Summaries of Independent Scientist (K) Awards

Lee, Grace

Institution: Harvard Pilgrim Health Care
Grant Title: Strategies for Group A Streptococcal Prevention
Grant Number: K08 HS013908
Duration: 5 years (2004-2009)
Total Award: $648,251

Project Description: The goal of this research is to enhance our understanding of how to incorporate patient preferences and advanced modeling methods in evaluating the cost effectiveness of interventions against infections. This project has four specific aims:

1. To determine the societal costs and health state preferences for Group A Streptococcus (GAS) infections such as pharyngitis.
2. To create a decision-analytic model to estimate the costs and health outcomes of selective vaccination strategies to prevent invasive GAS disease.
3. To determine the cost-effectiveness of universal vaccination strategies for infants and/or children through mathematical modeling.
4. To evaluate the costs and outcomes of current management strategies for pharyngitis and model the potential downstream impact of a GAS vaccine.

Career Goals:  Dr. Lee's overall long-term goal is to become a health services researcher who is able to bring her expertise in pediatric infectious diseases to the field. She seeks to advance her knowledge in decision sciences by further education in decision analysis and measurement of health state preferences. She also seeks to be able to translate research into policy in order to successfully communicate her research findings to a broad policy audience.

Progress to Date: The Cost & Preferences telephone survey is currently underway. Interviews are now complete and data analysis is underway. A preliminary decision-analytic model has been constructed in DATA Professional software. Probability estimates continue to be revised as new data regarding GAS pharyngitis and potential GAS vaccine candidates continue to be presented at national meetings and published in the literature. Cost and preference estimates will be obtained from our Cost & Preferences Survey in Specific Aim 1. A mathematical model has been constructed for GAS infection in order to model transmission dynamics of this pathogen in the population. The model focuses on the potential impact of serotype replacement since the vaccine candidate only covers 26 GAS serotypes (over 100 serotypes are known to exist). Dr. Lee continues to take classes, attend professional meetings and seminars, and spends 25% of her effort on clinical work.

Future Plans: In the coming year, Dr. Lee plans to complete the Cost & Preferences Survey in Specific Aim 1, including submitting a manuscript for publication. As planned, analyses will be completed for both the decision analytic model and the mathematical model described in Specific Aims 2 and 3. She plans to draft a manuscript for the decision analytic model in Specific Aim 2. She will also begin model construction for Specific Aim 4 during the coming year.

Highlights and Specific Accomplishments:

• Professional Societies:
  • Massachusetts Medical Society.
  • American Medical Association (Fellow).
  • American Academy of Pediatrics.
  • Infectious Diseases Society of America.
  • Pediatric Infectious Diseases Society.
  • Massachusetts Infectious Diseases Society.
  • Society for Medical Decision Making.
• Assistant Professor, Department of Ambulatory Care and Prevention, Harvard Medical School & Pilgrim Health Care, Boston, MA.
• Assistant Professor, Children's Hospital Boston, Division of Infectious Diseases, Boston, MA.
• Infectious Diseases Society of America Travel Award, 2002.
• Edward H. Kass Award for Clinical Excellence, Massachusetts Infectious Disease Society, 2003.
• Pyle Fellowship Award, Harvard Pilgrim Health Care, 2003.
• Scholars in Medicine Fellowship Award, Harvard Medical School, 2005.

K-Generated Publications:

• Lee GM, Salomon JA, LeBaron CW, Lieu TA. Health-state valuations for pertussis: methods for valuing short-term health states. Health Quality of Life Outcomes 2005;3(1):17.
• Lee GM, LeBaron CW, Murphy TV, Lett S, Schauer S, Lieu TA. Pertussis among adolescents and adults: Should we vaccinate? Pediatrics 2005;115:1675-84.
• Linder JA, Bates DW, Lee GM, Finkelstein JA. Antibiotic Treatment of Children with Sore Throat in the United States. JAMA 2005;294: 2315-22.
• Lee GM, Gortmaker SL, McIntosh K, Hughes MD, Oleske JM, for the PACTG 219C Team. Quality of Life in HIV-Infected Children. Pediatrics 2006;117:273-83.
• Lee GM and Wessels MR. Changing epidemiology of acute rheumatic fever in the United States. Clinical Infectious Diseases Journal 2006;42:448-50.

AHRQ Research Portfolio: Care Management; Prevention; Training.
AHRQ Goals: Efficiency

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