Research and publications

The published evidence behind our work

Selected peer-reviewed papers, with health systems, payers and life science companies among the co-authors. Together they show four things: simulated patients measure how physicians actually practice, measurement with feedback changes practice, the change shows up in real-world cost and quality data, and randomized simulated-patient studies can establish how a new technology changes clinical decisions.

Book a call See the publications

For health systems

Practice change at system scale

Measurement and feedback drive clinical and financial improvements, with examples that span clinical specialties and care settings.

Clinical training Observational studyReal-world results
Patient Simulation-Based Primary Care Training to Increase Evidence-Based COPD Care and Value-Based Success: Real-World Cost and Quality Impact Analysis
Primary care physicians and APPs across Henry Ford Health trained on simulated COPD patients. Their real patients with COPD then had 27% fewer emergency visits, 8% fewer hospitalizations and 37% fewer pulmonology referrals than the patients of colleagues who were not invited, about $1.3 million in savings to the system.
With Henry Ford Health, Henry Ford Physician Network, Jackson Health Network
The American Journal of Medicine, 2025
Read the paper: Patient Simulation-Based Primary Care Training to Increase Evidence-Based COPD Care and Value-Based Success: Real-World Cost and Quality Impact Analysis
Muma B, Keteyian C, Kolde D, Drake S, George D, Foust M, Fried S, Elsberg J, Thomas S, Johnston L, Kulawczyk A, Paculdo D, Cooney I, Peabody J, Burgon T. Am J Med. 2025;138(10):1360-1365.e2. doi:10.1016/j.amjmed.2025.05.032
Clinical training Observational study
Enhancing Evidence-Based Decision Making Through Primary Care Provider–Pharmacist Collaboration and Patient Simulation Training
Primary care physicians paired with a pharmacist improved their treatment scores on simulated patients more than physicians working alone, with the largest gains in stopping sulfonylureas (+16.2%) and prescribing SGLT2 inhibitors (+23.1%). The collaboration helped most with polypharmacy and deprescribing.
With Walgreens
JAPhA Practice Innovations, 2025
Read the paper: Enhancing Evidence-Based Decision Making Through Primary Care Provider–Pharmacist Collaboration and Patient Simulation Training
Chesler A, Puckett-Beasley J, Shakouri A, Borowski M, Eustis D, Paculdo D, Cooney I, Vergara JP, Fields C, Burgon T. JAPhA Pract Innov. 2025;2(2):100031. doi:10.1016/j.japhpi.2025.100031
Clinical training Randomized validation study
Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial
A national randomized trial in which practicing primary care physicians cared for eight weekly simulated cases with real-time evidence-based feedback and peer benchmarking. Three in four completed at least six cases, and evidence-based decisions improved across conditions, including diabetes (+8.3%) and quality measures such as diabetes eye exams (+22%) and asthma medications (+33%).
With a national sample of PCPs
Journal of Medical Internet Research, 2021
Read the paper: Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial
Burgon T, Casebeer L, Aasen H, Valdenor C, Tamondong-Lachica D, de Belen E, Paculdo D, Peabody J. J Med Internet Res. 2021;23(12):e31042. doi:10.2196/31042
Clinical training Observational studyReal-world results
Initiative to Improve Evidence-Based Chronic Obstructive Pulmonary Disease Hospitalist Care Using a Novel On-Line Gamification Patient Simulation Tool: A Prospective Study
245 hospitalists at 15 Novant Health facilities worked through simulated COPD cases over 16 weeks. Quality-of-care scores rose 10.5%, and in the real-world data COPD pharmacy costs fell 19%, with an annualized 233 fewer inpatient days, 371 fewer revisit days and nearly $1 million in inpatient savings.
With Novant Health
Healthcare (Basel), 2021
Read the paper: Initiative to Improve Evidence-Based Chronic Obstructive Pulmonary Disease Hospitalist Care Using a Novel On-Line Gamification Patient Simulation Tool: A Prospective Study
Strong J, Weems L, Burgon T, Branch J, Martin J, Paculdo D, Tamondong-Lachica D, Cruz J, Peabody J. Healthcare (Basel). 2021;9(10):1267. doi:10.3390/healthcare9101267
