Research Centers

Medical Practice Evaluation Center (MPEC)

The Medical Practice Evaluation Center (MPEC) is an interdivisional center dedicated to improving clinical outcomes, increasing value in health policy, and informing global public health through innovative research, collaboration, and education.

Overview

The Medical Practice Evaluation Center (MPEC) became a formalized interdivisional center within the Department of Medicine at Massachusetts General Hospital in 2011, housing faculty and staff from the Divisions of General Medicine and Infectious Disease. The multidisciplinary MPEC team, led by Drs. Kenneth Freedberg and Rochelle Walensky, is internationally recognized in the evaluation of clinical outcomes, costs, and cost-effectiveness for preventing, managing, and treatment HIV/AIDS and other infectious diseases.

Many of the research activities at MPEC utilize the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model. Since 1994, researchers at MGH have used this Monte Carlo simulation model to evaluate the cost-effectiveness of national and multinational strategies for combating HIV/AIDS. The model, first developed in response to the outbreak of the HIV/AIDS epidemic in the United States, has grown over time in both scope and application to provide comprehensive analyses for prospective treatment strategies of HIV/AIDS and AIDS-related complications, including tuberculosis and other infections.

The MPEC team collaborates with research teams in Botswana, Brazil, Côte d’Ivoire, France, India, Mozambique, South Africa, and Zimbabwe, as well as investigators from Brigham and Women’s Hospital, the Harvard School of Public Health, Weill Cornell Medical College, and Yale University. Research from the MPEC team has been published in several leading medical journals, including the Journal of the American Medical Association, New England Journal of Medicine, and AIDS.

Group Members

Directors:

Kenneth Freedberg, MD, MScKenneth A. Freedberg, MD, MSc is Professor of Medicine at Harvard Medical School,   Professor in the Department of Health Policy and Management at the Harvard School of Public Health, and a physician at the Massachusetts General Hospital. Dr. Freedberg is Co-Director of the Medical Practice Evaluation Center at MGH. He is Director of the Program in Clinical Epidemiology and Outcomes Research at the Harvard University Center for AIDS Research (CFAR) and Director of the Program in HIV Research in the Division of General Medicine at MGH. His research interests focus on HIV, TB, as well as other chronic disease clinical outcomes and health policy, utilizing the methods of comparative effectiveness, cost-effectiveness analysis, clinical epidemiology, and implementation science. Dr. Freedberg earned an MD from Harvard Medical School and also holds a Masters in Health Service Administration from the Harvard School of Public Health.

Rochelle Walensky, MD, MPHRochelle P. Walensky, MD, MPH is Professor of Medicine at Harvard Medical School and an infectious disease physician at the Brigham and Women's Hospital and Massachusetts General Hospital. Dr. Walensky is Co-Director of the Medical Practice Evaluation Center at MGH. She is Associate Director of the Program in Clinical Epidemiology and Outcomes Research at the Harvard CFAR. Her research interests include the promotion of routine HIV counseling, testing and referral, and the economic evaluation of alternative HIV testing and treatment policies. Dr. Walensky earned an MD from the Johns Hopkins School of Medicine and an MPH from the Harvard School of Public Health.

 

   For a full list of our faculty, fellows, students, and staff, please visit our Members page

 

   

 

 

 

 

 

 

 

 

Research Projects

The multidisciplinary MPEC team is internationally recognized in the evaluation of clinical outcomes, costs, and cost-effectiveness for preventing, managing, and treatment HIV/AIDS and other infectious diseases.

Many MPEC research projects utilize the CEPAC (Cost-Effectiveness in Preventing AIDS Complications) model, which simulates a large cohort of patients and follows each patient on a monthly basis until death. CEPAC uses published data on the natural history of HIV and opportunistic infections, as well as the efficacy and cost of prophylaxis and treatment along with other epidemiological parameters to simulate the overall impact of HIV on a specific population.  CEPAC researchers simulate prospective treatment strategies onto the cohort under varying epidemiological conditions and use the outputs to project a strategy’s efficacy and cost-effectiveness. For more information on the model, please visit the CEPAC web site.

Our faculty and fellows also conduct observational and interventional research studies in patient populations in the United States and in international settings.

Selected Recent Publications:

Hyle EP, Naidoo K, Su AE, El-Sadr WM, Freedberg KA. HIV, tuberculosis, and noncommunicable diseases: what is known about the costs, effects, and cost-effectiveness of integrated care? J Acquir Immune Defic Syndr. 2014 Sep 1;67 Suppl 1:S87-95.

Ciaranello AL, Leroy V, Rusibamayila A, Freedberg KA, Shapiro R, Engelsmann B, Lockman S, Kelly KA, Dabis F, Walensky RP. Individualizing the WHO HIV and infant feeding guidelines: optimal breastfeeding duration to maximize infant HIV-free survival. A IDS.2014 Jul;28 Suppl 3:S287-99.

Bassett IV, Regan S, Luthuli P, Mbonambi H, Bearnot B, Pendleton A, Robine M, Mukuvisi D, Thulare H, Walensky RP, Freedberg KA, Losina E, Mhlongo B. Linkage to care following community-based mobile HIV testing compared with clinic-based testing in Umlazi Township, Durban, South Africa. HIV Med. 2014 Jul;15(6):367-72.

Ouattara EN, Ross EL, Yazdanpanah Y, Wong AY, Robine M, Losina E, Moh R, Walensky RP, Danel C, Paltiel AD, Eholié SP, Freedberg KA, Anglaret X. Clinical impact and cost-effectiveness of making third-line antiretroviral therapy available in sub-Saharan Africa: A model-based analysis in Côte d'Ivoire. J Acquir Immune Defic Syndr. 2014 Jul 1;66(3):294-302.

