Cost-effectiveness Analysis to Inform BC Screening Policy

Institution: University of California, Davis
Investigator(s): Joy  Melnikow , M.D., M.P.H. -
Award Cycle: 2011 (Cycle 17) Grant #: 17IB-0007 Award: $149,996
Award Type: IDEA
Research Priorities
Health Policy & Health Services>Health Policy and Health Services: better serving women's needs

Initial Award Abstract (2011)

Non-technical overview of the research topic and relevance to breast cancer:
Cost effectiveness analysis (CEA) is a tool that policymakers and others can use to consider the potential impacts of various policy options on projected future health program benefits and costs. Breast cancer health programs for underserved women are faced with increasing need for services and declining budgets. Carefully constructed computer modeling can be useful in projecting potential outcomes of policy and budgetary choices. This project is based on a cost effectiveness model that was designed specifically for the Every Woman Counts (EWC) Program, a California safety net program providing breast cancer screening and diagnostic services to uninsured and underinsured women.

The question(s) or central hypotheses of the research:
The central research question of this proposal asks, “How can a user-friendly computer interface best facilitate the integration of cost effectiveness analysis into breast cancer health policy making?” This project will develop a computer interface to enable breast cancer policy makers, advocates, and researchers to choose program parameters and receive immediate feedback on the costs and outcomes of policy alternatives they are considering. This project is aimed at creating a user-friendly tool that will help to integrate research evidence into health policy making.

The general methodology:
We will hold a structured meeting with breast cancer policy stakeholders to identify priority questions related to breast cancer screening for underserved women in California, to increase their familiarity with CEA, and to begin to assess the user-friendly interface. Based on the policy priorities identified in the meeting, we will modify the EWC model and develop the computer interface for use by policy stakeholders. We will conduct follow-up interviews and additional testing of the model with the stakeholders that participated in the initial group meeting. Participant interviewing will provide us insight into how users perceive, understand, and use the policy model and into how they interpret the model output. At every step of the research process, the research team will work closely with a Project Advisory Board composed of representatives of breast cancer advocacy organizations, and state and county public health administrators. They will advise the research team on all aspects of the project.

Innovative elements of the project:
This research project consists of an innovative use of technology applied to an issue of increasing importance related to breast cancer screening. As health organizations, particularly those that serve uninsured and underinsured women, are pressed to provide more services to more women, cost effectiveness analysis provides a strategy for coping with limited resources. This project is innovative, not just in its application of CEA to policy for a specific breast cancer screening program, but also in providing a computer interface that enables non-technical users to directly estimate the results of their policy choices.

Advocacy involvement and relevance to the human issues associated with breast cancer:
Breast cancer advocates on the Advisory Board will be directly involved in the design of the project, interpretation of the findings, and development of the model. Advocates will also be involved in the study as participants in the structured meeting, as well as the subsequent testing and interviews about the model.