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Charles E. Phelps
University of Rochester
Health careActuarial scienceEconomicsPopulationMedicine
170Publications
35H-index
4,637Citations
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Publications 170
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#1Darius N. Lakdawalla (SC: University of Southern California)H-Index: 39
#2Charles E. Phelps (UR: University of Rochester)H-Index: 35
Abstract Standard cost-effectiveness models compare incremental cost increases to incremental average gains in health, commonly expressed in Quality-Adjusted Life Years (QALYs). Our research generalizes earlier models in several ways. We introduce risk aversion in Quality of Life (QoL), which leads to “willingness-to-pay” thresholds that rise with illness severity, potentially by an order of magnitude. Unlike traditional CEA analyses, which discriminate against persons with disabilities, our ana...
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#1Laura Panattoni (Fred Hutchinson Cancer Research Center)H-Index: 3
#2Charles E. Phelps (UR: University of Rochester)H-Index: 35
Last. Scott D. Ramsey (Fred Hutchinson Cancer Research Center)H-Index: 61
view all 7 authors...
OBJECTIVES: Chemotherapy is increasingly a preference-based choice among women diagnosed with early-stage breast cancer. Multicriteria decision analysis (MCDA) is a promising but underutilized method to facilitate shared decision making. We explored the feasibility of conducting an MCDA using direct rank ordering versus a time trade-off (TTO) to assess chemotherapy choice in a large population-based sample. METHODS: We surveyed 904 early-stage breast cancer survivors who were within 5 years of d...
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#1Charles E. Phelps (UR: University of Rochester)H-Index: 35
1 CitationsSource
Cost-effectiveness analysis (CEA) remains the de-facto method of choice to evaluate and compare medical interventions. Standard approaches to CEA use the average (mean) outcomes from clinical effectiveness studies such as randomized controlled trials. This paper generalizes standard methods to include uncertainty in clinical outcomes and proposes a generalized version of the quality-adjusted life-year (QALY), referred to as a quality- and risk-adjusted life-year (QRALY). Our approach requires ne...
2 CitationsSource
#1Charles E. Phelps (UR: University of Rochester)H-Index: 35
Abstract Objective To provide a new approach to estimate optimal willingness to pay (WTP) for health technology assessment (HTA). Study Design This analysis specified utility as a function of income and calibrated it using estimates of relative risk aversion, from which the optimal WTP (K) can be determined using Garber and Phelps’ results (1997). Methods This analysis used the highly flexible Weibull utility function, calibrated with estimates of relative risk aversion (r*) derived from multipl...
1 CitationsSource
#1Shelby D. ReedH-Index: 37
#2Robert W. DuboisH-Index: 32
Last. Charles E. PhelpsH-Index: 35
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#1Charles E. Phelps (UR: University of Rochester)H-Index: 35
#2Guruprasad Madhavan (National Academies)H-Index: 4
Abstract A number of methods have sought to determine the value of interventions and services that promote health, even when no agreement exists on the proper way to determine and define “value.” Previous valuation efforts began simply by counting deaths or measuring life expectancy, slowly evolving to the widespread use of cost-effectiveness analysis (CEA) as the de facto normative standard for medical interventions. Users of CEA recognize that the method is incomplete. Further, no meaningful a...
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#1Laura Panattoni (Fred Hutchinson Cancer Research Center)H-Index: 3
#2Tracy A. Lieu (KP: Kaiser Permanente)H-Index: 61
Last. Scott D. Ramsey (Fred Hutchinson Cancer Research Center)H-Index: 61
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Purpose Little is known about whether gene expression profile (GEP) testing and specific recurrence scores (e.g., medium risk) improve women’s confidence in their chemotherapy decision or perceived recurrence risk. We evaluate the relationship between these outcomes and GEP testing.
1 CitationsSource
#1Guruprasad Madhavan (National Academies)H-Index: 4
#2Charles E. Phelps (UR: University of Rochester)H-Index: 35
Last. Rino Rappuoli (GSK: GlaxoSmithKline)H-Index: 111
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Entities involved in population health often share a common mission while acting independently of one another and perhaps redundantly. Population health is in everybody’s interest, but nobody is really in charge of promoting it. Across governments, corporations, and frontline operations, lack of coordination, lack of resources, and lack of reliable, current information have often impeded the development of situation-awareness models and thus a broad operational integration for population health....
2 CitationsSource
1 CitationsSource
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