Overview
Notable features of my work are: (1) reliance on analytic strategies such as meta-analysis, simulation, decision analysis and cost-effectiveness analysis; (2) a balancing of methodological rigor the needs of medical professionals; and (3) dependence on interdisciplinary groups of experts.
This approach is best illustrated by the Stroke Prevention Patient Outcome Research Team (PORT), for which I served as principal investigator. Funded by the AHCPR, the PORT involved 35 investigators at 13 institutions. The Stroke PORT has been highly productive and has led to a stroke prevention project funded as a public/private partnership by the AHCPR and DuPont Pharma, the Managing Anticoagulation Services Trial (MAST). MAST is a practice improvement trial in 6 managed care organizations, focussing on optimizing anticoagulation for individuals with atrial fibrillation.
I serve as consultant in the general area of analytic strategies for clinical policy development, as well as for specific projects related to stroke (e.g., acute stroke treatment, management of atrial fibrillation, and use of carotid endarterectomy.) I have worked with AHCPR (now AHRQ), ACP, AHA, AAN, Robert Wood Johnson Foundation, NSA, WHO, and several pharmaceutical companies.
Key Words: clinical policy, disease management, stroke, decision analysis, clinical guidelines
Current Appointments & Affiliations
Professor Emeritus of Medicine
·
2026 - Present
Medicine, General Internal Medicine,
Medicine
Director of the Center for Clinical Health Policy Research
·
1988 - Present
Institutes and Centers,
School of Medicine
Professor of Pathology
·
2009 - Present
Pathology,
Clinical Science Departments
Affiliate, Duke Global Health Institute
·
2009 - Present
Duke Global Health Institute,
University Institutes and Centers
Recent Publications
Association between weather, air quality and asthma-related emergency department visits: a retrospective time-series study in Singapore.
Journal Article BMJ Open · December 18, 2025 OBJECTIVES: To evaluate the association between asthma-related emergency department (ED) visits and weather, air quality, monsoons, haze and cultural festivals in Singapore. DESIGN: Retrospective cohort study. SETTING: A public healthcare cluster that cove ... Full text Link to item CiteExpanding diagnostic testing for drug-resistant tuberculosis in high burden settings: a cost-effectiveness analysis.
Journal Article BMC Public Health · November 5, 2025 BACKGROUND: New and effective tools for detecting drug-resistant tuberculosis (DR-TB) include GeneXpert XDR and targeted Next Generation Sequencing (tNGS). However, data on their implementation in high TB-burden settings is limited. We aimed to determine c ... Full text Link to item CitePublic health insights of patients with asthma receiving primary, specialist or mixed care in Singapore using data from the SDG-CARE Asthma Registry.
Journal Article Respir Med · October 2025 PURPOSE: The prevalence and economic burden of asthma across the public healthcare landscape in Singapore is substantial, where the asthma patient journey often transitions between primary care (PC) and specialty care (SC) settings. PATIENTS AND METHODS: T ... Full text Link to item CiteRecent Grants
Expanding Quality Care for Glaucoma through a Provider-Patient Partnership
ResearchCo Investigator · Awarded by National Institutes of Health · 2007 - 2013Thrombosis and Hemostasis Centers Research and Prevention Network
ResearchConsultant · Awarded by Centers for Disease Control and Prevention · 2002 - 2013EPC Project: Medical Test Guides - training modules
ResearchCo Investigator · Awarded by Agency for Healthcare Research and Quality · 2011 - 2012View All Grants
Education, Training & Certifications
University of Maryland, College Park ·
1980
M.D.