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Project Information

COMPARATIVE EFFECTIVENESS OF DABIGATRAN AND WARFARIN FOR STROKE PREVENTION IN ATR

Agency:
AHRQ

HHS/Agency for Healthcare Research and Quality

Project Number:
1K18HS021992-01
Contact PI / Project Leader:
VAUGHAN SARRAZIN, MARY S
Awardee Organization:
UNIVERSITY OF IOWA

Description

Abstract Text:
DESCRIPTION (provided by applicant): For more than 15 years I have worked to better define the cost and quality of healthcare through analysis of large administrative databases. I have worked as a principal investigator, mentor, and collaborator on a wide array of claims-based research projects exploring novel methods for risk adjustment, racial disparities, and health outcomes in the area of cardiovascular disease. This application describes my plan to expand my methodological skills related to patient-centered comparative effectiveness research by investigating outcomes and treatment of atrial fibrillation (AF). Compared to other cardiovascular conditions, research in AF is far less developed. In particular, there is a paucity of studies that have used administrative data to investigate AF treatment and outcomes in contemporary clinical practice. The Institute of Medicine has listed AF as one of the nation's top 25 comparative effectiveness research priorities. AF occurs when disturbances in cardiac electrical activity causes the heart to pump blood ineffectively, ultimately leading to fatigue, lower quality of life, and lower life expectancy. A particularly serious complication of AF is ischemic stroke. The risk of stroke may be lowered with anticoagulation therapy (e.g., warfarin), although the reduction in stroke risk is often accompanied by an increase in the risk of bleeding. In recent years new anticoagulation medications (dabigatran) have been introduced but the effectiveness of these new medications outside of clinical trials is relatively unknown. In this proposal I describe my plan to develop critical new expertise in patient-centered comparative effectiveness research and apply my skills to investigate the effectiveness of warfarin and dabigatran among Medicare beneficiaries with newly diagnosed AF. I will use a novel qualitative method to assess safety and effectiveness concerns regarding anticoagulation therapy posted by patients and families on internet discussion forums. I will then use administrative data to conduct rigorous statistical inquiry to address the effectiveness and adverse effects associated with anticoagulation by warfarin or dabigatran. I will be mentored by a team of experienced researchers with expertise in four critical areas: qualitative research methods, analysis of pharmacy claims data, adjustment for confounding in observational data, and clinical management of AF. PUBLIC HEALTH RELEVANCE: The proposal is designed to maximize opportunities for Dr. Mary Vaughan Sarrazin to develop skills for comparative effectiveness research (CER) while capitalizing on her 15-year experience conducting research with administrative data. The project will focus on the risks and benefits of anticoagulation therapy for preventing stroke in patients with atrial fibrillation. The study will use a novel approach to assess stakeholder concerns, which will then be addressed through administrative data using advanced statistical methods to address confounding. In total, this study will result in important findings regarding stroke prevention in AF, while advancing Dr. Vaughan Sarrazin's expertise in CER so that she may continue to conduct high quality research and support the growth of CER within the University of Iowa research community.
Project Terms:
Address; administrative database; Adverse effects; Anticoagulation; Area; Atrial Fibrillation; base; beneficiary; Benefits and Risks; blood pump; Cardiovascular Diseases; Cardiovascular system; Clinical Management; clinical practice; Clinical Trials; Communities; comparative effectiveness; Complication; cost; Data; Data Adjustments; design; Effectiveness; effectiveness research; experience; Family; Fatigue; Growth; health care quality; health disparity; Heart; heart electrical activity; Hemorrhage; Institute of Medicine (U.S.); Internet; Iowa; Ischemic Stroke; Life Expectancy; Medicare; Mentors; Methods; Newly Diagnosed; novel; novel strategies; Outcome; patient oriented; Patients; Pharmaceutical Preparations; Pharmacy facility; Principal Investigator; public health relevance; Qualitative Methods; Qualitative Research; Quality of life; Research; Research Methodology; Research Personnel; Research Priority; Research Project Grants; Research Support; Risk; Risk Adjustment; Safety; skills; Statistical Methods; stroke; Stroke prevention; Treatment outcome; Universities; Warfarin; Work

Details

Contact PI / Project Leader Information:
Name:  VAUGHAN SARRAZIN, MARY S
Other PI Information:
Not Applicable
Awardee Organization:
Name:  UNIVERSITY OF IOWA
City:  IOWA CITY    
Country:  UNITED STATES
Congressional District:
State Code:  IA
District:  02
Other Information:
Fiscal Year: 2012
Award Notice Date: 06-Sep-2012
DUNS Number: 062761671
Project Start Date: 06-Sep-2012
Budget Start Date: 06-Sep-2012
CFDA Code: 226
Project End Date: 31-Aug-2014
Budget End Date: 31-Aug-2013
Agency: ?

Agency: The entity responsible for the administering of a research grant, project, or contract. This may represent a federal department, agency, or sub-agency (institute or center). Details on agencies in Federal RePORTER can be found in the FAQ page.

HHS/Agency for Healthcare Research and Quality
Project Funding Information for 2012:
Year Agency

Agency: The entity responsible for the administering of a research grant, project, or contract. This may represent a federal department, agency, or sub-agency (institute or center). Details on agencies in Federal RePORTER can be found in the FAQ page.

FY Total Cost
2012 AHRQ

HHS/Agency for Healthcare Research and Quality

$160,727

Results

i

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