Shelby Reed

Overview:

Shelby D. Reed, PhD, is a professor in medicine at the Duke University School of Medicine. She works primarily at the Duke Clinical Research Institute. Dr. Reed holds a PhD in pharmaceutical health services research from the University of Maryland School of Pharmacy and completed a 2-year postdoctoral fellowship in the Pharmaceutical Outcomes Research and Policy Program and the Center for AIDS Research at the University of Washington. Dr. Reed has nearly 20 years of experience in economic evaluation, health services research and health policy. Dr. Reed has extensive expertise in designing and conducting trial-based and model-based cost-effectiveness analyses of medical diagnostics and interventions in numerous therapeutic areas. She was a member of the ISPOR Task Forces that published recommendations for Good Research Practices for Cost-Effectiveness Analysis Alongside Clinical Trials in 2005 and 2015. She has led a wide range of economic and epidemiological studies using secondary data from health care claims, clinical trials, surveys and disease registries. In her evaluations of health policy issues, she has developed computer models to analyze the potential economic impact of trends in clinical trial design, changes in reimbursement policies, financial incentives and the regulatory process in the development of orphan drugs, and the societal value of alternative approaches to identifying drug safety problems. 

Areas of expertise: Health Economics, Health Measurement, Health Policy, and Health Services Research

Positions:

Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Professor in Medicine

Medicine, General Internal Medicine
School of Medicine

Associate of the Duke Initiative for Science & Society

Duke Science & Society
Institutes and Provost's Academic Units

Member in the Duke Clinical Research Institute

Duke Clinical Research Institute
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 1998

University of Maryland, College Park

Grants:

Tissue and Data Acquisition Activity for the Study of Gynecologic Disease

Administered By
Obstetrics and Gynecology, Gynecologic Oncology
Role
Collaborator
Start Date
End Date

Multi-factorial Intervention to Slow Progression of Diabetic Kidney Disease

Administered By
Basic Science Departments
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Integrated Population Program for Diabetic Kidney Disease

Administered By
Basic Science Departments
Awarded By
National Institutes of Health
Role
Economist
Start Date
End Date

Take Control of Your Blood Pressure (TCYB) Study

Administered By
Medicine, General Internal Medicine
Awarded By
National Institutes of Health
Role
Economist
Start Date
End Date

Thyrogen Utilization Patterns in the Treatment of Thyroid Cancer

Administered By
Duke Clinical Research Institute
Role
Co Investigator
Start Date
End Date

Publications:

Comparing the Noncomparable: The Need for Equivalence Measures That Make Sense in Health-Economic Evaluations.

BACKGROUND: The popularity of quality-adjusted life years (QALYs) has been resistant to concerns about validity and reliability. Utility-theoretic outcome equivalents are widely used in other areas of applied economics. Equivalence values can be derived for time, money, risk, and other metrics. These equivalence measures preserve all available information about individual preferences and are valid measures of individual welfare changes. OBJECTIVE: The objective of this study was to derive alternative generalized equivalence measures from first principles and illustrate their application in an empirical comparative-effectiveness example. METHODS: We specify a general-equilibrium model incorporating neoclassical utility functions, health production function, severity-duration preferences, and labor-market tradeoff function. The empirical implementation takes advantage of discrete-choice experiment methods that are widely accepted in other areas of applied economics and increasingly in health economics. We illustrate the practical significance of restrictive QALY assumptions using comparative-effectiveness results based on both QALYs and estimates of welfare-theoretic time-equivalent values for anti-tumor necrosis factor and prolonged corticosteroid treatments for Crohn's disease in three distinct preference classes. RESULTS: The QALY difference between the two treatments is 0.2 months, while time-equivalent values range between 0.5 and 1.3 months for aggregate and class-specific differences. Thus, the QALY-based analysis understates welfare-theoretic values by 60%-85%. CONCLUSION: These results suggest that using disease-specific equivalence values offer a meaningful alternative to QALYs to compare global outcomes across treatments. The equivalence values approach is consistent with principles of welfare economics and offers several features not represented in QALYs, including accounting for preference nonlinearities in disease severity and duration, inclusion of preference-relevant nonclinical healthcare factors, representing preferences of clinically-relevant patient subpopulations, and including utility losses related to risk aversion.
Authors
Johnson, FR; Scott, FI; Reed, SD; Lewis, JD; Bewtra, M
MLA Citation
Johnson, F. Reed, et al. “Comparing the Noncomparable: The Need for Equivalence Measures That Make Sense in Health-Economic Evaluations..” Value Health, vol. 22, no. 6, June 2019, pp. 684–92. Pubmed, doi:10.1016/j.jval.2019.03.011.
URI
https://scholars.duke.edu/individual/pub1389957
PMID
31198186
Source
pubmed
Published In
Value Health
Volume
22
Published Date
Start Page
684
End Page
692
DOI
10.1016/j.jval.2019.03.011

