Spotlight on R. Scott Braithwaite, MD, MS, FACP
R. Scott Braithwaite, MD, MS, FACP, received his MS in clinical research from the Institute for Clinical Research Education (ICRE) in 2004 and is the focus of the ICRE Graduate Spotlight.
Formerly an associate professor of medicine at Yale University, Dr. Braithwaite was recently appointed chief of the Section of Value and Comparative Effectiveness and director of The Outcomes Research Collaboration for Health (TORCH) at New York University. He is a recipient of the prestigious Robert Wood Johnson Foundation Faculty Scholar Award and the lead author of the Society of Medical Decision Making's white paper on comparative effectiveness of health care options.
One of the targets of Dr. Braithwaite's research is superfluous resource expenditures in the U.S. health care system. As he stated, "My direct experience with the health care system and its inefficiencies has been my biggest influence in deciding to make clinical research an addition to my medical career." When he was in the ICRE clinical research program, he trained in the Effectiveness, Outcomes, and Quality Research Track and used his electives to substantially increase his skills in mathematical modeling.
Dr. Braithwaite's research focuses on using computer simulations and mathematical modeling to assist in real-world decision making and address questions that cannot be directly answered with standard analytic methods such as randomized controlled trials. He has used modeling methods to explore a series of issues in contemporary health care, including the optimal treatment of patients with HIV infection, the tailoring of clinical guidelines to specific characteristics of patients, and the evaluation of alternative methods to link incentives in the health care system to the value of health care services.
Dr. Braithwaite's work has been a combination of the application of current methodologies to important problems and the advancement of techniques of decision sciences to enable the development of more clinically realistic models of disease and treatment. For example, his envelope-pushing research in the modeling of HIV infection, which combines mechanistic models of the acquisition of viral resistance with standard treatment decision models, has enabled him to estimate the long-term outcomes of various HIV treatment strategies from relatively short-term trial results.
One of Dr. Braithwaite's studies, "A Framework for Tailoring Clinical Guidelines to Comorbidity at the Point of Care," looked at two common comorbidities—HIV infections and congestive heart failure—and estimated under what circumstances a patient with one of these illnesses would experience benefit from colorectal cancer screening and under what circumstances the patient would experience harm or no impact at all. This line of research seeks to answer these questions: Is the benefit from this screening worth the cost in every case? At what point would the screening provide benefit or harm to the patient? Dr. Braithwaite's research applies rigorous mathematical modeling methods to complex problems in health care and health policy, with the goal of improving health care quality while reducing unnecessary resource expenditures.
