Health Care Policy Research
Robert H. Jones, MD
Mary and Deryl Hart Professor of Surgery
Dr. Jones' major research interest is enhancing the value of health care. Value implies best quality for least cost. Understanding quality requires measurement of important outcomes, processes, and structure of health care delivery. Costs of concern relate both to resource consumption and negative outcomes of treatment.
Jones' prior work with the Duke Databank for Cardiovascular Diseases and the New York State Cardiac Surgery Database has addressed specific health care decisions in patients with coronary artery disease. These issues involve defining best strategies for recognition and management of this common disorder. Participation in multicenter randomized trials addressing specific therapeutic questions for patients with coronary artery disease also has provided a resource to intercompare outcomes in large cardiovascular databases and in randomized trials.
Dr. Jones led the group responsible for creation of the NHLBI/AHCPR guideline, Unstable Angina: Diagnosis and Management. This document has been recognized as a prototype for future development of other clinical practice guidelines. Clinical evaluation instruments have been derived from this guideline to assess the quality of care of patients with unstable angina.
Dr. Jones led the NIH-funded international Surgical Treatment for Ischemic Heart Failure (STICH) trial that addressed the question of the value of adding surgical ventricular reconstruction (SVR) to CABG in ischemic cardiomyopathy patients with anterior dyskinesia. The survival of 1,212 ischemic cardiomyopathy patients five years after randomization to intensive medical therapy with or without CABG will be reported soon. Moreover, surviving patients will be followed for an additional five years. The wealth of data available on the 2,136 patients will be used to address a number of secondary questions that are certain to enhance the value of cardiac surgery in future health care of patients with ischemic cardiomyopathy.