Clinical training Observational studyReal-world results
Reducing Unneeded Clinical Variation in Sepsis and Heart Failure Care to Improve Outcomes and Reduce Cost: A Collaborative Engagement with Hospitalists in a MultiState System
Hospitalists at eight AdventHealth hospitals cared for simulated sepsis and heart failure patients, with feedback, over two years, and were compared with six hospitals that did not take part. Their evidence-based care scores rose nearly 8%, length of stay fell faster than in the comparison group, and $2.4 million in savings was attributable to the project beyond system-wide improvements.
With AdventHealth
Journal of Hospital Medicine, 2019
Read the paper: Reducing Unneeded Clinical Variation in Sepsis and Heart Failure Care to Improve Outcomes and Reduce Cost: A Collaborative Engagement with Hospitalists in a MultiState System
Yurso M, Box B, Burgon T, Hauck L, Tagg K, Clem K, Paculdo D, Acelajado MC, Tamondong-Lachica D, Peabody JW. J Hosp Med. 2019;14(9):541-546. doi:10.12788/jhm.3220
Clinical training Observational studyReal-world results
Engaging Primary Care Providers to Reduce Unwanted Clinical Variation and Support ACO Cost and Quality Goals: A Unique Provider-Payer Collaboration
Primary care clinicians in a Connecticut ACO took six rounds of simulated cases with individual and group feedback over two years. In the cases, evidence-based quality scores rose 27% and unneeded testing fell 55%; their real ACO quality measures improved beyond the comparison group, with more than $4.8 million in calculated savings on unneeded tests and specialist referrals.
With ProHealth Physicians, Aetna Accountable Care Solutions
Population Health Management, 2019
Read the paper: Engaging Primary Care Providers to Reduce Unwanted Clinical Variation and Support ACO Cost and Quality Goals: A Unique Provider-Payer Collaboration
Burgon TB, Cox-Chapman J, Czarnecki C, Kropp R, Guerriere R, Paculdo D, Peabody JW. Popul Health Manag. 2019;22(4):321-329. doi:10.1089/pop.2018.0111
Clinical training Observational studyReal-world results
Reducing Unwarranted Oncology Care Variation Across a Clinically Integrated Network: A Collaborative Physician Engagement Strategy
103 medical oncologists in a clinically integrated network cared for simulated breast and lung cancer patients every four months over six rounds, with feedback against evidence-based guidelines and their peers. Overall quality scores improved 11.9%, evidence-based chemotherapy regimens rose nearly 10 percentage points, and unnecessary test ordering fell 25%; in the network's own claims data, metastatic imaging workups for early-stage breast cancer declined in step with the simulations.
With Advocate Physician Partners
Journal of Oncology Practice, 2019
Read the paper: Reducing Unwarranted Oncology Care Variation Across a Clinically Integrated Network: A Collaborative Physician Engagement Strategy
Richards JM, Burgon TB, Tamondong-Lachica D, Bitran JD, Liangco WL, Paculdo DR, Peabody JW. J Oncol Pract. 2019;15(12):e1076-e1084. doi:10.1200/JOP.18.00754
Clinical training Observational studyReal-world results
A Better Pathway? Building Consensus and Engaging Providers With Feedback to Improve and Standardize Cancer Care
A multidisciplinary breast cancer team at an NCI-designated cancer center measured its care decisions on simulated patients, built its own breast cancer pathways, and received individual and group feedback on adherence. Overall quality scores rose from 47.5% to 61.1%, diagnostic accuracy improved by 22.1%, and unnecessary test orders fell by an estimated $305 per patient case.
With Huntsman Cancer Institute, University of Utah
Clinical Breast Cancer, 2019
Read the paper: A Better Pathway? Building Consensus and Engaging Providers With Feedback to Improve and Standardize Cancer Care
Colonna S, Sweetenham J, Burgon TB, Buys SS, Lynch R, Au T, Johnson E, Kubal T, Paculdo D, Acelajado MC, Peabody JW. Clin Breast Cancer. 2019;19(2):e376-e384. doi:10.1016/j.clbc.2018.12.010

How we work with health systems

For life science

Clinical utility, established in randomized trials

Randomized simulated-patient trials of diagnostic, monitoring and genomic technologies identify the specific use cases that drive clinical utility among real-world, practicing physicians.

