By Dirk Elston, MD, January 02, 2014When we advocate for our specialty and discuss the unique value of care by a board-certified dermatologist, we are often met with a familiar comment: “Show us the data.” In a health care environment that is changing rapidly, resources will increasingly be allocated based on data-driven decisions. We recognize that without credible data, we will be marginalized, and the Academy is working hard to help meet the specialty’s research and data needs. At our last Board meeting, we heard from the Council on Science and Research regarding the ongoing efforts of the Data Collection Planning Workgroup. This team polled key AAD councils, committees, and task forces to gain a broad perspective on the data dermatology needs — the key data we need in order to demonstrate our value to payers, policymakers, and the public. The Workgroup and Council are assessing our current data-gathering efforts so we can identify gaps and make plans to fill them.
Credible outcomes data are essential, and an Academy workgroup is developing a six-month pilot to assess the validity of easily captured outcomes data points that apply broadly to many of the diseases we treat. Without data supporting the most relevant outcomes, payers and purchasers choose their own, which often relate more to cost than to efficacy of care. The goal is to connect these clinical outcomes to patient-reported outcomes information, as many studies indicate that if patients feel that their own treatment goals are understood and being pursued, their treatment adherence will improve. This ultimately lowers costs and improves outcomes. (See this month's feature for discussion of why health plans find patient-reported outcomes measures valuable.)
Adverse events and patient safety remain key areas of focus for the Academy. A critical step is the identification of what outcomes to measure. An AAD workgroup is looking at how we can collect sufficient data to prove what the most important adverse events in dermatology are. This data collection will build on previous efforts by surveying physicians, support staff, and patient advocacy groups. We anticipate being able to use the results to inform the kind of quality improvement activities for dermatologists that more and more payers are requiring. [pagebreak]
In addition to outcomes data, the AAD plays an important role in helping to establish priorities for health research in dermatology. Identifying knowledge gaps was a key step. The top unmet research need in dermatology that was identified at our Research Agenda Consensus Conference involved pruritus. Many of our patients have itch-related issues, but there’s been little research to explore the mechanisms behind it or ways to prevent it — and this limits what we can offer our patients to address this important quality-of-life issue. We’re holding a symposium on the topic on Monday, March 24 at the Annual Meeting in Denver where leaders and experts in the field will talk about this and discuss what tools we might develop, how measurement of itch might be standardized, and where the most pressing research gaps within this huge topic area are so efforts can be steered in the most promising directions.
Another research need discussed at our conference involved cutaneous oncology. The Board recently approved the development of the Transplant Skin Cancer Network, which will conduct research regarding the mortality rate of squamous cell carcinomas that occur in transplant patients. Our hope is that this network will eventually conduct NIH-funded research on the topic. In the meantime, Academy research efforts like this are made possible, in part, by donations from members and others; if you’d like to support them, visit donate.AADdevelopment.org/research
There’s no question that the future of medicine will be more data-driven than the past. Your AAD is working hard to make sure dermatology is ready.