Harkness Project Title: Enhancing Priority Decision-Making in Comparative Effectiveness Research
Placement: Agency for Healthcare Research and Quality
Mentors: Carolyn Clancy, M.D., Director, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services
Jean Slutsky, PA, Director, Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services
Co-mentor: Alan Garber, M.D., Ph.D., Professor, Stanford University
Biography at time of Harkness Fellowship: Adam Elshaug, Ph.D., a 2010-11 Harkness Fellow in Health Care Policy and Practice, is Hanson Fellow at Adelaide Health Technology Assessment (AHTA) and senior research fellow/senior lecturer in public health at The University of Adelaide. Elshaug has focused his research in the area of refining use of low-value health services; evidentiary, clinical and policy barriers to reform and implementation. Elshaug collaborates and consults with government health agencies (federal and provincial) in Australia and internationally (Spain, U.K., Canada) to advance policy reform in this area. Elshaug is currently working with the Australian government to design and implement a formal disinvestment policy agenda within Medicare. Elshaug serves as an Associate Editor for the journal BMC Health Services Research and has published in journals such as the BMJ, Quality and Safety in Health Care, and Medical Journal of Australia. He is chief investigator on two large disinvestment research grants, is recipient of numerous awards as a new or emerging researcher, and has received over 60 invitations to address conferences as well as government, academic, insurance and health technology assessment groups internationally. Elshaug holds a Ph.D. and M.P.H. from The University of Adelaide.
Project: Adam Elshaug focused on gaining insight into how policymakers translate comparative effectiveness research findings into policy and reform processes, particularly when comparative clinical ineffectiveness is identified. The project included two phases. First, for a particular health service whose effectiveness recent research has got doubt upon (vertebrolpasty and kyphoplasty), Elshaug quantified the budget impact of reducing utilization. The second phase involved semi-structured interviews with policy stakeholders, including their reaction to the budget impact metrics.
Career Activity Since Fellowship
Current Position: Associate Professor of Health Care Policy and HCF Foundation Principal Research Fellow, Menzies Centre for Health Policy (MCHP), School of Public Health, The University of Sydney (Updated July 2014)
R. Lopert and A. G. Elshaug, "Australia's 'Fourth Hurdle' Drug Review Comparing Costs and Benefits Holds Lessons for the United States," Health Affairs, March 2013 32(4):778–87.
Elshaug AG, McWilliams JM, Landon BE. The value of low-value lists. JAMA, 2013; 309(8): 775-776.Scott IA, Elshaug AG. Foregoing low-value care: how much evidence is needed to change beliefs? Intern Med J, 2013; 43(2): 107-109.
Watt AM, Hiller JE, Braunack-Mayer A, Moss JR, Buchan H, Wale J, Riitano D, Hodgetts K, Street J, Elshaug AG, for The ASTUTE Health Study Group. The ASTUTE Health study protocol: deliberative stakeholder engagements to inform implementation approaches to healthcare disinvestment. Implement Sci, 2012 Oct 22; 7: 101.
Elshaug AG, Watt AM, Mundy L, Willis CD. “Over 150 potentially low-value health care practices: an Australian Study.” Medical Journal of Australia, November 2012.
Treadwell J, Uhl S, Tipton K, Shamliyan T, Viswanathan M, Berkman N, Sun X, Coleman C, Elshaug AG, Singh S, Wang S, Ramakrishnan R, . Assessing Equivalence and Noninferiority. J Clin Epi. 2012; June 25
Treadwell J, Uhl S, Tipton K, Singh S, Santaguida L, Sun X, Berkman N, Viswanathan M, Coleman C, Shamliyan T, Wang S, Ramakrishnan R, Elshaug AG. Assessing Equivalence and Noninferiority. Methods Research Report. (Prepared by the EPC Workgroup under Contract No. 290-2007-10063.) AHRQ Publication No. 12-EHC045-EF. Rockville, MD: Agency for Healthcare Research and Quality; June 2012. www.effectivehealthcare.ahrq.gov.Elshaug AG and Garber AM. How CER Could Pay for Itself - Insights from Vertebral Fracture Treatments. New England Journal of Medicine, 2011 April 14 364;15: 1390-93.
Elshaug AG, Bessen T, Moss JR, Hiller JE. "Addressing “waste” in diagnostic imaging: some implications of comparative effectiveness research." J Am Coll Radiol. 2010 Aug;7(8):603-13.