David Matchar
Director, Center for Clinical Health Policy Research
Appointment:
David Matchar
Director, Center for Clinical Health Policy Research
My scientific contributions relate innovative use of evidence to inform clinical and public policy decision making. My early work centered on stroke prevention and treatment (questionable value of carotid testing in low risk individuals, underuse and poor quality of use of anticoagulation for stroke prevention, the value of aggressive anticoagulation monitoring including the use of patient self-testing strategies, and the unappreciated role of rehabilitation in stroke care.) In cognitive impairment, my contribution has been to clarify the role of diagnostic testing for Alzheimer’s disease, the importance of early diagnosis on planning and avoidance of unnecessary testing and evaluation. In chronic kidney disease, I have guided a series of projects aimed at developing evidence-based tailored strategies for improving conformance to guidelines.
More recently, my work has applied simulation modeling to clarify the challenges of a rapidly aging population, including future prevalence of disability and the impact of education the trajectory of prevalence, understanding the role of different forms of long-term care services in alleviating caregiver burden, and estimating health care manpower requirements under alternative models of care. This work has led to the formulation of a needs-based framework for healthcare delivery and the development, validation and application of the Simple Segmentation Tool (SST), a simplified inventory of patient-level health service needs, different combinations of which can be mapped to different appropriate means for addressing these needs. I have extended this effort from developed countries (US, Singapore, and Switzerland) to low/middle income countries (Cambodia, Thailand).
I serve as consultant in the general area of analytic strategies for clinical policy development, as well as for specific projects related to stroke (e.g., acute stroke treatment, management of atrial fibrillation, and use of carotid endarterectomy.) I have worked with AHCPR (now AHRQ), ACP, AHA, AAN, Robert Wood Johnson Foundation, NSA, WHO, and several pharmaceutical companies.
Publications
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Koh V, Xuan LW, Zhe TK, Singh N, B Matchar D, Chan A. Performance of digital technologies in assessing fall risks among older adults with cognitive impairment: a systematic review. Geroscience. 2024 Mar 4;Ng TKS, Wee HN, Ching J, Kovalik J-P, Chan AW, Matchar DB. Plasma Acylcarnitines as Metabolic Signatures of Declining Health-Related Quality of Life Measure in Community-Dwelling Older Adults: A Combined Cross-sectional and Longitudinal Pilot Study. J Gerontol A Biol Sci Med Sci. 2024 Mar 1;79(3).Lam SSW, Chen J, Wu JT, Lee CF, Ragavendran N, Ong MEH, et al. Association of quality-of-care indicators with asthma outcomes: A retrospective observational study for asthma care in Singapore. Annals of the Academy of Medicine Singapore. 2023 Oct 1;52(10):497–509.Lai WX, Chan AW-M, Matchar DB, Ansah JP, Lien CTC, Ismail NH, et al. Group Model Building on causes and interventions for falls in Singapore: insights from a systems thinking approach. BMC Geriatr. 2023 Sep 22;23(1):586.
See more publications at Scholars@Duke