Impact of exenatide on medical costs and health utilities in type 2 diabetes: experience from EXSCEL

Authors
Reed, SD; Li, Y; Dakin, H; Becker, F; Leal, J; Gustavson, SM; Kartman, B; Wittbrodt, E; Mentz, RJ; Pagidipati, NJ; Bethel, MA; Gray, AM; Holman, RR; Hernandez, AF
MLA Citation
Reed, S. D., et al. “Impact of exenatide on medical costs and health utilities in type 2 diabetes: experience from EXSCEL.” Diabetologia, vol. 61, SPRINGER, 2018, pp. S426–S426.
URI
https://scholars.duke.edu/individual/pub1350810
Source
wos
Published In
Diabetologia
Volume
61
Published Date
Start Page
S426
End Page
S426

Testing a behavioral intervention to improve adherence to adjuvant endocrine therapy (AET).

Authors
Kimmick, GG; Bosworth, HB; Keefe, FJ; Sutton, L; Owen, L; Erkanli, A; Reed, SD; Staley, SA; Pak, S; Barrett, N; Huettel, S; Shelby, RA
MLA Citation
Kimmick, Gretchen Genevieve, et al. “Testing a behavioral intervention to improve adherence to adjuvant endocrine therapy (AET)..” Journal of Clinical Oncology, vol. 35, no. 15_suppl, American Society of Clinical Oncology (ASCO), 2017, pp. TPS10128–TPS10128. Crossref, doi:10.1200/jco.2017.35.15_suppl.tps10128.
URI
https://scholars.duke.edu/individual/pub1286420
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
35
Published Date
Start Page
TPS10128
End Page
TPS10128
DOI
10.1200/jco.2017.35.15_suppl.tps10128

The clinical course of health status and association with outcomes in patients hospitalized for heart failure: insights from ASCEND-HF.