Clinical utility research Randomized virtual trial, conference abstract
Impact of a blood-based biomarker on neurologist diagnostic decision-making for Alzheimer's disease: a randomized virtual trial
142 board-certified neurologists cared for 852 simulated patients. With access to a p-tau217/amyloid-beta 1-42 blood biomarker, diagnostic concordance with expert-defined diagnoses in mild and early Alzheimer's disease improved by 26.2 percentage points (P=.007), while PET and CSF ordering fell by 23.9 percentage points: better decisions and less downstream utilization in one study.
Alzheimer's Association International Conference, 2026
Full manuscript in development. Trever Burgon is principal investigator, of record with the IRB and on ClinicalTrials.gov.
Das L, Burgon T, Bhatt K, Ferrara KG, Paculdo D, De Belen E, Valdenor C. Presented at the Alzheimer's Association International Conference, July 2026, London.
Clinical utility research Randomized controlled trial
Helping primary care providers recognize and respond to medication non-adherence and drug-drug interactions: A randomized-controlled clinical utility trial in a value-based care setting
139 primary care providers in a large multi-state practice cared for simulated patients with chronic disease; half had results from a saliva-based test for medication non-adherence and drug-drug interactions. With the test, correct diagnosis of non-adherence rose from 10% to 80% and of drug interactions from 19% to 53%, with matching gains in appropriate treatment.
With Aegis Sciences Corporation, Wayne State University School of Medicine
PLOS ONE, 2026
Read the paper: Helping primary care providers recognize and respond to medication non-adherence and drug-drug interactions: A randomized-controlled clinical utility trial in a value-based care setting
Burgon T, Paculdo D, Schrecker J, Ferrara KG, David RE, Johnson S, Valdenor C, Peabody J. PLoS One. 2026;21(3):e0344906. doi:10.1371/journal.pone.0344906
Clinical utility research Randomized controlled trial
A Randomized Controlled Study on Clinical Adherence to Evidence-Based Guidelines in the Management of Simulated Patients With Barrett's Esophagus and the Clinical Utility of a Tissue Systems Pathology Test: Results From Q-TAB
A three-arm randomized trial among 259 practicing gastroenterologists and GI surgeons caring for simulated patients with Barrett's esophagus. Physicians given a tissue systems pathology (TSP-9) result were more likely to assess the risk of progression correctly and treat in line with US guidelines (+6.9%), and far more likely to follow annual endoscopic surveillance where it was indicated (+18.5%).
With Castle Biosciences
Clinical and Translational Gastroenterology, 2024
Read the paper: A Randomized Controlled Study on Clinical Adherence to Evidence-Based Guidelines in the Management of Simulated Patients With Barrett's Esophagus and the Clinical Utility of a Tissue Systems Pathology Test: Results From Q-TAB
Peabody JW, Cruz JDC, Ganesan D, Paculdo D, Critchley-Thorne RJ, Wani S, Shaheen NJ. Clin Transl Gastroenterol. 2024;15(1):e00644. doi:10.14309/ctg.0000000000000644
Clinical utility research Randomized controlled trial
Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney Injury During Percutaneous Cardiovascular Procedures
A two-round randomized trial among 154 interventional cardiologists caring for simulated patients at risk of contrast-induced kidney injury. Physicians given a urine L-FABP result improved their care by 4.6% over controls, were 2.9 times more likely to identify a patient's risk correctly, and more than twice as likely to treat it, with the greatest value before and during the procedure.
With Hikari Dx
Cardiorenal Medicine, 2022
Read the paper: Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney Injury During Percutaneous Cardiovascular Procedures
Peabody J, Paculdo D, Valdenor C, McCullough PA, Noiri E, Sugaya T, Dahlen JR. Cardiorenal Med. 2022;12(1):11-19. doi:10.1159/000520820
Clinical utility research Randomized controlled trial
Finding the Clinical Utility of 1,5-Anhydroglucitol Among Primary Care Practitioners
A randomized trial among 145 primary care physicians caring for simulated patients with diabetes and short-term swings in glucose control. Physicians given a 1,5-anhydroglucitol result scored 3.2% higher on overall quality than controls, with nearly all of the gain in patients whose high glucose was caused by a medication, where scores rose 8.1%.
With Hikari Dx
Journal of Clinical & Translational Endocrinology, 2020
Read the paper: Finding the Clinical Utility of 1,5-Anhydroglucitol Among Primary Care Practitioners
Peabody J, Paculdo D, Acelajado MC, Burgon T, Dahlen JR. J Clin Transl Endocrinol. 2020;20:100224. doi:10.1016/j.jcte.2020.100224
Clinical utility research Review
Establishing Clinical Utility for Diagnostic Tests Using a Randomized Controlled, Virtual Patient Trial Design
The methods paper: four randomized virtual-patient trials of diagnostic tests, each with the same two-round control and intervention design. Two showed clinical utility across the intended population and two in a sub-segment of it, and two of the tests went on to positive Palmetto coverage decisions. The reference for anyone asking whether the design is sound.
Diagnostics (Basel), 2019
Read the paper: Establishing Clinical Utility for Diagnostic Tests Using a Randomized Controlled, Virtual Patient Trial Design
Peabody J, Tran M, Paculdo D, Valdenor C, Burgon T, Jeter E. Diagnostics (Basel). 2019;9(3):67. doi:10.3390/diagnostics9030067
Clinical utility research Randomized controlled trial
Impact of a protein-based assay that predicts prostate cancer aggressiveness on urologists' recommendations for active treatment or active surveillance: a randomized clinical utility trial
129 board-certified urologists cared for simulated patients with newly diagnosed early-stage prostate cancer. Those given a protein-based assay that predicts tumor aggressiveness were significantly more likely to recommend the preferred course, active surveillance or active treatment (p = 0.004), and to involve the patient in the decision.
With Metamark Genetics
BMC Urology, 2017
Read the paper: Impact of a protein-based assay that predicts prostate cancer aggressiveness on urologists' recommendations for active treatment or active surveillance: a randomized clinical utility trial
Peabody JW, DeMaria LM, Tamondong-Lachica D, Florentino J, Czarina Acelajado M, Ouenes O, Richie JP, Burgon T. BMC Urol. 2017;17(1):51. doi:10.1186/s12894-017-0243-1

