Dr Adam Elshaug

Biography/ Background

*NOTE: Dr Elshaug is currently based in the Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. He has also accepted an offer to become The Commonwealth Fund's Inaugural Visiting Fellow for 2012-13 (New York City).

Dr Elshaug is a health services and policy researcher with expertise in the area of disinvestment; identifying and critically reviewing the use of low-value health care services. With a strong multi-disciplinary background in psychology, sociology, physiology, clinical epidemiology and health policy, Dr Elshaug has made a commitment to collaborate and consult closely with federal and provincial government health agencies and other third-party payers in Australia and internationally (Spain, Canada, USA) to advance real-world policy reform in this area. Elshaug is currently working to design and implement a formal low-value policy agenda within Australian Medicare. Dr Elshaug also has experience evaluating major submissions by pharmaceutical manufacturers and industry sponsors seeking eligibility for public subsidy via Australia's Pharmaceutical Benefits Advisory Committee (PBAC) and Medical Services Advisory Committee (MSAC) processes.

Dr Elshaug is co-CI of the ASTUTE Health Study, recipient of numerous research awards and over 80 invitations to address conferences, government, academic, insurance and health technology assessment groups internationally. He serves as Associate Editor for BMC Health Services Research.

In 2009 Dr Elshaug was awarded a Harkness Fellowship (The Commonwealth Fund, New York City, USA) and Sidney Sax Public Health Fellowship (National Health and Medical Research Council of Australia). These - respectively - will occur from 2010-2013 at the Agency for Healthcare Research and Quality (AHRQ, USA) and Harvard Medical School (Boston, USA). 

Qualifications:

B.A. - Psychology and Sociology (University of South Australia)

B.Sc.(Hons) - Physiology/Obstetrics and Gynaecology (The University of Adelaide)

M.P.H. - Clinical Epidemiology/Health Economics and Policy (The University of Adelaide)

Ph.D. - Health Services and Policy Research: 'Building the Evidence Base for Disinvestment from Ineffective Health Care Practices: A Case Study in Obstructive Sleep Apnoea Syndrome' (The University of Adelaide)

Disciplinary Orientation:

Health Services and Policy Research; Epidemiology (Clinical)

Areas of Interest:

• Behavioural economics
• Comparative effectiveness research and policy models to support the re-allocation of resources away from ineffective, less effective or inappropriately applied health care practices;
• Clinical and policy assessments in healthcare to advance the translation of evidence into practice;
• Clinical and cost-effectiveness research and explorations of opportunity cost;
• Multiple stakeholder participation and engagement in health care decision making;
• Health Technology Assessment
• Direct-to-consumer advertising of health care products and services

Current Projects:

July 2010 - July 2011: Harkness Fellow in Healthcare Policy and Practice (The Commonwealth Fund). Based in Washington DC - Agency for Healthcare Research and Quality (AHRQ), Rockville, MD, USA. Project Title: Enhancing priority decision-making in comparative effectiveness research (CER).

August 2011 - August 2013: NHMRC Sidney Sax Public Health Fellow based in Boston, MA, USA - Department of Health Care Policy, Harvard Medical School. Project Title: Comparative effectiveness, comparative value: reducing waste to reinvest in safe, effective and cost-effective care.

August 2012 - August 2013: Inaugural Visiting Fellow, The Commonwealth Fund, New York City.

As well as pursuing his own Fellowship program, Dr Elshaug is a Chief Investigator of the NHMRC-funded ASTUTE Health Study (Assessing Service and Technology Use To Enhance Health). For details please follow this link:

http://www.adelaide.edu.au/ahta/whatwedo/disinvestment/  

Select Media Interest in Research:

• The Washington Post, 'Comparative effectiveness research' tackles medicine's unanswered questions
• ABC Radio National Health Report, 'Upper airway surgery for OSA and, disinvestment'
• Medical Observer ‘Push for evidence-based approach to funding health interventions’
• ABC Radio South Queensland  ‘Could your doctor be wasting your time and money?

