Dr. Ava John-Baptiste
"Teaching in the Interfaculty Program in Public Health has afforded me the opportunity to explore the use of health economics to support public health decision-making. Public health interventions in education, food security, fair income policies, environmental protection and disaster readiness, amongst others, are as important and possibly more important that hospital-based care in promoting health and well-being. Applying health economic tools to public health decision-making is challenging but rewarding. I enjoyed developing a case-based course focused on applying economic evaluation to improve decision-making in this area."
What are your research interests?
- Evidence synthesis to support decision-making including systematic review, meta-analysis and decision modeling
- Economic evaluation of hospital-based health technologies
- Cost reduction and disinvestment in technologies of low or uncertain value
What current positions do you hold?
I am an assistant professor in the departments of Epidemiology & Biostatistics, Anesthesia & Perioperative Medicine and the Interfaculty Program in Public Health. I also serve as a health economist in the Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI).
What is your educational background?
I earned my PhD at the Institute for Health Policy, Management and Evaluation at the University of Toronto under the supervision of Dr. Murray Krahn. Through a post-doctoral fellowship at the Agency for Healthcare Research and Quality, in the United States, I learned about the role of evidence-synthesis in supporting clinical and health policy decision-making.
Why did you decide to pursue a career in this field?
Quantitative subjects have always fascinated me. The disciplines of health economics and statistics are based on abstract concepts like expected value and probability distributions. I love these abstractions, and am happiest when programming decision models and statistical analyses. I also want to make a difference by applying quantitative skills to solving health-related problems. I chose a career in health economics because it allows me to apply abstract concepts to answer concrete and fundamental questions about health and well-being.
Health economists are concerned about the impact of uncertainty and scarcity on decision-making. Each individual understands these challenges intuitively. Limitations on time, money and other resources prevent each one of us from accomplishing all that we would like to accomplish. In health care, policy decision makers have to decide which drugs, devices, surgical techniques and health programs to fund. Decisions have to be made now based on the best information available. Health economists quantify effectiveness, costs and uncertainty to support these decisions.
What milestones or reasons directed you to working at Western?
The opportunity to become a part of the MEDICI Centre was a major factor in my decision to come to Western (https://www.schulich.uwo.ca/anesthesia/people/bios/johnbaptiste_ava.html). MEDICI is a hospital-based health technology assessment unit that supports evidence-based decision-making in London hospitals. Administrators and clinicians refer questions about the safety, effectiveness and cost-effectiveness of health technologies, which can include drugs, devices, techniques and programs. At MEDICI we answer policy-relevant questions, and use these questions as a starting point for conducting methodological research. For example, supported by MEDICI, the London hospitals made the evidence-based decision to disinvest in hydroxy-ethyl starches for fluid replacement therapy. Other options like saline, were equally safe and effective, but less costly. Using the hydroxyl-ethyl starches question as a starting point, we are investigating how economic evaluation differs for disinvestment decision-making as compared to investment decision-making.
Selected Publications:
- A. John-Baptiste PhD, L.J. Sowerby MD MHM, C.J. Chin MD, J. Martin PharmD MSc, B.W. Rotenberg MD MPH. Comparing surgical trays with redundant instruments with trays with reduced instruments: a cost analysis. CMAJ Open. 2016 Aug; 4(3):E404-E408. doi: 10.9778/cmajo.20150092.
- John-Baptiste A, Schapira MM, Cravens C, Chambers JD, Neumann PJ, Siegel J, Lawrence W. The Role of Decision Models in Health Care Policy: A Case Study. Med Decis Making. 2016 Jul;36(5):666-79. doi: 10.1177/0272989X16646732.