How we work with life science companies

Publications

Selected publications, newest first

Audience

Study type

Clinical utility research Randomized controlled trial
Helping primary care providers recognize and respond to medication non-adherence and drug-drug interactions: A randomized-controlled clinical utility trial in a value-based care setting
139 primary care providers in a large multi-state practice cared for simulated patients with chronic disease; half had results from a saliva-based test for medication non-adherence and drug-drug interactions. With the test, correct diagnosis of non-adherence rose from 10% to 80% and of drug interactions from 19% to 53%, with matching gains in appropriate treatment.
With Aegis Sciences Corporation, Wayne State University School of Medicine
PLOS ONE, 2026
Read the paper: Helping primary care providers recognize and respond to medication non-adherence and drug-drug interactions: A randomized-controlled clinical utility trial in a value-based care setting
Burgon T, Paculdo D, Schrecker J, Ferrara KG, David RE, Johnson S, Valdenor C, Peabody J. PLoS One. 2026;21(3):e0344906. doi:10.1371/journal.pone.0344906
Clinical utility research Randomized virtual trial, conference abstract
Impact of a blood-based biomarker on neurologist diagnostic decision-making for Alzheimer's disease: a randomized virtual trial
142 board-certified neurologists cared for 852 simulated patients. With access to a p-tau217/amyloid-beta 1-42 blood biomarker, diagnostic concordance with expert-defined diagnoses in mild and early Alzheimer's disease improved by 26.2 percentage points (P=.007), while PET and CSF ordering fell by 23.9 percentage points: better decisions and less downstream utilization in one study.
Alzheimer's Association International Conference, 2026
Full manuscript in development. Trever Burgon is principal investigator, of record with the IRB and on ClinicalTrials.gov.
Das L, Burgon T, Bhatt K, Ferrara KG, Paculdo D, De Belen E, Valdenor C. Presented at the Alzheimer's Association International Conference, July 2026, London.
Clinical training Observational study
Enhancing Evidence-Based Decision Making Through Primary Care Provider–Pharmacist Collaboration and Patient Simulation Training
Primary care physicians paired with a pharmacist improved their treatment scores on simulated patients more than physicians working alone, with the largest gains in stopping sulfonylureas (+16.2%) and prescribing SGLT2 inhibitors (+23.1%). The collaboration helped most with polypharmacy and deprescribing.
With Walgreens
JAPhA Practice Innovations, 2025
Read the paper: Enhancing Evidence-Based Decision Making Through Primary Care Provider–Pharmacist Collaboration and Patient Simulation Training
Chesler A, Puckett-Beasley J, Shakouri A, Borowski M, Eustis D, Paculdo D, Cooney I, Vergara JP, Fields C, Burgon T. JAPhA Pract Innov. 2025;2(2):100031. doi:10.1016/j.japhpi.2025.100031
Clinical training Observational studyReal-world results
Patient Simulation-Based Primary Care Training to Increase Evidence-Based COPD Care and Value-Based Success: Real-World Cost and Quality Impact Analysis
Primary care physicians and APPs across Henry Ford Health trained on simulated COPD patients. Their real patients with COPD then had 27% fewer emergency visits, 8% fewer hospitalizations and 37% fewer pulmonology referrals than the patients of colleagues who were not invited, about $1.3 million in savings to the system.
With Henry Ford Health, Henry Ford Physician Network, Jackson Health Network
The American Journal of Medicine, 2025
Read the paper: Patient Simulation-Based Primary Care Training to Increase Evidence-Based COPD Care and Value-Based Success: Real-World Cost and Quality Impact Analysis
Muma B, Keteyian C, Kolde D, Drake S, George D, Foust M, Fried S, Elsberg J, Thomas S, Johnston L, Kulawczyk A, Paculdo D, Cooney I, Peabody J, Burgon T. Am J Med. 2025;138(10):1360-1365.e2. doi:10.1016/j.amjmed.2025.05.032
Clinical utility research Randomized controlled trial
