Scholars@Duke
David Bruce Matchar

David Bruce Matchar

Professor Emeritus of Medicine
Medicine, General Internal Medicine
Box 102811, DUMC, Durham, NC 27705
Erwin Terrace II, Box 16, Durham, NC 27710

Featured Works

Cost-effectiveness analysis of strategies for diagnosing celiac disease.

Journal article Dig Dis Sci · March 2008 Featured Publication OBJECTIVE: To compare strategies for diagnosing celiac disease (CD). METHODS: A decision analytic model was used to compare five strategies on diagnostic performance and costs. RESULTS: First, tTG screening alone is the least costly strategy ($22/individua ... Full text Link to item Cite

Systematic review: comparative effectiveness of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers for treating essential hypertension.

Journal article Ann Intern Med · January 1, 2008 Featured Publication BACKGROUND: The relative effectiveness of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) for lowering blood pressure is unknown. PURPOSE: To compare the benefits and harms of ACE inhibitors versus ARBs for treati ... Full text Link to item Cite

Review of evidence for genetic testing for CYP450 polymorphisms in management of patients with nonpsychotic depression with selective serotonin reuptake inhibitors.

Journal article Genet Med · December 2007 Featured Publication PURPOSE: Cytochrome P450 (CYP450) enzymes metabolize selective serotonin reuptake inhibitor (SSRI) drugs used in treatment of depression. Variants in these genes may impact treatment efficacy and tolerability. The purpose of this study was 2-fold: to syste ... Full text Link to item Cite

Is genetic testing for cytochrome P450 polymorphisms ready for implementation?

Journal article Am Fam Physician · August 1, 2007 Featured Publication Link to item Cite

Advanced chronic kidney disease practice patterns among nephrologists and non-nephrologists: a database analysis.

Journal article Clin J Am Soc Nephrol · March 2007 Featured Publication Chronic kidney disease (CKD) outcomes, including progression to end stage, is influenced by patient treatment and is known to be suboptimal. A commercial database was analyzed to assess practice patterns and conformance to clinical practice guidelines amon ... Full text Link to item Cite

Noninvasive imaging for coronary artery disease: a technology assessment for the Medicare Coverage Advisory Commission.

Journal article Am Heart J · February 2007 Featured Publication This report describes a review of the available scientific evidence through 2005 on direct noninvasive imaging tests (NITs) for coronary artery disease. In particular, the report addresses 6 key questions provided by the Agency for Healthcare Research and ... Full text Link to item Cite

Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation.

Journal article JAMA · January 10, 2007 Featured Publication CONTEXT: Recent studies of drug-eluting intracoronary stents suggest that current antiplatelet regimens may not be sufficient to prevent late stent thrombosis. OBJECTIVE: To assess the association between clopidogrel use and long-term clinical outcomes of ... Full text Link to item Cite

Relationship between nephrologist care and progression of chronic kidney disease.

Journal article N C Med J · 2007 Featured Publication BACKGROUND: Since chronic kidney disease (CKD) affects 11% of the United States population, and its incidence is rising, experts recommend early referral to nephrologists in the hope that it may delay the onset of end-stage disease and improve survival. Ho ... Link to item Cite

Testing for cytochrome P450 polymorphisms in adults with non-psychotic depression treated with selective serotonin reuptake inhibitors (SSRIs).

Journal article Evid Rep Technol Assess (Full Rep) · January 2007 Featured Publication OBJECTIVES: To determine if testing for cytochrome P450 (CYP450) polymorphisms in adults entering selective serotonin reuptake inhibitor (SSRI) treatment for non-psychotic depression leads to improvement in outcomes, or if testing results are useful in med ... Link to item Cite

Management of recalled pacemakers and implantable cardioverter-defibrillators: a decision analysis model.

Journal article JAMA · July 26, 2006 Featured Publication CONTEXT: Limited information exists to direct clinical management after an implantable device has been put under advisory. A better understanding of the risks and benefits of device replacement compared with continued clinical follow-up would be helpful to ... Full text Link to item Cite

Changing physician knowledge, attitudes, and beliefs about migraine: evaluation of a new educational intervention.