Levison J, Triant V, Losina E, Keefe K, Freedberg K, Regan S. Development and validation of a computer-based algorithm to identify foreign-born patients with HIV infection from the electronic medical record. Appl Clin Inform. 2014 Jun 18;5(2):557-70.

McCormick AW, Abuelezam NN, Rhode ER, Hou T, Walensky RP, Pei PP, Becker JE, DiLorenzo MA, Losina E, Freedberg KA, Lipsitch M, Seage GR 3rd. Development, calibration and performance of an HIV transmission model incorporating natural history and behavioral patterns: application in South Africa. PLoS One. 2014 May 27;9(5):e98272.

Shenoy ES, Noubary F, Kim J, Rosenberg ES, Cotter JA, Lee H, Walensky RP, Hooper DC. Concordance of PCR and culture from nasal swabs for detection of methicillin-resistant Staphylococcus aureus in a setting of concurrent antistaphylococcal antibiotics. J Clin Microbiol. 2014 Apr;52(4):1235-7.

Linas BP, Barter DM, Leff JA, DiLorenzo M, Schackman BR, Horsburgh CR, Assoumou SA, Salomon JA, Weinstein MC, Kim AY, Freedberg KA. The cost-effectiveness of improved hepatitis C virus therapies in HIV/hepatitis C virus coinfected patients. AIDS. 2014 Jan 28;28(3):365-76.

Drain PK, Losina E, Coleman SM, Giddy J, Ross D, Katz JN, Walensky RP, Freedberg KA, Bassett IV. Diagnostic accuracy of a point-of-care urine test for tuberculosis screening among newly-diagnosed HIV-infected adults: a prospective, clinic-based study. BMC Infect Dis. 2014 Feb 26;14:110.

Bassett IV, Govindasamy D, Erlwanger AS, Hyle EP, Kranzer K, van Schaik N, Noubary F, Paltiel AD, Wood R, Walensky RP, Losina E, Bekker LG, Freedberg KA. Mobile HIV screening in Cape Town, South Africa: clinical impact, cost and cost-effectiveness. PLoS One. 2014 Jan 22;9(1):e85197.

Longenecker CT, Triant VA. Initiation of antiretroviral therapy at high CD4 cell counts: does it reduce the risk of cardiovascular disease? Curr Opin HIV AIDS. 2014 Jan;9(1):54-62.

Ciaranello AL, Morris BL, Walensky RP, Weinstein MC, Ayaya S, Doherty K, Leroy V, Hou T, Desmonde S, Lu Z, Noubary F, Patel K, Ramirez-Avila L, Losina E, Seage GR 3rd, Freedberg KA. Validation and calibration of a computer simulation model of pediatric HIV infection. PLoS One. 2013 Dec 13;8(12):e83389.

Walensky RP, Ross EL, Kumarasamy N, Wood R, Noubary F, Paltiel AD, Nakamura YM, Godbole SV, Panchia R, Sanne I, Weinstein MC, Losina E, Mayer KH, Chen YQ, Wang L, McCauley M, Gamble T, Seage GR 3rd, Cohen MS, Freedberg KA. Cost-effectiveness of HIV treatment as prevention in serodiscordant couples. N Engl J Med. 2013 Oct 31;369(18):1715-25.

Hyle EP, Sax PE, Walensky RP. Potential savings by reduced CD4 monitoring in stable patients with HIV receiving antiretroviral therapy. JAMA Intern Med. 2013 Oct 14;173(18):1746-8.

Shenoy ES, Kim J, Rosenberg ES, Cotter JA, Lee H, Walensky RP, Hooper DC. Discontinuation of contact precautions for methicillin-resistant staphylococcus aureus: a randomized controlled trial comparing passive and active screening with culture and polymerase chain reaction. Clin Infect Dis. 2013 Jul;57(2):176-84.

Schackman BR, Haas DW, Becker JE, Berkowitz BK, Sax PE, Daar ES, Ribaudo HJ, Freedberg KA. Cost-effectiveness analysis of UGT1A1 genetic testing to inform antiretroviral prescribing in HIV disease. Antivir Ther. 2013;18(3):399-408.

Levison JH, Wood R, Scott CA, Ciaranello AL, Martinson NA, Rusu C, Losina E, Freedberg KA, Walensky RP. The clinical and economic impact of genotype testing at first-line antiretroviral therapy failure for HIV-infected patients in South Africa. Clin Infect Dis. 2013 Feb;56(4):587-97.

Anglaret X, Scott CA, Walensky RP, Ouattara E, Losina E, Moh R, Becker JE, Uhler L, Danel C, Messou E, Eholié S, Freedberg KA. Could early antiretroviral therapy entail more risks than benefits in sub-Saharan African HIV-infected adults? A model-based analysis. Antivir Ther. 2013;18(1):45-55

Walensky RP, Sax PE, Nakamura YM, Weinstein MC, Pei PP, Freedberg KA, Paltiel AD, Schackman BR. Economic savings versus health losses: the cost-effectiveness of generic antiretroviral therapy in the United States. Ann Intern Med. 2013 Jan 15;158(2):84-92.

 

A full list of our publications can be found on PubMed.

A list of CEPAC publication can be found on the CEPAC Publications Page.

MPEC Medical Practice Evaluation Center

50 Staniford Street
9th floor
Boston, MA 02114

Phone: 617-724-8445
Email: MPEC@mgh.harvard.edu

Public Transportation Access: yes
Disabled Access: yes