A Randomized Controlled Study on Clinical Adherence to Evidence-Based Guidelines in the Management of Simulated Patients With Barrett's Esophagus and the Clinical Utility of a Tissue Systems Pathology Test: Results From Q-TAB
A three-arm randomized trial among 259 practicing gastroenterologists and GI surgeons caring for simulated patients with Barrett's esophagus. Physicians given a tissue systems pathology (TSP-9) result were more likely to assess the risk of progression correctly and treat in line with US guidelines (+6.9%), and far more likely to follow annual endoscopic surveillance where it was indicated (+18.5%).
With Castle Biosciences
Clinical and Translational Gastroenterology, 2024
Read the paper: A Randomized Controlled Study on Clinical Adherence to Evidence-Based Guidelines in the Management of Simulated Patients With Barrett's Esophagus and the Clinical Utility of a Tissue Systems Pathology Test: Results From Q-TAB
Peabody JW, Cruz JDC, Ganesan D, Paculdo D, Critchley-Thorne RJ, Wani S, Shaheen NJ. Clin Transl Gastroenterol. 2024;15(1):e00644. doi:10.14309/ctg.0000000000000644
Clinical utility research Randomized controlled trial
Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney Injury During Percutaneous Cardiovascular Procedures
A two-round randomized trial among 154 interventional cardiologists caring for simulated patients at risk of contrast-induced kidney injury. Physicians given a urine L-FABP result improved their care by 4.6% over controls, were 2.9 times more likely to identify a patient's risk correctly, and more than twice as likely to treat it, with the greatest value before and during the procedure.
With Hikari Dx
Cardiorenal Medicine, 2022
Read the paper: Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney Injury During Percutaneous Cardiovascular Procedures
Peabody J, Paculdo D, Valdenor C, McCullough PA, Noiri E, Sugaya T, Dahlen JR. Cardiorenal Med. 2022;12(1):11-19. doi:10.1159/000520820
Clinical training Observational studyReal-world results
Initiative to Improve Evidence-Based Chronic Obstructive Pulmonary Disease Hospitalist Care Using a Novel On-Line Gamification Patient Simulation Tool: A Prospective Study
245 hospitalists at 15 Novant Health facilities worked through simulated COPD cases over 16 weeks. Quality-of-care scores rose 10.5%, and in the real-world data COPD pharmacy costs fell 19%, with an annualized 233 fewer inpatient days, 371 fewer revisit days and nearly $1 million in inpatient savings.
With Novant Health
Healthcare (Basel), 2021
Read the paper: Initiative to Improve Evidence-Based Chronic Obstructive Pulmonary Disease Hospitalist Care Using a Novel On-Line Gamification Patient Simulation Tool: A Prospective Study
Strong J, Weems L, Burgon T, Branch J, Martin J, Paculdo D, Tamondong-Lachica D, Cruz J, Peabody J. Healthcare (Basel). 2021;9(10):1267. doi:10.3390/healthcare9101267
Clinical training Randomized validation study
Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial
A national randomized trial in which practicing primary care physicians cared for eight weekly simulated cases with real-time evidence-based feedback and peer benchmarking. Three in four completed at least six cases, and evidence-based decisions improved across conditions, including diabetes (+8.3%) and quality measures such as diabetes eye exams (+22%) and asthma medications (+33%).
With a national sample of PCPs
Journal of Medical Internet Research, 2021
Read the paper: Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial
Burgon T, Casebeer L, Aasen H, Valdenor C, Tamondong-Lachica D, de Belen E, Paculdo D, Peabody J. J Med Internet Res. 2021;23(12):e31042. doi:10.2196/31042
Clinical utility research Randomized controlled trial
Finding the Clinical Utility of 1,5-Anhydroglucitol Among Primary Care Practitioners
