Understanding the Impact of Opioid Policies on the Opioid Epidemic Using Graphical Causal Models and Causal Discovery

使用图形因果模型和因果发现了解阿片类药物政策对阿片类药物流行的影响

基本信息

批准号：
10186725
负责人：
Hawre Jalal
金额：
$ 18万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-15 至 2022-01-01
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10186725
关键词：
Address Adopted Age Algorithms Area Award Biological Models Centers for Disease Control and Prevention (U.S.)Chronic Clinical Complement Complex Data Decision Aid Development Development Plans Drug usage Epidemic Epidemiology Evaluation Feedback Foundations Funding Gender Geography Goals HIV Health Health Policy Health Services Health Services Research Hepatitis K-Series Research Career Programs Knowledge Learning Marijuana Mathematical Model Simulation Mentors Mentorship Methodology Methods Modeling Modernization Naloxone National Institute of Drug Abuse Opioid Outcome Overdose Pain Paper Pharmaceutical Preparations Policies Policy Maker Policy Research Productivity Public Health Public Health Schools Quality of life Race Research Research Personnel Research Priority Risk Scholarship Science Scientist Shapes Source Strategic Planning Subgroup Substance Use Disorder System Time Training Translating United States Universities Variant Work base biomedical informatics career career development causal model disorder prevention health management illicit opioid innovation longitudinal dataset marijuana legalization mathematical methods models and simulation mortality opioid epidemic opioid mortality opioid overdose opioid policy opioid use disorder overdose death policy implication prescription drug abuse prescription monitoring program prescription opioid professor programs sex substance use success tool

项目摘要

ABSTRACT This NIDA Mentored Research Scientist Career Development Award (K01) for Dr. Hawre Jalal, an Assistant Professor of Health Policy and Management at the University of Pittsburgh Graduate School of Public Health, will establish Dr. Jalal as a health decision scientist with expertise in the impact of opioid- related policies using advanced methods in causal analyses. The opioid epidemic is a modern public health crisis responsible for reduced quality of life, decreased productivity, and increased risk of chronic conditions and mortality. State opioid policies may have shaped the outcome of the epidemic by benefiting some groups while having unintended consequences on other groups, such as the impact of limiting opioid prescribing to treat legitimate pain. However, most prior studies of these policies have been limited by (1) focusing on a single policy at a time, (2) ignoring the time it may take for a policy to be implemented and effective, and (3) treating the policies as binary variables (yes/no) even though policies vary widely across states. The research proposed in this award focuses on rigorously evaluating the benefits and the unintended consequences of state-opioid policies, such as prescription drug monitoring programs, on important outcomes, such as opioid-related overdose deaths. We propose (1) to use state-of-the-art causal models and causal discovery algorithms to systematically search for causal influences of policy components on the observed outcomes of opioid use disorder (Aim 1), (2) to identify policy combinations that likely increase benefits and reduce harms (Aim 2), and (3) to reveal priority research areas in the policy space by conducting formal value of information (VOI) analysis (Aim 3). The scientific premise for this proposal is strong. Evaluation of opioid policies are one of the top priorities for the NIDA 2016-2020 strategic plan. This project draws on Dr. Jalal’s extensive quantitative training, and knowledge of the epidemiology of the opioid use disorder and overdose deaths. This work will extend Dr. Jalal’s scholarship into the field of policy evaluation while incorporating advanced methods of causal discovery from observational data in health services research. Dr. Jalal will thus engage in training and career development activities that focus on acquiring expertise in causal modeling and in the interpretation and assessment of licit and illicit opioid-related policies. Through mentorship from bioinformaticians, health decision scientists and policy and clinical experts, Dr. Jalal will also focus on applying training in these content areas to health policy research. This training plan complements the proposed research and will equip Dr. Jalal to establish an independent research program examining the broader impact of the various policies on outcomes, such as HIV and hepatitis.

