Our research seeks to delineate how changes in regulatory frameworks, policy, and financial incentives in health care can impact, in both intended and unintended ways, the way that physicians take care of their patients.  Recent publications include a review of medical overuse in dermatology, an evaluation of the growing impact of private equity in dermatology, and patients’ perspectives on the use of artificial intelligence in skin cancer screening. 

Areas of focus include measures to reduce unnecessary dermatology referrals for acne via “shared care” with referring physicians facilitated by EHR-based clinical decision support tools.

We’ve also evaluated trends in costs for dermatology pharmaceuticals, potential savings for patients and the health care system overall, and the economic and political environment that facilitates these conditions. 

For recent highlights of our work, see below:

March 11, 2020

Patient Perspectives on the Use of Artificial Intelligence for Skin Cancer Screening

Caroline A. Nelson, MD;  Lourdes Maria Pérez-Chada, MD, MMSc;  Andrew Creadore, BS;  Sara Jiayang Li, BS;  Kelly Lo, BS;  Priya Manjaly;  Ashley Bahareh Pournamdari, BA;  Elizabeth Tkachenko, BS;  John S. Barbieri, MD, MBA;  Justin M. Ko, MD, MBA;  Alka V. Menon, PhD;  Rebecca Ivy Hartman, MD, MPH;  Arash Mostaghimi, MD, MPA, MPH

In this paper we used qualitative methods to evaluate patient’s attitudes towards artificial intelligence (AI) in dermatology. We found that overall, patients are receptive of the idea of using AI in skin cancer screenings as long as the human physician-patient relationship is preserved. Listen to Dr. Caroline Nelson, medical dermatologist at the Yale School of Medicine, discuss this topic in an interview with the JAMA Dermatology below:

Also be sure to check out Dr. Carrie Kovarik’s related editorial in JAMA Dermatology: Patient Perspectives on the Use of Artificial Intelligence

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Selected Publications:

Nelson CA, Perez-Chada LM, Creadore A, et al. Patient Perspectives on the Use of Artificial Intelligence for Skin Cancer Screening: A Qualitative Study. JAMA dermatology. 2020.

Li DG, Pournamdari AB, Liu KJ, Laskowski K, Joyce C, Mostaghimi A. Evaluation of Point-of-Care Decision Support for Adult Acne Treatment by Primary Care Clinicians. JAMA dermatology. 2020.

Barbieri JS, Roe AH, Mostaghimi A. Simplifying Contraception Requirements for iPLEDGE: A Decision Analysis. Journal of the American Academy of Dermatology. 2020.

Yanovsky RL, Mostaghimi A, Buzney E, Watson A. Patient Ability to Interpret Dermatopathology Reports in an Academic Dermatology Practice. JAMA dermatology. 2020.

Seiger K, Mostaghimi A, Silk AW, Schmults CD, Ruiz ES. Association of Rising Cost and Use of Oral Anticancer Drugs With Medicare Part D Spending From 2013 Through 2017. JAMA oncology. 2019.

Pournamdari AB, Tkachenko E, Barbieri J, Adamson AS, Mostaghimi A. A State-of-the-Art Review Highlighting Medical Overuse in Dermatology, 2017-2018: A Systematic Review. JAMA dermatology. 2019.

Tan S, Seiger K, Renehan P, Mostaghimi A. Trends in Private Equity Acquisition of Dermatology Practices in the United States. JAMA dermatology. 2019.

Li DG, Najafzadeh M, Kesselheim AS, Mostaghimi A. Spending on World Health Organization essential medicines in Medicare Part D, 2011-15: retrospective cost analysis. BMJ. 2019;366:l4257.

Li DG, Singer S, Mostaghimi A. Prevalence and Disclosure of Potential Conflicts of Interest in Dermatology Patient Advocacy Organizations. JAMA dermatology. 2019;155(4):460-464.

Barbieri JS, St Claire K, Mostaghimi A, Albrecht J. Evaluation of Clinical Compendia Used for Medicare Part D Coverage Determinations for Off-label Prescribing in Dermatology. JAMA dermatology. 2019;155(3):315-320.

Li DG, Joyce C, Mostaghimi A. Association Between Market Competition and Prices of Generic Topical Dermatology Drugs. JAMA dermatology. 2018;154(12):1441-1446.

Mostaghimi A, Adamson AS. Translating Administrative Health Care Data to Treatment Decisions in Dermatology: The Blind Men and the Elephant. JAMA dermatology. 2018;154(11):1256-1257.

Li DG, Xia FD, Rana J, et al. Factors Influencing Patient Decisions Regarding Treatments for Skin Growths: A Cross-Sectional Study. Dermatology research and practice. 2018;2018:3941347.

Di Xia F, Fuhlbrigge M, Dommasch E, Joyce C, Mostaghimi A. Cost of Routine Herpes Simplex Virus Infection Visits to U.S. Emergency Departments 2006-2013. The western journal of emergency medicine. 2018;19(4):689-692.

Noe MH, Mostaghimi A. The Challenges of Big Data in Dermatology. Journal of the American Academy of Dermatology. 2018.

Tan SY, Buzney E, Mostaghimi A. Trends in phototherapy utilization among Medicare beneficiaries in the United States, 2000 to 2015. Journal of the American Academy of Dermatology. 2018;79(4):672-679.

Song H, Adamson AS, Mostaghimi A. Trends in Medicare spending on topical immunomodulators and chemotherapies. Journal of the American Academy of Dermatology. 2018;78(1):173-175.

Xia FD, Rana J, Young GJ, et al. Generational influence on patient learning preferences in dermatology. Journal of the American Academy of Dermatology. 2018;78(6):1221-1223.

Tan SY, Tsoucas D, Mostaghimi A. Association of Dermatologist Density With the Volume and Costs of Dermatology Procedures Among Medicare Beneficiaries. JAMA dermatology. 2018;154(1):73-76.          

Di Xia F, Fuhlbrigge M, Waul M, Joyce C, Mostaghimi A. Characteristics of Patients Presenting to the Emergency Department and Urgent Care for Treatment of Sunburn. JAMA dermatology. 2017;153(9):934-935.

Dommasch ED, Joyce CJ, Mostaghimi A. Trends in Nationwide Herpes Zoster Emergency Department Utilization From 2006 to 2013. JAMA dermatology. 2017;153(9):874-881.

Song H, Adamson A, Mostaghimi A. Medicare Part D Payments for Topical Steroids: Rising Costs and Potential Savings. JAMA dermatology. 2017;153(8):755-759.

Weng QY, Buzney E, Joyce C, Mostaghimi A. Distance of travel to phototherapy is associated with early nonadherence: A retrospective cohort study. Journal of the American Academy of Dermatology. 2016;74(6):1256-1259.

Liu KJ, Hartman RI, Joyce C, Mostaghimi A. Modeling the Effect of Shared Care to Optimize Acne Referrals From Primary Care Clinicians to Dermatologists. JAMA dermatology. 2016;152(6):655-660.

Halim K, Weng QY, Kuye I, Joyce C, Mostaghimi A. Use of Health Care Resources and Costs After Patient Nonattendance in Dermatology. JAMA dermatology. 2016;152(2):220-221.