A randomized trial among 145 primary care physicians caring for simulated patients with diabetes and short-term swings in glucose control. Physicians given a 1,5-anhydroglucitol result scored 3.2% higher on overall quality than controls, with nearly all of the gain in patients whose high glucose was caused by a medication, where scores rose 8.1%.
With Hikari Dx
Journal of Clinical & Translational Endocrinology, 2020
Read the paper: Finding the Clinical Utility of 1,5-Anhydroglucitol Among Primary Care Practitioners
Peabody J, Paculdo D, Acelajado MC, Burgon T, Dahlen JR. J Clin Transl Endocrinol. 2020;20:100224. doi:10.1016/j.jcte.2020.100224
Clinical training Observational studyReal-world results
A Better Pathway? Building Consensus and Engaging Providers With Feedback to Improve and Standardize Cancer Care
A multidisciplinary breast cancer team at an NCI-designated cancer center measured its care decisions on simulated patients, built its own breast cancer pathways, and received individual and group feedback on adherence. Overall quality scores rose from 47.5% to 61.1%, diagnostic accuracy improved by 22.1%, and unnecessary test orders fell by an estimated $305 per patient case.
With Huntsman Cancer Institute, University of Utah
Clinical Breast Cancer, 2019
Read the paper: A Better Pathway? Building Consensus and Engaging Providers With Feedback to Improve and Standardize Cancer Care
Colonna S, Sweetenham J, Burgon TB, Buys SS, Lynch R, Au T, Johnson E, Kubal T, Paculdo D, Acelajado MC, Peabody JW. Clin Breast Cancer. 2019;19(2):e376-e384. doi:10.1016/j.clbc.2018.12.010
Clinical training Observational studyReal-world results
Engaging Primary Care Providers to Reduce Unwanted Clinical Variation and Support ACO Cost and Quality Goals: A Unique Provider-Payer Collaboration
Primary care clinicians in a Connecticut ACO took six rounds of simulated cases with individual and group feedback over two years. In the cases, evidence-based quality scores rose 27% and unneeded testing fell 55%; their real ACO quality measures improved beyond the comparison group, with more than $4.8 million in calculated savings on unneeded tests and specialist referrals.
With ProHealth Physicians, Aetna Accountable Care Solutions
Population Health Management, 2019
Read the paper: Engaging Primary Care Providers to Reduce Unwanted Clinical Variation and Support ACO Cost and Quality Goals: A Unique Provider-Payer Collaboration
Burgon TB, Cox-Chapman J, Czarnecki C, Kropp R, Guerriere R, Paculdo D, Peabody JW. Popul Health Manag. 2019;22(4):321-329. doi:10.1089/pop.2018.0111
Clinical utility research Review
Establishing Clinical Utility for Diagnostic Tests Using a Randomized Controlled, Virtual Patient Trial Design
The methods paper: four randomized virtual-patient trials of diagnostic tests, each with the same two-round control and intervention design. Two showed clinical utility across the intended population and two in a sub-segment of it, and two of the tests went on to positive Palmetto coverage decisions. The reference for anyone asking whether the design is sound.
Diagnostics (Basel), 2019
Read the paper: Establishing Clinical Utility for Diagnostic Tests Using a Randomized Controlled, Virtual Patient Trial Design
Peabody J, Tran M, Paculdo D, Valdenor C, Burgon T, Jeter E. Diagnostics (Basel). 2019;9(3):67. doi:10.3390/diagnostics9030067
Clinical training Observational studyReal-world results
Reducing Unneeded Clinical Variation in Sepsis and Heart Failure Care to Improve Outcomes and Reduce Cost: A Collaborative Engagement with Hospitalists in a MultiState System
Hospitalists at eight AdventHealth hospitals cared for simulated sepsis and heart failure patients, with feedback, over two years, and were compared with six hospitals that did not take part. Their evidence-based care scores rose nearly 8%, length of stay fell faster than in the comparison group, and $2.4 million in savings was attributable to the project beyond system-wide improvements.
With AdventHealth
Journal of Hospital Medicine, 2019
Read the paper: Reducing Unneeded Clinical Variation in Sepsis and Heart Failure Care to Improve Outcomes and Reduce Cost: A Collaborative Engagement with Hospitalists in a MultiState System
