Issues of the Aging HIV Population
R. Scott Braithwaite, MD, MSc

Dr. Braithwaite, is an Assistant Professor of Medicine in the Section of General Internal Medicine at Yale University School of Medicine, and a Staff Physician at the VA Connecticut Healthcare System. Dr. Braithwaite received his Bachelor’s Degree in Physics from the Massachusetts Institute of Technology, received his M.D. from the State University of New York at Stony Brook, and trained in Internal Medicine at the University of Washington. He completed a research fellowship in Decision Analysis and Medical Decision Making at Tufts University, and received a Masters Degree in Clinical Research at the University of Pittsburgh. He is active in the Society for Medical Decision Making and recently chaired the scientific review committee for the 2007 national meeting.

Dr. Braithwaite occupies an exciting niche at the intersection of health services research and the decision sciences. Through a variety of research tools, he estimates the benefits that the health care system is delivering so we can get more "bang" for our health care "buck".” This is a particularly important concern for the United States health care system, which spends far more money on health care per-capita than any other country, yet delivers benefits that are often modest and unevenly distributed.

His research project for the Physician Faculty Scholars Program is entitled “Tailoring Clinical Guidelines to Comorbidity,” and addresses the problem that clinical guidelines (e.g., cancer screening tests) are increasingly applied across the entire patient spectrum including those who are unlikely to benefit because of serious co-existing illnesses. It seeks to develop objective decision rules that will help providers and payers know when to adapt clinical guidelines, and has the potential both to improve health care quality and to reduce unnecessary resource expenditures.

ABOUT PLENARY SESSION:
Discussion of the rising prevalence of comorbidity in an aging HIV population, and use of novel methods to tailor care for this changing population. Illustrative questions that will be addressed will include (1) should screening recommendations for colorectal cancer be individualized for HIV-infected individuals, and (2) should timing of antiretroviral initiation be individualized based on age and/or comorbidity? This talk will include a brief discussion of the payoff time, a new method for tailoring care to highly comorbid populations.
(Slides)