AIMS: A longitudinal and comprehensive analysis of health-related quality of life (HRQOL) was performed during hospitalization for heart failure (HF) or soon after discharge. METHODS AND RESULTS: A post-hoc analysis was performed of the ASCEND-HF trial. The EuroQOL five dimensions questionnaire (EQ-5D) was administered to study participants at baseline, 24 h, discharge/day 10, and day 30. EQ-5D includes functional dimensions mapped to corresponding utility scores (i.e. 0 = death and 1 = perfect health), and a visual analogue scale (VAS) ranging from 0 (i.e. 'worst imaginable health state') to 100 (i.e. 'best imaginable health state'). The association between baseline and discharge EQ-5D measurements and subsequent clinical outcomes including death and rehospitalization were assessed using multivariable logistic regression and Cox proportional hazards regression. A total of 6943 patients (97%) had complete EQ-5D data at baseline. Mapped utility and VAS scores (mean ± SD) increased over time, respectively, from 0.56 ± 0.23 and 45 ± 22 at baseline to 0.67 ± 0.26 and 58 ± 22 at 24 h and to 0.79 ± 0.20 and 68 ± 22 at discharge, and remained stable at day 30. Lower mapped utility scores at baseline [odds ratio (OR) per 0.1 decrease in utility score 1.03, 95% confidence interval (CI) 1.00-1.06] and discharge (OR 1.10, 95% CI 1.05-1.15) and VAS scores at baseline (OR per 10 point decrease 1.05, 95% CI 1.01-1.09) were significantly associated with increased risk of 30-day all-cause death or HF rehospitalization. CONCLUSIONS: Patients hospitalized for HF had severely impaired health status at baseline and, although this improved substantially during admission, health status remained abnormal at discharge.
Authors
Ambrosy, AP; Hernandez, AF; Armstrong, PW; Butler, J; Dunning, A; Ezekowitz, JA; Felker, GM; Greene, SJ; Kaul, P; McMurray, JJ; Metra, M; O'Connor, CM; Reed, SD; Schulte, PJ; Starling, RC; Tang, WHW; Voors, AA; Mentz, RJ
MLA Citation
Ambrosy, Andrew P., et al. “The clinical course of health status and association with outcomes in patients hospitalized for heart failure: insights from ASCEND-HF..” Eur J Heart Fail, vol. 18, no. 3, Mar. 2016, pp. 306–13. Pubmed, doi:10.1002/ejhf.420.
URI
https://scholars.duke.edu/individual/pub1092518
PMID
26467269
Source
pubmed
Published In
Eur J Heart Fail
Volume
18
Published Date
Start Page
306
End Page
313
DOI
10.1002/ejhf.420

Initial Trends in the Use of the 21-Gene Recurrence Score Assay for Patients With Breast Cancer in the Medicare Population, 2005-2009.

IMPORTANCE: In 2006, the Centers for Medicare & Medicaid Services approved coverage for the use of the 21-gene recurrence score (RS) assay in women with early-stage, estrogen receptor-positive, node-negative breast cancers to help guide recommendations for adjuvant chemotherapy. Use of the assay in community settings has not been previously examined in a nationally representative sample of patients. OBJECTIVE: To examine trends in the use of the RS assay in routine clinical practice in a nationally representative sample of women with breast cancer. DESIGN, SETTING, AND PARTICIPANTS: Retrospective observational study of Medicare beneficiaries diagnosed with incident breast cancer between 2005 and 2009, as recorded in a Surveillance, Epidemiology, and End Results data set with linked Medicare claims through 2010. MAIN OUTCOMES AND MEASURES: Demographic and clinical variables associated with the use of the assay. RESULTS: A total of 70,802 patients met the study criteria. Use of the RS assay increased from 1.1% in 2005 to 10.1% in 2009 (P < .001). The majority of tests (60.9%) occurred in patients with National Comprehensive Cancer Network-defined intermediate-risk disease (ie, estrogen receptor-positive, node-negative tumors >1 cm). Most patients with other than intermediate-risk disease had borderline indications for testing, including T1b (47.5%) or N1 (26.8%) disease. Testing was associated with younger age, fewer comorbid conditions, higher-grade disease, and being married. Among patients younger than 70 years with intermediate-risk disease, testing rates increased from 7.7% in 2005 to 38.8% in 2009 (P < .001). In multivariable analysis, testing was modestly higher in Northeast than in Western registries (odds ratio, 1.83; 95% CI, 1.49-2.26) but was otherwise not associated with region, local census tract demographic characteristics, black race, location in an urban area, or tumor histologic characteristics. CONCLUSIONS AND RELEVANCE: The RS assay was adopted quickly in clinical practice after the Medicare coverage decision in 2006, and use appears to be consistent with guidelines and equitable across geographic and racial groups. Factors influencing adoption of the assay and its impact on adjuvant chemotherapy use in clinical practice remain important areas of study.
Authors
Dinan, MA; Mi, X; Reed, SD; Hirsch, BR; Lyman, GH; Curtis, LH
MLA Citation
Dinan, Michaela A., et al. “Initial Trends in the Use of the 21-Gene Recurrence Score Assay for Patients With Breast Cancer in the Medicare Population, 2005-2009..” Jama Oncol, vol. 1, no. 2, May 2015, pp. 158–66. Pubmed, doi:10.1001/jamaoncol.2015.43.
URI
https://scholars.duke.edu/individual/pub1079143
PMID
26181015
Source
pubmed
Published In
Jama Oncol
Volume
1
Published Date
Start Page
158
End Page
166
DOI
10.1001/jamaoncol.2015.43