Yurso M, Box B, Burgon T, Hauck L, Tagg K, Clem K, Paculdo D, Acelajado MC, Tamondong-Lachica D, Peabody JW. J Hosp Med. 2019;14(9):541-546. doi:10.12788/jhm.3220
Clinical training Observational studyReal-world results
Reducing Unwarranted Oncology Care Variation Across a Clinically Integrated Network: A Collaborative Physician Engagement Strategy
103 medical oncologists in a clinically integrated network cared for simulated breast and lung cancer patients every four months over six rounds, with feedback against evidence-based guidelines and their peers. Overall quality scores improved 11.9%, evidence-based chemotherapy regimens rose nearly 10 percentage points, and unnecessary test ordering fell 25%; in the network's own claims data, metastatic imaging workups for early-stage breast cancer declined in step with the simulations.
With Advocate Physician Partners
Journal of Oncology Practice, 2019
Read the paper: Reducing Unwarranted Oncology Care Variation Across a Clinically Integrated Network: A Collaborative Physician Engagement Strategy
Richards JM, Burgon TB, Tamondong-Lachica D, Bitran JD, Liangco WL, Paculdo DR, Peabody JW. J Oncol Pract. 2019;15(12):e1076-e1084. doi:10.1200/JOP.18.00754
Clinical utility research Randomized controlled trial
Impact of a protein-based assay that predicts prostate cancer aggressiveness on urologists' recommendations for active treatment or active surveillance: a randomized clinical utility trial
129 board-certified urologists cared for simulated patients with newly diagnosed early-stage prostate cancer. Those given a protein-based assay that predicts tumor aggressiveness were significantly more likely to recommend the preferred course, active surveillance or active treatment (p = 0.004), and to involve the patient in the decision.
With Metamark Genetics
BMC Urology, 2017
Read the paper: Impact of a protein-based assay that predicts prostate cancer aggressiveness on urologists' recommendations for active treatment or active surveillance: a randomized clinical utility trial
Peabody JW, DeMaria LM, Tamondong-Lachica D, Florentino J, Czarina Acelajado M, Ouenes O, Richie JP, Burgon T. BMC Urol. 2017;17(1):51. doi:10.1186/s12894-017-0243-1
Clinical utility research Randomized controlled trial
Clinical Utility of a Comprehensive, Whole Genome CMA Testing Platform in Pediatrics: A Prospective Randomized Controlled Trial of Simulated Patients in Physician Practices
A randomized trial among practicing pediatricians and specialists caring for simulated children with developmental disorders. Physicians given a higher-resolution chromosomal microarray test scored 7.2% higher on overall quality and 10.9% higher on diagnosis and treatment, with gains in condition-specific interventions for rare disorders.
With Lineagen
PLOS ONE, 2016
Read the paper: Clinical Utility of a Comprehensive, Whole Genome CMA Testing Platform in Pediatrics: A Prospective Randomized Controlled Trial of Simulated Patients in Physician Practices
Peabody J, Martin M, DeMaria L, Florentino J, Paculdo D, Paul M, Vanzo R, Wassman ER, Burgon T. PLoS One. 2016;11(12):e0169064. doi:10.1371/journal.pone.0169064
Clinical training Observational study
Improving Clinical Practice Using a Novel Engagement Approach: Measurement, Benchmarking and Feedback, a Longitudinal Study
Breast cancer providers at four sites across the United States worked through 12 simulated cases per site over several rounds of measurement, benchmarking and feedback. By the fourth round, overall quality scores had risen 14% from baseline and diagnosis and treatment plan scores 12%.
Journal of Clinical Medicine Research, 2016
Read the paper: Improving Clinical Practice Using a Novel Engagement Approach: Measurement, Benchmarking and Feedback, a Longitudinal Study
Peabody JW, Paculdo DR, Tamondong-Lachica D, Florentino J, Ouenes O, Shimkhada R, DeMaria L, Burgon TB. J Clin Med Res. 2016;8(9):633-640. doi:10.14740/jocmr2620w

