Quality and Appropriate Use

Dr. Keyhani’s research program includes the examination of the quality of care in the US health system and health care policy research. Her quality of care research to date has focused on examining the underuse and overuse of medical procedures, comparing receipt of appropriate therapy in different systems of care (e.g. Medicare versus Veterans Health Administration) and examining system factors that contribute to improved quality. Over the past few years year, her quality of care work has focused more specifically on stroke therapies such as carotid endarterectomy and thrombolytic therapy. Her policy research to date has largely focused on areas important to health care reform and factors that may contribute to inefficiency and the use of inappropriate care in the US health care system. This includes having surveyed physicians on their views towards insurance coverage, national guidelines, comparative effectiveness research, defensive medicine and conflicts of interest in medicine; as well as examining policy issues surrounding overuse of health care service with a specific focus on examining the relationship between systems of care and overuse.   

Dr. Keyhani’s outcomes research is grounded in the quality of care and policy work conducted over the past decade. One current project includes evaluating the comparative effectiveness of carotid endarterectomy and stenting to modern medical therapy for patients with asymptomatic carotid stenosis. This study incorporates natural language processing to create a cohort of patients with asymptomatic carotid stenosis. Other projects focus on extracting measures of social risk using natural language processing from the electronic medical record (living alone, lack of social support, substance abuse) to improve the patient-level prediction of 30-day hospital readmission as well as examining their impact on hospital profiling.