抽象的 Hawre Jalal 博士荣获 NIDA 指导研究科学家职业发展奖 (K01) 匹兹堡大学研究生院卫生政策与管理助理教授公共卫生部门将把贾拉勒博士确立为健康决策科学家，在阿片类药物的影响方面拥有专业知识- 使用先进的因果分析方法制定相关政策。阿片类药物流行是一场现代公共卫生危机，导致生活质量下降，生产力下降，慢性病和死亡风险增加。可能通过使某些群体受益而影响了流行病的结果，但同时也造成了意想不到的后果对其他群体的后果，例如限制阿片类药物处方治疗合法药物的影响然而，大多数先前对这些政策的研究都受到以下限制：（1）关注单一政策。一次，(2) 忽略政策实施和生效可能需要的时间，以及 (3) 处理尽管各州的政策差异很大，但政策作为二元变量（是/否）。该奖项提出的研究重点是严格评估收益和国家阿片类药物政策（例如处方药监测计划）的意外后果我们建议 (1) 使用最先进的技术。因果模型和因果发现算法，系统地搜索政策的因果影响阿片类药物使用障碍观察结果的组成部分（目标 1）、（2）以确定政策可能增加益处并减少危害的组合（目标 2），以及 (3) 揭示优先研究通过进行正式的信息价值 (VOI) 分析（目标 3）。该提案的科学前提是强有力的，对阿片类药物政策的评估是最重要的之一。 NIDA 2016-2020 战略计划的优先事项该项目借鉴了贾拉勒博士广泛的定量研究。这项工作涉及阿片类药物使用障碍和过量死亡的培训和流行病学知识。将把贾拉勒博士的奖学金扩展到政策评估领域，同时推进因此，Jalal 博士将研究从卫生服务研究中的观察数据中发现因果关系的方法。参与以获取因果专业知识为重点的培训和职业发展活动合法和非法阿片类药物相关政策的建模以及解释和评估。来自生物信息学家、健康决策科学家以及政策和临床专家 Jalal 博士的指导本培训计划还将重点关注将这些内容领域的培训应用于卫生政策研究。补充了拟议的研究，并使贾拉尔博士能够建立独立的研究计划审查各种政策对艾滋病毒和肝炎等结果的更广泛影响。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Data Needs in Opioid Systems Modeling: Challenges and Future Directions.

DOI：
10.1016/j.amepre.2020.08.017
发表时间：
2021-03
期刊：
American journal of preventive medicine
影响因子：
5.5
作者：
Jalali MS;Ewing E;Bannister CB;Glos L;Eggers S;Lim TY;Stringfellow E;Stafford CA;Pacula RL;Jalal H;Kazemi-Tabriz R
通讯作者：
Kazemi-Tabriz R

An Introductory Tutorial on Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example.

DOI：
10.1177/0272989x221103163
发表时间：
2023-01
期刊：
MEDICAL DECISION MAKING
影响因子：
3.6
作者：
Alarid-Escudero, Fernando;Krijkamp, Eline;Enns, Eva A.;Yang, Alan;Hunink, M. G. Myriam;Pechlivanoglou, Petros;Jalal, Hawre
通讯作者：
Jalal, Hawre

Exponential growth of drug overdose poisoning and opportunities for intervention.

药物过量中毒的指数增长和干预机会。

DOI：
10.1111/add.15841
发表时间：
2022
期刊：
Addiction (Abingdon, England)
影响因子：
0
作者：
Jalal,Hawre;Burke,DonaldS
通讯作者：
Burke,DonaldS

Carfentanil and the rise and fall of overdose deaths in the United States.

DOI：
10.1111/add.15260
发表时间：
2021-06
期刊：
Addiction (Abingdon, England)
影响因子：
0
作者：
Jalal H;Burke DS
通讯作者：
Burke DS

A Tutorial on Time-Dependent Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example.

DOI：
10.1177/0272989x221121747
发表时间：
2023-01
期刊：
MEDICAL DECISION MAKING
影响因子：
3.6
作者：
Alarid-Escudero, Fernando;Krijkamp, Eline;Enns, Eva A.;Yang, Alan;Hunink, M. G. Myriam;Pechlivanoglou, Petros;Jalal, Hawre
通讯作者：
Jalal, Hawre