographic Variation in Medicare Costs

Wide geographic variation in Medicare costs is largely explained by health differences across communities rather than inefficient care delivery, according to a study published online today in the SAGE journal Medical Care Research and Review.

Patrick Romano (left) of the UC Davis Center for Healthcare Policy and Research Previous research found that Medicare could reduce spending by as much as 30 percent without harming health if all providers adopted treatment patterns found in low-cost areas, but today's study calls into question how well these analyses accounted for differences in Medicare beneficiaries' health status.

James Reschovsky of the Center for Studying Health System Change, together with Jack Hadley of George Mason University and Patrick Romano of the UC Davis Center for Healthcare Policy and Research, examined multiple ways of adjusting for patient health. They found that a broader accounting of health status explained at least 75 percent to 85 percent of Medicare geographic cost differences between high- and low-cost areas.

"Geographic variation research has been used to argue that there is considerable waste and inefficiency in the delivery of health care. We do not question this conclusion, but caution that inefficiencies in American health care may not be nearly as strongly related to geography as the Dartmouth Atlas of Healthcare and others have suggested. ...Although data limitations may preclude ever developing the perfect casemix adjustment approach, our results suggest that the portion of the geographic variation that can be explained by patient health is much greater than previously estimated, leaving less of the geographic variation potentially attributable to inefficiency," the article states. (read more)

"We are not challenging the fundamental notion that there is practice variation... we are only questioning the proper "unit of analysis" to understand that practice variation.

We think it is more condition-specific and procedure-specific variation (and that it is more apparent at the physician, medical group, or hospital level) than a global pattern of high-spending areas and low-spending areas.

In other words, if you moved Mayo to Louisiana, it might not look quite so efficient, because people are sicker in Louisiana than they are in Minnesota."

- Patrick S. Romano, MD, MPH


CHPR Grants Team Receives STAR Awards

The members of the CHPR Grants Team were honored to receive awards under the UC Davis Staff Appreciation and Recognition (STAR) Program for their work to assist center members in preparation of grants proposals. Several of these proposals resulted in awards with funding totaling more than $8 million.

Certificates were presented to Colleen Cameron, Carolyn Coleman, and Laura Bates Sterner during a recent staff meeting. Congratulations to these staff members for their outstanding work in bringing important research funding to the Center and UC Davis.

CHPR Director Melnikow Receives UC Davis Distinguished Scholarly Public Service Award

Joy Melnikow, Director of the CHPR and Professor in the deparment of Family and Community Medicine was chosen to receive one of four 2013 Academic Senate Distinguished Scholarly Public Service Awards. The awards were bestowed during a ceremony held on May 14, 2013, in the Activities and Recreation Center Ballroom on the Davis Campus.

The three other honorees were John Eadie, Wildlife, Fish and Conservation Biology; Scott Fishman, Anesthesiology and Pain Medicine; and Jay Lund, Civil and Environmental Engineering.


Zrelak Honored by AANN, wins NNF Research Grant

Patricia Zrelak, Administrative Nurse Researcher with the UC Davis Center for Healthcare Policy and Research, was selected to receive the 2013 Excellence in Clinical Practice Award from the American Association of Neuroscience Nurses (AANN). The award was presented on March 11, 2013 at the AANN annual meeting in Charlotte, NC.

She has also been awarded $10,000 from the Neuroscience Nursing Foundation for her research proposal entitled "Use of administrative data to develop and validate a set of nurse sensitive measures in patients with stroke."

In addition to her role with the CHPR, Dr. Zrelak is the administrative nurse for the UC Davis Stroke Program and is a Certified Neuroscience REgistered Nurse with Research interests in stroke and dementia.

Fenton Receives Joan Oettinger Memorial Award for Cancer Research

Joshua Fenton, a UC Davis associate professor of family and community medicine, is the recipient of the UC Davis School of Medicine's 2013 Joan Oettinger Memorial Award for his research in cancer screening and prevention and his dedication to improving the quality of health-care services.

Fenton's research focuses on enhancing the value and efficiency of primary-care services, including screening tests for breast and colorectal cancer. His most recent study showed that computer-aided detection a costly and widely used mammography technology finds some breast cancers better than mammography alone, however it also significantly expands false alarms and treatments for an early form of cancer that may never progress. Fenton's work on breast cancer screening has been published in major medical journals, including the New England Journal of Medicine and the Annals of Internal Medicine.

"Dr. Fenton's work is helping us determine if the use of certain health-care technologies necessarily leads to better patient care," said Klea Bertakis, chair of the UC Davis Department of Family and Community Medicine. "He is having a major national impact on the importance of relying on evidence-based medicine to guide treatment decisions." (read more)


"Coaching Boys into Men" One of Top Ten Violence Prevention Research Articles of 2012

The Journal "Psychology of Violence" has selected "Coaching boys into men": a cluster-randomized controlled trial of a dating violence prevention program" to include in its list of best violence provention research articles of 2012.

The influential study, which tested a school athletics-based dating violence prevention program, was headed by Elizabeth Miller of the Children's Hospital of Pittsburgh. the study was begun while Miller was at UC Davis. The study findings support the assertion that dating violence can be reduced through use of school athletics-based programs.

Several CHPR members and staff were involved in fieldwork and analysis, including co-authors Daniel J. Tancredi, a professor-in-residence with the UC Davis department of Pediatrics and CHPR Executive Committee member, and project manager M. Catrina Virata.


University of California, Davis
Center for Healthcare Policy and Research
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