Journal article Headache · May 2006 Featured Publication OBJECTIVE: Use a presurvey of primary care providers (PCPs) enrolled in a continuing medical education (CME) program on headache management to ascertain their existing knowledge, attitudes, and beliefs regarding migraine and use a postsurvey to determine t ... Full text Link to item Cite

Facilitated process improvement: an approach to the seamless linkage between evidence and practice in CKD.

Journal article Am J Kidney Dis · March 2006 Featured Publication BACKGROUND: Two common strategies for guideline implementation are preformed practice improvement tools, such as flowcharts, and process reengineering by total quality management (TQM) teams. Prespecified tools fail to accommodate local circumstances, TQM ... Full text Link to item Cite

Evidence-based practice center network and health technology assessment in the United States: bridging the cultural gap.

Journal article Int J Technol Assess Health Care · 2006 Featured Publication OBJECTIVES: The purpose of this study was to identify the Evidence-Based Practice Center (EPC) network participants' perceptions of the characteristics of the EPC process and the relationship of the process to the success of EPC reports. METHODS: Semistruc ... Full text Link to item Cite

Improving the process of developing technical reports for health care decision makers: using the theory of constraints in the evidence-based practice centers.

Journal article Int J Technol Assess Health Care · 2006 Featured Publication OBJECTIVES: To apply the Theory of Constraints (TOC) to the Evidence-based Practice Center (EPC) process. METHODS: Participants in the EPC process were interviewed, and the technical contracting literature was reviewed. Undesirable effects (UDEs) that migh ... Full text Link to item Cite

Medicare HMO penetration and mortality outcomes of ischemic stroke.

Journal article Am J Manag Care · January 2006 Featured Publication OBJECTIVE: To examine associations between Medicare health maintenance organization (HMO) penetration and stroke mortality outcomes among older persons. STUDY DESIGN: Panel analysis of nationally representative secondary data from 1993 to 1998. METHODS: Th ... Link to item Cite

A cost-minimization analysis comparing azithromycin-based and levofloxacin-based protocols for the treatment of patients hospitalized with community-acquired pneumonia: results from the CAP-IN trial.

Journal article Chest · November 2005 Featured Publication BACKGROUND: A randomized trial was performed comparing azithromycin and levofloxacin for treating moderately to severely ill patients hospitalized with community-acquired pneumonia. This is a cost-minimization analysis comparing those regimens. METHODS: Th ... Full text Link to item Cite

Burden of illness and satisfaction with care among patients with headache seen in a primary care setting.

Journal article Headache · September 2005 Featured Publication OBJECTIVE: To assess the current level of headache burden and the headache management needs at three diverse clinical sites. BACKGROUND: Headache is a common disabling disorder that is costly for the patient and a management challenge for physicians. The d ... Full text Link to item Cite

Dissemination of Evidence-based Practice Center reports.

Journal article Ann Intern Med · June 21, 2005 Featured Publication The Evidence-based Practice Center (EPC) program within the Agency for Healthcare Research and Quality (AHRQ) provides detailed evidence reports for partner organizations that they can translate into activities that improve patient care. A review of these ... Full text Link to item Cite

The impact of patient self-testing of prothrombin time for managing anticoagulation: rationale and design of VA Cooperative Study #481--the Home INR Study (THINRS).

Journal article J Thromb Thrombolysis · June 2005 Featured Publication BACKGROUND: Anticoagulation (AC) with warfarin reduces the risk of thromboembolism (TE) in a variety of applications, yet despite compelling evidence of the value and importance of high quality AC, warfarin remains underused, and dosing is often suboptimal ... Full text Link to item Cite

Meta-analysis of survival and relief of angina pectoris after transmyocardial revascularization.

Journal article Am J Cardiol · May 15, 2005 Featured Publication A meta-analysis of 7 randomized trials involving 1,053 patients was performed to evaluate the effect of transmyocardial laser revascularization as the sole procedural intervention on survival and angina relief. At 1 year, transmyocardial laser revasculariz ... Full text Link to item Cite

FDG-PET for management of cervical and ovarian cancer.

