In episode 63 of Going anti-Viral, Dr Mari Kitahata joins host Dr Michael Saag to discuss the role of outcomes research on clinical decisions for patient care. Dr Kitahata is a Professor of Medicine at the University of Washington (UW) in the Division of Allergy and Infectious Diseases. For more than 3 decades, she has directed the UW/Fred Hutch Center for AIDS Research (CFAR) Clinical Research Core. Dr Kitahata’s research focuses on improving long-term outcomes for people with HIV and she has led studies demonstrating key determinants of increased survival in people with HIV including early initiation of antiretroviral therapy and care managed by physicians with greater HIV experience. Dr Kitahata discusses the significance of outcomes research in clinical settings, particularly in the context of HIV care. She explains the differences between efficacy and effectiveness, the challenges faced in observational studies, and the importance of statistical techniques to address biases. Dr Kitahata and Dr Saag discuss the role of electronic medical records (EMRs) in enhancing data collection and the necessity of data validation through adjudication processes. Additionally, the conversation touches on the importance of patient-reported outcomes and the limitations of EMR data, including issues of misclassification. Finally, Dr Saag and Dr Kitahata discuss the distinction between predictive modeling and etiologic modeling in research, underscoring the complexities of clinical care and the future directions for outcomes research.

0:00 – Introduction

2:30 – Efficacy versus effectiveness

5:51 – Challenges in outcomes research

8:27 – Statistical techniques in observational studies

16:13 – The role of electronic medical records

19:36 – Patient-reported outcomes and their importance

22:18 – Data validation and adjudication

28:30 – Limitations of observational data

35:08 – The future of outcomes research 

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Produced by IAS-USA, Going anti–Viral is a podcast for clinicians involved in research and care in HIV, its complications, and other viral infections. This podcast is intended as a technical source of information for specialists in this field, but anyone listening will enjoy learning more about the state of modern medicine around viral infections.

Going anti-Viral’s host is Dr Michael Saag, a physician, prominent HIV researcher at the University of Alabama at Birmingham, and volunteer IAS–USA board member. In most episodes, Dr Saag interviews an expert in infectious diseases or emerging pandemics about their area of specialty and current developments in the field. Other episodes are drawn from the IAS–USA vast catalogue of panel discussions, Dialogues, and other audio from various meetings and conferences.

Email [email protected] to send feedback, show suggestions, or questions to be answered on a later episode.

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