Teaching:

• Public Health 1A & 1B: Core courses in the B.Health.Sci;
• Foundations of Public Health: Postgraduate GCPH/GDPH/MPH/MHEP
• Ethics, Economics and Epidemiology: Core course in 3rd year Medicine;
• Postgraduate teaching in epidemiology, health services and health systems (MPH/MHEP);
• Available to supervise Honours, Masters and PhD students.

Select Publications (link to PubMed):

 

Elshaug AG, McWilliams JM, Landon BE. The value of low-value lists. JAMA (Journal of the American Medical Association), 2013 Feb 27;309(8):775-6.

Polisena J, Clifford T, Elshaug AG, Mitton C, Russell E, Skidmore B. Case Studies on disinvestment and reallocation decision-making: A systematic review. International Journal of Technology Assessment in Health Care. (forthcoming)

Scott IA, Elshaug AG. Foregoing low-value care: how much evidence is needed to change beliefs? Internal Medicine Journal, 2013 Feb;43(2):107-9.

Carter D, Watt AM, Braunack-Mayer A, Elshaug AG, Moss JR, Hiller JE, and The ASTUTE Health Study Group. Should there be a female age-limit on public funding for assisted reproductive technology? Differing conceptions of justice in resource allocation. Journal of Bioethical Inquiry, 2013 Jan 4. [Epub ahead of print]

Elshaug AG, Watt AM, Mundy T, Willis CD. Over 150 potentially low-value health care practices: an Australian study. Medical Journal of Australia, 2012; 197(10): 556-560. (Open Access)

Watt AM, Hiller JE, Braunack-Mayer A, Moss JR, Buchan H, Wale J, Riitano D, Hodgetts K, Street J, Elshaug AG, for The ASTUTE Health Study Group. The ASTUTE Health study protocol: deliberative stakeholder engagements to inform implementation approaches to healthcare disinvestment. Implementation Science, 2012 Oct 22; 7: 101. (Open Access)

Hodgetts K, Elshaug AG, Hiller J. What counts and how to count it: Clinicians’ constructions of evidence in a disinvestment context. Social Science & Medicine, 2012; 75(12): 2191-2199. 

Watt AM, Willis CD, Hodgetts K, Elshaug AG, Hiller JE, and The ASTUTE Health Study Group. Engaging clinicians in evidence-based disinvestment: Role and perceptions of evidence. International Journal of Technology Assessment in Health Care, 2012; 28(3): 211-219.

Treadwell JR, Uhl S, Tipton K, Shamliyan T, Viswanathan M, Berkman N, Sun X, Coleman C, Elshaug AG, Singh S, Wang S, Ramakrishnan R. Assessing equivalence and noninferiority. Journal of Clinical Epidemiology, 2012; June 23 [Epub ahead of print].

O’Keefe M, Elshaug AG, Burgess T, Peirce E and Nettelbeck T. Use of the Delphi Technique to Facilitate Interdisciplinary Consensus on Academic Program Structure. Focus on Health Professional Education, 2012; 14(1): 55-66.

Street JM, Hennessy S, Watt AM, Hiller JE and Elshaug AG. News and social media: windows into community perspectives on disinvestment. International Journal of Technology Assessment in Health Care, 2011; 27(4): 376-383.

Elshaug AG and Garber AM. How CER Could Pay for Itself - Insights from Vertebral Fracture Treatments. New England Journal of Medicine, 2011; 364(15): 1390-93. 

 

Watt AM, Elshaug AG, Willis CD, Hiller JE, for The ASTUTE Health Study Group. Assisted reproductive technologies: a systematic review of safety and effectiveness to inform disinvestment policy. Health Policy, 2011 Oct;102(2-3): 200-13.