Journal article Gynecol Oncol · April 2005 Featured Publication OBJECTIVE: To assess the diagnostic performance of Positron Emission Tomography using fluorodeoxyglucose (FDG-PET) in comparison to conventional imaging modalities in the assessment of patients with cervical and ovarian cancer. METHODS: Studies published b ... Full text Link to item Cite

Cost of multiple sclerosis by level of disability: a review of literature.

Journal article Mult Scler · April 2005 Featured Publication We performed a review of the economic literature to identify what is known about the relationship between Expanded Disability Status Scale (EDSS) categories and cost of multiple sclerosis (MS). We sought cohort studies of patients with multiple sclerosis t ... Full text Link to item Cite

Health policy and outcomes research 2004.

Journal article Stroke · February 2005 Featured Publication Full text Link to item Cite

Cost-effectiveness of antiplatelet agents in secondary stroke prevention: the limits of certainty.

Journal article Value Health · 2005 Featured Publication UNLABELLED: Which of the available antiplatelet therapies should be preferred for secondary prevention of recurrent ischemic stroke has been contentious. OBJECTIVE: We applied the Duke Stroke Policy Model (DSPM) to reconsider this issue, paying particular ... Full text Link to item Cite

Meta-analysis: the detection of pancreatic malignancy with positron emission tomography.

Journal article Aliment Pharmacol Ther · November 15, 2004 Featured Publication BACKGROUND: Several factors contribute to the high mortality of pancreatic cancer, including limitations of diagnostic imaging. AIM: To perform a meta-analysis to assess the diagnostic accuracy of Fluro-deoxy-glucose positron emission tomography with compu ... Full text Link to item Cite

Testing for von Willebrand disease in women with menorrhagia: a systematic review.

Journal article Obstet Gynecol · August 2004 Featured Publication OBJECTIVE: To review the evidence supporting screening of adult women with menorrhagia for von Willebrand disease. DATA SOURCES: MEDLINE search from January 1,1990, to December 31, 2003, for articles in English, using keywords "menorrhagia," "von Willebran ... Full text Link to item Cite

Charlson Index comorbidity adjustment for ischemic stroke outcome studies.

Journal article Stroke · August 2004 Featured Publication BACKGROUND AND PURPOSE: The Charlson Index is commonly used in outcome studies to adjust for patient comorbid conditions, but has not been specifically validated for use in studies of ischemic stroke. The purpose of the present study was to determine wheth ... Full text Link to item Cite

A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation.

Journal article Health Qual Life Outcomes · May 6, 2004 Featured Publication BACKGROUND: Anticoagulation can reduce quality of life, and different models of anticoagulation management might have different impacts on satisfaction with this component of medical care. Yet, to our knowledge, there are no scales measuring quality of lif ... Full text Open Access Link to item Cite

Criteria to determine disability related to multiple sclerosis.

Journal article Evid Rep Technol Assess (Summ) · May 2004 Featured Publication Link to item Cite

How strong is the relationship between functional status and quality of life among persons with stroke?

Journal article J Rehabil Res Dev · May 2004 Featured Publication The quantitative relationship between functional status and self-reported quality of life is relatively unexamined. As part of the 1-, 6-, and 12-month telephone follow-up of consecutive patients in an observational study of patients with stroke, we found ... Full text Link to item Cite

Pharmacoeconomics of atrial fibrillation and stroke prevention.

Journal article Am J Manag Care · April 2004 Featured Publication Atrial fibrillation (AF) is a common arrhythmia that significantly increases the risk of stroke by the formation and embolism of left-atrial appendage thrombi. This risk can be substantially reduced with antithrombotic therapies such as aspirin or warfarin ... Link to item Cite

Alzheimer disease: operating characteristics of PET--a meta-analysis.

Journal article Radiology · April 2004 Featured Publication PURPOSE: To assess the operating characteristics of positron emission tomography (PET) by using fluorine 18 fluorodeoxyglucose (FDG) in the diagnosis of Alzheimer disease. MATERIALS AND METHODS: Articles published between 1989 and 2003 were identified in t ... Full text Link to item Cite

Health policy and outcome research in stroke.

