Training the Next Generation of Leaders in Clinical Preventive Services
Profiles from the AHRQ Research Centers for Excellence
While pursuing her Master's degree in Public Health, Jamie Carter, an MD/MPH student at the University of North Carolina, learned to apply a critical perspective to evaluate when the benefits of health care services outweigh the harms. As she explained, "there have been so many new technologies in medicine that sound great, but then 5-10 years after these things have been implemented we realize that we actually may be doing more harm than good." Carter chose to do her Master's degree practicum at the Research Center for Excellence in Clinical Preventive Services (ReCPSs) because she wanted to learn more about issues related to overuse and harms of clinical preventive services and she felt that the center was doing "interesting, new, and innovative" work on this topic.
Carter worked on a number of different projects at the center to fulfill her practicum, but the main project was one to conceptualize the epidemiology of overuse of preventive services. As part of this work, Carter worked with other Center staff to determine how to best measure overuse, which they quickly discovered was "more challenging than measuring underuse."
In addition to her practicum, Carter chose to do the culminating paper for her Master's degree within the center. For this paper she focused on cancer over-diagnosis—the diagnosis and treatment of cancers that do not go on to cause symptoms or death. She conducted a systematic review of how cancer over-diagnosis has been measured, compared the relative advantages and disadvantages of each measure, and then determined which measure she thought was the most accurate and least biased way to look at cancer over-diagnosis. Carter conducted this research under the guidance of Dr. Harris, the Center Director of ReCPS, and they presented the findings at the Preventing Overdiagnosis conference at Dartmouth in September 2013. Carter is hoping to eventually publish this work in an academic journal.
Carter not only developed an expertise in the area of overuse of preventive services and cancer over-diagnosis through her work with ReCPS, she also learned a great deal about how to design and conduct a research study. Prior to her practicum, Carter had not previously been involved in any health services research. Through her work at the Center, she learned about how to develop a research question, determine what to measure and how to measure it, and how to apply research methodologies to analyze results. Working at ReCPS piqued her interest in health services research, and Carter is currently considering how she can focus on issues related to overuse and harms in her career.
For more information about the Research Center for Excellence in Clinical Preventive Services and its training program please visit its Web site: http://smart-screening.org.
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