 

Willis CD, Elshaug AG, Milverton JL, Watt AM, Metz MP, Hiller JE, for The ASTUTE Health Study Group. Diagnostic performance of serum cobalamin tests: a systematic review and meta-analysis. Pathology, 2011, Aug; 43(5): 472-481.

 

Elshaug AG*, Bessen T* (equal first author), Moss JR, and Hiller JE. Addressing “Waste” in Diagnostic Imaging: Some Implications of Comparative Effectiveness Research. Journal of the American College of Radiology. 2010 Aug;7(8): 603-613.

Elshaug AG, Watt AM, Moss JR, and Hiller JE. Policy perspectives on the obsolescence of health technologies in Canada [HTS Policy Forum discussion paper]. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH); 2009.

Elshaug AG, Moss JR, Littlejohns P, Karnon J, Merlin TL and Hiller JE. Identifying existing health care services that do not provide value for money. Medical Journal of Australia, 2009; 190(5): 269-273.

Elshaug AG, Hiller JE and Moss JR. Exploring policy makers' perspectives on a clinical controversy: airway surgery for adult obstructive sleep apnoea. Quality & Safety in Health Care, 2009; 18(5): 397-401.  

Elshaug AG, Hiller JE and Moss JR. Exploring Policymakers' Perspectives on Disinvestment from Ineffective Health Care Practices. International Journal of Technology Assessment in Health Care, 2008; 24(1): 1-9.

Elshaug AG, Moss JR, Hiller JE and Maddern GJ. Upper airway surgery should not be first line treatment for obstructive sleep apnoea in adults. BMJ (British Medical Journal), 2008; 336(7634): 44-45.

Elshaug AG, Hiller JE, Tunis SR and Moss JR. Challenges in Australian policy processes for disinvestment from existing, ineffective health care practices. Australia and New Zealand Health Policy, 2007; 4: 23 (31 October 2007).

Elshaug AG, Moss JR, Southcott A and Hiller JE. Redefining success in airway surgery for Obstructive Sleep Apnea: A meta analysis and synthesis of the evidence. Sleep, 2007; 30(4): 461-467.

Elshaug AG, Moss JR, Southcott A and Hiller JE. An analysis of the evidence-practice continuum: Is surgery for Obstructive Sleep Apnoea contraindicated? Journal of Evaluation in Clinical Practice, 2007; 13(1): 3-9.

Research Funding:

• 2011-2015 NHMRC Sidney Sax Public Health Fellowship (627061). Elshaug AG. Comparative effectiveness, comparative value: reducing waste to reinvest in safe, effective and cost-effective care. $341,202 (Harvard Medical School and The University of Adelaide)

• 2010-11 Commonwealth Fund (New York City). Elshaug AG. Harkness Fellowship in Health Care Policy and Practice. Title: Enhancing priority decision-making in comparative effectiveness research (CER). USD$107,000 (Agency for Healthcare Research and Quality (AHRQ), Maryland, USA)

• 2009-2012 NHMRC Project Grant (565327). Hiller JE, Elshaug AG, Braunack-Mayer A, Moss JR, Wale J, Buchan H. Title: Changing policy and practice in health care. $860,750
• 2008-2011 ARC Linkage (LP0883930). CIs: Karnon JD, Beilby J, Holton CH, Hakendorf PH, Ben-Tovim DI, Ryan P, Eckermann SD, Sawyer MG, Roos NP, Woollacott AL, Banham D, Pegram R, Thompson S, Elshaug AG. Title: Evaluating the long-term costs and benefits of community-based initiatives. $300,000

 Membership of Professional Associations

• Health Services Research Association of Australia and New Zealand (HSRAANZ) 
• Health Technology Assessment International (HTAi)
• AcademyHealth
• International Society for Pharmacoeconomics and Outcomes Research (ISPOR)
• Network Member: Effective Practice and Organisation of Care Group (EPOC), Cochrane

Entry last updated: Friday, 1 Mar 2013