Journal article Stroke · February 2004 Featured Publication Full text Link to item Cite

When to stress over triptans: a Markov analysis of cardiovascular risk in migraine treatment.

Journal article Headache · 2004 Featured Publication BACKGROUND: Migraines affect 10% of the U.S. population and the episodes are frequently associated with significant disability. Triptans, 5HT1 receptor agonists, can be highly effective in treating pain and reducing disability. However, reports of cardiac ... Full text Link to item Cite

Do anticoagulation management services improve care? Implications of the Managing Anticoagulation Services Trial.

Journal article Card Electrophysiol Rev · December 2003 Featured Publication An Anticoagulation Clinic Service (ACS) has been proposed as one strategy for improving warfarin treatment for patients with atrial fibrillation. In the Managing Anticoagulation Services Trial (MAST), ACSs meeting specifications for high quality care were ... Full text Link to item Cite

Making evidence-based practice improvement more than a comforting sentiment.

Journal article Am J Med · October 1, 2003 Featured Publication Full text Link to item Cite

A clinical decision and economic analysis model of cancer pain management.

Journal article Am J Manag Care · October 2003 Featured Publication OBJECTIVE: To design a model that educates clinical decision makers and healthcare professionals about the burden of cancer pain in their individual populations, and that assists them in weighing the effectiveness and cost of different cancer pain manageme ... Link to item Cite

VA Stroke Study: neurologist care is associated with increased testing but improved outcomes.

Journal article Neurology · September 23, 2003 Featured Publication OBJECTIVE: VA Stroke Study (VASt) data were analyzed to determine whether neurologist management affected the process and outcome of care of patients with ischemic stroke. METHODS: VASt prospectively identified patients with stroke admitted to nine VA hosp ... Full text Link to item Cite

Veterans Administration Acute Stroke (VASt) Study: lack of race/ethnic-based differences in utilization of stroke-related procedures or services.

Journal article Stroke · April 2003 Featured Publication BACKGROUND AND PURPOSE: Race/ethnic-based disparities in the utilization of health-related services have been reported. Data collected as part of the Veterans Administration Acute Stroke Study (VASt) were analyzed to determine whether similar differences w ... Full text Link to item Cite

Effects of race and poverty on the process and outcome of inpatient rehabilitation services among stroke patients.

Journal article Stroke · April 2003 Featured Publication BACKGROUND AND PURPOSE: The greater mortality and residual physical impairments among black stroke patients may be attributable to differential utilization of rehabilitation services. This report examines, within an equal-access healthcare system, racial d ... Full text Link to item Cite

Health policy in stroke: translating what we know into what we do.

Journal article Stroke · February 2003 Featured Publication Full text Link to item Cite

Racial differences in survival post cerebral infarction among the elderly.

Journal article Neurology · January 28, 2003 Featured Publication OBJECTIVE: To investigate whether there are differences in poststroke survival between African American and white patients, aged 65 and over, in the United States. METHODS: A biracial cohort of patients was selected from a random 20% national sample of Med ... Full text Link to item Cite

An economic analysis of external hip protector use in ambulatory nursing facility residents.

Journal article Age Ageing · January 2003 Featured Publication OBJECTIVE: to evaluate the economic impact of external hip protector use in nursing facilities. DESIGN: cost-effectiveness and cost-utility analyses. MEASUREMENTS: event probabilities, intervention effectiveness, treatment costs, and utility of hip fractur ... Full text Link to item Cite

Headache management program improves outcome for chronic headache.

Journal article Headache · 2003 Featured Publication OBJECTIVE: To determine the feasibility of developing a headache management program and to assess the outcomes of patients referred to the program for treatment of chronic headache. BACKGROUND: Effective headache treatment requires that the patient receive ... Full text Link to item Cite

When should functional neuroimaging techniques be used in the diagnosis and management of Alzheimer's dementia? A decision analysis.

Journal article Value Health · 2003 Featured Publication BACKGROUND: Functional neuroimaging, including positron emission tomography (PET), has been proposed for use in diagnosing Alzheimer's disease-related dementia (AD). OBJECTIVE: The objective of this study was identify the circumstances under which PET scan ... Full text Link to item Cite