Comparative Effectiveness studies

Our researchers compare the benefits and harms of various methods for the prevention, treatment, and delivery of care to determine what will work best for specific people or populations. We collaborate with the Center for Effectiveness & Safety Research, a national Kaiser Permanente network that addresses questions in comparative effectiveness and on the safety of drugs, devices, biologics, and care delivery strategies.

A Sequential Multiple Assignment Randomized Trial (SMART) Assessing Medication and CBT Sequencing Strategies in the Treatment of Predominantly Ethnic Minority, Underserved Youth with Anxiety Disorders

Anxiety disorders affect more than 20 percent of youth, often interfering with self-esteem, confidence, family relationships, friendships, or school performance. Although psychological and medication therapies are helpful to many patients, not all patients respond to a given therapy, and those who do frequently respond relapse later. Treatment of a child who has an anxiety disorder begins with the question of which treatment to begin first: psychological or medication therapy. Few studies, however, have compared these two treatments directly, leaving patients, parents, and clinicians without scientific evidence for which treatment is likely to be most helpful. Another question is what to do when the initial treatment is not as helpful as desired: Should the initial single treatment be intensified, or should the other treatment be added to the first, producing a combined psychological and medication therapy? This randomized trial will clarify whether treatment of anxiety should be initiated with medication or cognitive-behavioral therapy and how to proceed if the initial treatment is not as successful as desired.

Site Principal Investigator:

Corinna Koebnick, PhD, MSc

Funding Source:

Patient-Centered Outcomes Research Institute (PCORI)

Funding Years:

2021 - 2024

Adverse Health Outcomes in Breast Cancer Survivors exposed to Pain Medications

The aim of this longitudinal cohort study is to evaluate the comparative safety and risk of opioids and psychotropic drugs in women with breast cancer who suffer from chronic pain due to cancer or its treatments.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

California Breast Cancer Research Program (CBCRP)

Funding Years:

2020 - 2023

ASCEND Clinical Trial

A clinical trial to study the efficacy of natalizumab on reducing disability progression in subjects with secondary progressive multiple sclerosis.

Principal Investigator:

Annette M. Langer-Gould, MD, PhD, MS

Funding Source:

Biogen Idec, Inc.

Funding Years:

2011 - 2016

Cholesterol-lowering medication as risk factors for amyotrophic lateral sclerosis

The primary objective of this study is to investigate whether the use of cholesterol-lowering medications increases the risk of developing ALS or influences the rate of disease progression among individuals who have ALS.

Principal Investigator:

Annette M. Langer-Gould, MD, PhD, MS

Funding Source:

Centers for Disease Control and Prevention (CDC)

Funding Years:

2012 - 2013

Chronic Myelogenous Leukemia and Outcomes of Tyrosine Kinase Inhibitor Therapy

The aim of this investigation initiated retrospective cohort study are to examine long-term health effects in the cohort of CML and determine if health effects vary by drug adherence to TKIs.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

Novartis Pharmaceuticals Corporation

Funding Years:

2013 - 2018

Comparing Strategies for Implementing Primary HPV Testing for Routine Cervical Cancer Screening

The major goal of this project is to compare two implementation strategies to facilitate adoption of primary HPV testing for routine cervical cancer screening measured by patient-, provider- and system-centered outcomes. A sub-analysis and survey data collection will evaluate the impact of the COVID pandemic on this practice change and cervical cancer screening.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

Patient-Centered Outcomes Research Institute (PCORI)

Funding Years:

2019 - 2023

Comparison of type 2 diabetes pharmacotherapy regimens using targeted learning

The multi-center study will compare newer classes of drugs with older, lower-cost medications, and take a close look at whether the benefits and harms differ between patients who are at low risk or high risk of developing heart problems. The study will also look at whether benefits and harms differ based on the patient’s age, sex, race or ethnicity, heart and kidney function, or other health problems. The findings will help patients with type 2 diabetes and their doctors make more personalized medication treatment decisions.

Site Principal Investigator:

Jaejin An, PhD

Funding Source:

Patient-Centered Outcomes Research Institute (PCORI)

Funding Years:

2021 - 2025

Research Categories:

,

Comparison of vaccine effectiveness against hospitalization for influenza between cell-based and egg-based influenza vaccines

The proposed study aims to compare the vaccine effectiveness (VE) against hospitalization for influenza between Flucelvax Quadrivalent and egg-based influenza vaccines used in Kaiser Permanente Southern California (KPSC) during the 2017-2018 season.

Principal Investigator:

Hung Fu Tseng, PhD, MPH

Funding Source:

Seqirus, Inc.

Funding Years:

2018 - 2019

Effectiveness and Safety of Recombinant Zoster Vaccine (RZV) in Patients with Psoriasis (PsO) or Psoriatic Arthritis (PsA)

The vaccine effectiveness (VE) objectives are to estimate the VE of at least one RZV dose in preventing herpes zoster (HZ) in adults>=18 years of age with psoriasis (PsO) and psoriatic arthritis (PsA). The safety objectives are to assess the number of incident flare cases within 30 days following any RZV vaccination as compared to the risk in self-controlled comparison periods, in adults>=18 years of age with PsO and PsA.

Principal Investigator:

Hung Fu Tseng, PhD, MPH

Funding Source:

GlaxoSmithKline, LLC

Funding Years:

2022 - 2028

Effectiveness of pneumococcal conjugate vaccine against severe clinical outcomes of coronavirus disease 2019 (COVID-19) among adults: a cohort study

The objectives of this study were to assess the effectiveness of PCV13 against severe COVID-19 outcomes and to assess the burden of PCV13-preventable illness attributable to COVID-19.