Research Areas:

Academic Medical Centers
Alzheimer Disease
Ambulatory Care
Anemia, Sickle Cell
Angiotensin-Converting Enzyme Inhibitors
Anti-Bacterial Agents
Anticoagulants
Antifungal Agents
Antineoplastic Agents
Arthritis, Rheumatoid
Arthroplasty, Replacement, Knee
Bacterial Infections
Behavior Therapy
Biotechnology
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Blood Transfusion
Brain
Brain Ischemia
Breast Neoplasms
Candida glabrata
Cardiac Surgical Procedures
Cardiovascular Diseases
Cardiovascular Surgical Procedures
Cerebrovascular Disorders
Chemoprevention
Chemotherapy, Adjuvant
Chronic Disease
Clinical Trial
Clinical Trials as Topic
Cohort Studies
Commerce
Comorbidity
Comparative Effectiveness Research
Continental Population Groups
Cost Savings
Cost of Illness
Cost-Benefit Analysis
Costs
Costs and Cost Analysis
Data Collection
Data Interpretation, Statistical
Decision Making
Decision Support Techniques
Decision Trees
Dermatitis, Atopic
Device Approval
Diabetes Mellitus
Diabetes Mellitus, Type 1
Diffusion of Innovation
Disease Management
Disease Progression
Disease-Free Survival
Drug Approval
Drug Costs
Drug Industry
Drug Prescriptions
Drug Therapy, Combination
Economics, Hospital
Economics, Pharmaceutical
Efficiency, Organizational
Evidence-Based Medicine
Exercise Therapy
Financial Management
Financing, Organized
Follow-Up Studies
Forecasting
Fractures, Bone
Gene Expression Profiling
Government Regulation
Health Care Costs
Health Care Rationing
Health Expenditures
Health Resources
Health Services
Health Services Research
Health Status
Heart Failure
Hospital Costs
Hospital Mortality
Hospitalization
Hypertension
Inpatients
Insulin Infusion Systems
Kidney Failure, Chronic
Length of Stay
Linear Models
Lymph Node Excision
Medical Laboratory Science
Medicine
Methicillin-Resistant Staphylococcus aureus
Models, Economic
Models, Statistical
Multivariate Analysis
Myocardial Infarction
Myocardial Ischemia
Neoplasm Metastasis
Neoplasm Recurrence, Local
Neoplasms
Orthopedic Procedures
Osteoarthritis
Outcome Assessment (Health Care)
Outcome and Process Assessment (Health Care)
Ovarian Neoplasms
Pancreatectomy
Pancreatic Neoplasms
Patient Care Management
Patient Discharge
Patient Readmission
Patient-Centered Care
Perception
Peripheral Nervous System Diseases
Pharmacy
Physician's Practice Patterns
Policy Making
Polymorphism, Genetic
Practice Patterns, Physicians'
Predictive Value of Tests
Program Evaluation
Proportional Hazards Models
Prostatic Neoplasms
Quality of Life
Questionnaires
Radiotherapy, Adjuvant
Randomized Controlled Trials as Topic
Recurrence
Registries
Renal Dialysis
Research Design
Resource Allocation
Respiratory Function Tests
Risk Assessment
Risk Factors
Social Values
Socioeconomic Factors
Staphylococcal Infections
Staphylococcus aureus
Stem Cell Transplantation
Stents
Stroke
Subarachnoid Hemorrhage
Surgical Procedures, Operative
Surgical Wound Infection
Surveys and Questionnaires
Terminal Care
Thyroid Neoplasms
Thyroidectomy
Treatment Outcome
Ventricular Dysfunction, Left