Jason N Doctor, Ph.D.

Associate Professor
Clinical Pharmacy and Pharmaceutical Economics & Policy

Phone: (323) 442-3435
Fax: (323) 442-1462
Email: jdoctor@pharmacy.usc.edu

Research Interest
I have been interested in understanding how best to represent preferences for health outcomes in pharmaceutical and health economic studies with a focus on Quality-adjusted Life Year (QALY) models. The QALY model yields a measure of life expectancy with adjustments for quality of life; each year of survival is valued somewhere along the continuum between 0 (death) and 1.0 (full health). For example, in the simplest model, a pharmaceutical treatment that improves quality of life by 0.2 for each of five years will result in the equivalent of one QALY gained over that five year period. This system has the advantage of considering both benefits and side-effects of pharmaceuticals in terms of the common QALY unit. However, how numbers are assigned to health states in this model is a matter of major importance and of considerable debate. There are both theoretical and methodological arguments that assignment of these numbers must be based on subject?s willingness to risk death. The other extreme involves simple state valuations using rating scales, or trade-offs between health quality and length of life when no risk of death is involved. All of the different approaches are influences by psychological biases associated with how preference responses are gathered. Verification of QALY assumptions and mitigation of psychological bias is essential to the application of the models in pharmaceutical economic studies. A secondary interest of mine has been the application of formal models for decision making in health and medicine.

Ongoing funded research projects are: (a) the application of QALYs in the cost-effectiveness of pharmacotherapy for post-traumatic stress disorder; (b) the validation of QALYs in the selection of Intensity-Modulated Radiation Therapy for prostate and head and neck cancer treatment plan selection; (c) the application of belief networks in public health disease surveillance; (d) decision theoretic belief networks with a focus on error-management within blood lab data.

Biography
Dr. Doctor received his Ph.D. in clinical psychology from the University of California at San Diego. He served as a research fellow at the University of Washington. Prior to coming to USC this year, Dr. Doctor was an Associate Professor of Medical Education & Biomedical Informatics, Health Services and Rehabilitation Medicine at the University of Washington.

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Selected Projects/Publications
Doctor JN, Miyamoto JM. Deriving quality-adjusted life years (QALYs) from constant proportional time trade and risk posture conditions. J Mathematical Psychology 2003; 47,557-567.

Doctor JN, Bleichrodt H, Miyamoto JM, Temkin NR, Dikem SS. A new and more robust test of QALYs. J Health Economics 2004; 23,353-367.

Bleichrodt H, Doctor J, Stolk E. Equity weighting QALYs:the rank dependent QALY model. J Health Economics 2005; 24,655-678.

Doctor JN, Castro J, Temkin NR, Fraser RT, Machamer JE, Dikmen SS. Workers' risk of unemployment after traumatic brain injury: a normed comparison. J International Neuropsychological Society 2005; 11,1-6.

Doctor JN, Miyamoto JM. Person tradeoffs and the problem of risk. Expert Reviews in Pharmacoeconomics & Outcome Research 2005;5,667-682.

Sox CM, Koepsell TD, Doctor JN, Christakis DA. Pediatricians' clinical decision making: results of two randomized controlled trials of decisions support. Arch Ped and Adol Med 2006; 160,487-492.

Kahn JM, Doctor JN, Rubenfeld GD. Stress ulcer prophlaxis in mechanically ventilated patients: integrating evidence and judgment using a decision analysis. Intensive Care Medicine 2006, {Epub ahead of print}.