Principal Investigator:

Sara Yee Tartof, PhD, MPH

Funding Source:

Pfizer, Inc.

Funding Years:

2020 - 2021

Effectiveness of pneumococcal vaccination to prevent hospitalized all-cause pneumonia among adults>=18 years at Kaiser Permanente Southern California

The objectives of this study are to estimate the incidence of invasive pneumococcal disease (IPD), pneumococcal pneumonia (PP), all-cause pneumonia, and lower respiratory tract infections (LRTI) by Advisory Committee on Immunization Practices (ACIP)-defined risk profile in adults>=18 years.

Principal Investigator:

Sara Yee Tartof, PhD, MPH

Funding Source:

Pfizer, Inc.

Funding Years:

2020 - 2023

Longitudinal Assessment of Benefits and Harms of Cannabis Use Among Community-Based Cancer Patients During Initial Cancer Treatment

Given the lack of evidence regarding the benefits or harms of cannabis, we will conduct a new study of 1000 adult cancer patients to compare people who use cannabis versus non-users. Our study will provide new information to educate individuals and their healthcare providers about whether to consider using cannabis alongside other conventional ways to manage cancer-related symptoms.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2023 - 2028

Research Categories:

,

Management of direct oral anticoagulants to lower adverse events in atrial fibrillation (MODL-AF)

The overall objective of this project is to identify the direct oral anticoagulant care model(s) that maximize(s) (1) safety (major bleeding), (2) effectiveness (stroke), and (3) cost.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Agency for Healthcare Research and Quality (AHRQ)

Funding Years:

2018 - 2022

Optimizing Risk Stratification and Comparative Effectiveness Research for Atrial Fibrilliation

The major goals of this project was to develop a collaboration of population-based researchers as well as a research platform using a contemporary cohort of about 40,000 adults with atrial fibrillation to improve comparative effectiveness studies, risk stratification of outcomes and the planning and conduct of future observational studies and randomized trials for atrial fibrillation.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Heart, Lung, and Blood Institute (NHLBI)

Funding Years:

2009 - 2012

Real World Effectiveness and Economic Impact of Subcutaneous Methotrexate compared to Oral Methotrexate Treatment for Rheumatoid Arthritis

This prospective study will evaluate the real-world effectiveness of subcutaneous vs. oral methotrexate treatment on disease activity and functional status of rheumatoid arthritis patients. We will also evaluate effectiveness on patient centered outcomes, treatment adherence, cost, and work productivity. Lastly, using a discrete choice experiment, we will estimate patient’s valuation of these outcomes and their willingness to pay.

Principal Investigator:

Aniket A. Kawatkar, PhD, MS

Funding Source:

Medac Pharma, Inc.

Funding Years:

2016

Real World Evidence of Paxlovid at Kaiser Permanente Southern California

This project will describe characteristics associated with prescribing and dispensing of individuals receiving Paxlovid and not receiving Paxlovid among SARS-CoV-2 positive individuals.

Principal Investigator:

Sara Yee Tartof, PhD, MPH

Funding Source:

Pfizer, Inc.

Funding Years:

2022 - 2024

Real-World Study of the Comparative Effectiveness of Licensed Influenza Vaccines in Preventing Hospitalizations with Influenza in the 2022-2023 Influenza Season

Comparative vaccine effectiveness of influenza vaccine in the 2022-2023 season.

Principal Investigator:

Hung Fu Tseng, PhD, MPH

Funding Source:

ModernaTX, Inc.

Funding Years:

2023 - 2025

Reducing Childhood Obesity through EHR-supported Motivational Interviewing

Rates of childhood obesity in the U.S. remain at historic highs. Primary care settings lack interventions to address the childhood obesity epidemic that are feasible and sustainable without requiring significant resources. We will test a motivational interviewing-based intervention shown to lower children’s BMI in a real-world clinical setting with the goal of halting and reversing the childhood obesity epidemic.

Principal Investigator:

Corinna Koebnick, PhD, MSc

Funding Source:

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Funding Years:

2021 - 2026

Skeletal Outcomes in Primary Hyperparathyroidism

The aim of the study is to retrospectively compare fracture rates and BMD changes in patients with PHPT who have received the following types of treatment: observation, bisphosphonate therapy, surgery, or both surgery and bisphosphonate therapy.

Principal Investigator:

Annette L. Adams, PhD, MPH

Funding Source:

University of California, Los Angeles (UCLA)

Funding Years:

2013 - 2019

The Comparative effectiveness of Warfarin and New Oral Anticoagulants for the Extended Treatment of Venous Thromboembolism

The overall goal of this project is to provide information on the benefits and harms comparing different treatment options for the extended treatment of VTE, information that can be used by clinicians and patients in deciding on the optimal treatment strategy.
COVID-19-Related Project Enhancement
Recent studies have reported that COVID-19 is associated with abnormal coagulation profiles and may predispose patients to VTE and other types of thrombotic events. The goals of this study are to determine the risk of VTE following COVID-19 hospitalization and whether the risk of post-hospitalization VTE varies by age, prior history of VTE or severity of COVID-19.

Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Patient-Centered Outcomes Research Institute (PCORI)

Funding Years:

2016 - 2021

Use of Multiple Biomarkers with the Risk of Ovarian Cancer Algorithm (ROCA) for Early Detection of Ovarian Cancer in Female Carriers of BRCA1 and BRCA2 mutations

The goal of this prospective recruitment study is to determine if ovarian cancer screening is enhanced by more frequent biomarker testing (CA125 & HE4) versus usual testing frequency in women with BRCA1/2 mutations.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

Garfield Memorial Fund

Funding Years:

2016 - 2019