Deborah Schrag, MD, MPH
Professor, Department of Medicine, Harvard Medical School
Chief, Division of Population Sciences, Medical Oncology, Dana-Farber Cancer Institute
DF/HCC Program AffiliationGastrointestinal Malignancies
Cancer Care Delivery Research, Leader
DF/HCC AssociationsDeputy Associate Director, Population Sciences, Executive Committee
Member, Center Scientific Council
Research AbstractI am a health services researcher focusing on the study of cancer care delivery. I describe the patterns and outcomes of cancer treatment in order to determine how well treatments with efficacy established in the clinical trial setting are translated into practice in non-research settings. This involves strategic use of observational and found data sources and application of statistical techniques to evaluate the impact of treatment interventions in non-experimental settings. Recent work has focussed on technology diffusion and efforts to determine what determines how rapidly new treatments are adopted and the factors that drive utilization. My current project seeks to evaluate the quality of care delivered to indigent patients with cancer who are insured by the State Medicaid programs in New York and California. By using Medicaid enrollment and claims histories linked to other data sources including hospital discharge abstracts and tumor registry data, the goal is to prioritize areas for improving care delivery to the poor. Ultimately, the goal is to inform design of sustainable systems architecture for ongoing surveillance of the quality of cancer care.
An alternate theme of my research involves improving the cancer care experience for patients by enhancing data collection, information systems and ultimately patient-clinician communication. Specifically, I am interested in monitoring patient toxicity during chemotherapy treatment by using web-based interface for online symptom reporting. With collaborators, I seek to determine whether we can more effectively engage patients in reporting their symptoms and thereby minimize toxicity without compromising outcomes. In addition, I am interested in evaluating the extent to which individually tailored patient information such as the preparation of treatment summaries and treatment plans serve to enhance care coordination and quality.
I pursue these research areas through a series of collaborative projects and work with health services researchers, biostatisticians, epidemiologists, clinical trialists, decision scientists and economists. I work with a variety of organizations such as ASCO, the NCCN, CALGB and ABIM to develop strategies to evaluate and improve the quality of cancer care. Although most of the research questions I am interested are relevant across the spectrum of malignant disease, as a practicing gastrointestinal oncologist, I have greatest expertise in GI tumors and have focused to greatest extent on studying these themes with respect to colorectal cancer.