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The published evidence behind our work

Practice change at system scale

Patient Simulation-Based Primary Care Training to Increase Evidence-Based COPD Care and Value-Based Success: Real-World Cost and Quality Impact Analysis

Enhancing Evidence-Based Decision Making Through Primary Care Provider–Pharmacist Collaboration and Patient Simulation Training

Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial

Initiative to Improve Evidence-Based Chronic Obstructive Pulmonary Disease Hospitalist Care Using a Novel On-Line Gamification Patient Simulation Tool: A Prospective Study

Reducing Unneeded Clinical Variation in Sepsis and Heart Failure Care to Improve Outcomes and Reduce Cost: A Collaborative Engagement with Hospitalists in a MultiState System

Engaging Primary Care Providers to Reduce Unwanted Clinical Variation and Support ACO Cost and Quality Goals: A Unique Provider-Payer Collaboration

Reducing Unwarranted Oncology Care Variation Across a Clinically Integrated Network: A Collaborative Physician Engagement Strategy

A Better Pathway? Building Consensus and Engaging Providers With Feedback to Improve and Standardize Cancer Care

Clinical utility, established in randomized trials

Impact of a blood-based biomarker on neurologist diagnostic decision-making for Alzheimer's disease: a randomized virtual trial

Helping primary care providers recognize and respond to medication non-adherence and drug-drug interactions: A randomized-controlled clinical utility trial in a value-based care setting

A Randomized Controlled Study on Clinical Adherence to Evidence-Based Guidelines in the Management of Simulated Patients With Barrett's Esophagus and the Clinical Utility of a Tissue Systems Pathology Test: Results From Q-TAB

Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney Injury During Percutaneous Cardiovascular Procedures

Finding the Clinical Utility of 1,5-Anhydroglucitol Among Primary Care Practitioners

Establishing Clinical Utility for Diagnostic Tests Using a Randomized Controlled, Virtual Patient Trial Design

Impact of a protein-based assay that predicts prostate cancer aggressiveness on urologists' recommendations for active treatment or active surveillance: a randomized clinical utility trial