Public Health Interests
The objective that guides Dr. Paltiel's scholarly activities is to promote a reasoned approach to choices under uncertainty and resource scarcity in health and medicine. Trained in the field of Operations Research, Dr. Paltiel designs and implements model-based cost-effectiveness analyses of medical technologies and public health interventions. His published research, including more than 100 peer-reviewed papers, spans both methods development and applications to a wide range of disease areas and clinical specialties. He has a special interest and expertise in HIV/AIDS and has published broadly on the cost-effectiveness of testing, prevention, treatment, and care, both in the United States and around the world.
Among the many talented modelers at Yale, Dr. Paltiel's unique contribution lies in bringing a decision-analytic and cost-effectiveness overlay to public health policy and resource allocation. His expertise in both the theory of choice under uncertainty and its practical adaptation to policy-relevant applications provides substantial opportunity to mentor colleagues interested in promoting a more reasoned approach to clinical practice and priority setting in health and medicine.
Extensive Research Description
- Novel approaches to the design and evaluation of combination HIV prevention. The goals of this NIMH-funded grant project are to develop and illustrate three novel ways of thinking about HIV prevention program design and evaluation: viewing HIV prevention in terms of policy bundles; looking beyond program cost-effectiveness to program affordability; and designing financial incentives that translate into better long-term HIV outcomes. The broad objective that guides this research is to squeeze the greatest possible benefit out of every HIV prevention dollar.
- Economic Modeling for HIV, Viral Hepatitis, STD, TB and School Health. The goal of this CDC-funded collaborative grant to the Harvard School of Public Health (Principal Investigator: Joshua Salomon) is to conduct health and economic modeling to inform decision-making on HIV, hepatitis, STD, TB and school health at national, state and local levels, in partnership with the National Center for HIV/AIDS Viral Hepatitis, STD and TB Prevention.
- Cost-Effectiveness of Preventing AIDS Complications (CEPAC-US). The goal of this NIAID-funded collaborative grant to Massachusetts General Hospital (Principal Investigator: Kenneth Freedberg) is to develop a computer simulation model of advanced HIV disease and use to project the costs and consequences of alternative patient care strategies.
- Optimizing HIV Care in Less Developed Countries (CEPAC-International). The goal of this NIAID-funded collaborative grant to Massachusetts General Hospital (Principal Investigator: Kenneth Freedberg) is to provide mentoring for young investigators in patient-oriented HIV research and use ongoing HIV simulation model in conjunction with mentoring efforts to address critical HIV clinical management questions in the US and internationally.
- Making Better Decisions: Policy Modeling for AIDS & Drug Abuse. The goal of this NIDA-funded collaborative grant to Stanford University (Principal Investigator: Douglas Owens) is to develop and apply mathematical policy modeling techniques to the evaluation of AIDS‑related public health interventions.
- Novel Methods to Inform HIV/TB Clinical Trial Development. The goals of this NIAID-funded collaborative grant (Principal Investigator: Rochelle Walensky) are to apply a mathematical simulation modeling framework, based on the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) Model, to the NIAID/ACTG clinical trials infrastructure. We propose to inform the development, design, and assessment of therapeutic, diagnostic, and 'strategy' clinical trials in HIV/TB care in international settings. The ultimate goal of this project is to apply novel scientific methods in a highly innovative fashion, to maximize trial investments. It will develop new scientific knowledge of value to HIV/TB investigators, as well as clinical trialists in many areas of medicine.
- Typhoid modeling studies for typhoid conjugate vaccine cost effectiveness and for typhoid delivery strategy. The goals of this project, funded by a grant from the Bill & Melinda Gates Foundation (Principal Investigator: Virginia E. Pitzer), are to conduct research aimed toward the prevention of HIV infection and the reduction of the negative consequences of HIV disease in vulnerable and underserved populations in the U.S.
- Demographic and clinical features of inclusion body myositis in north America. Paltiel AD, Ingvarsson E, Lee DK, Leff RL, Nowak RJ, Petschke KD, Richards-Shubik S, Zhou A, Shubik M, O'Connor KC. Muscle Nerve. 2014 Dec 30. doi: 10.1002/mus.24562. [Epub ahead of print]
- Cost-effectiveness of genotype testing for primary resistance in Brazil. Luz PM, Morris BL, Grinsztejn B, Freedberg KA, Veloso VG, Walensky RP, Losina E, Nakamura YM, Girouard MP, Sax PE, Struchiner CJ, Paltiel AD. J Acquir Immune Defic Syndr. 2015 Feb 1;68(2):152-61. doi: 10.1097/QAI.0000000000000426.
- HIV cure strategies: how good must they be to improve on current antiretroviral therapy? Sax PE, Sypek A, Berkowitz BK, Morris BL, Losina E, Paltiel AD, Kelly KA, Seage GR 3rd, Walensky RP, Weinstein MC, Eron J, Freedberg KA. PLoS One. 2014 Nov 14;9(11):e113031. doi: 10.1371/journal.pone.0113031. eCollection 2014. Erratum in: PLoS One. 2015;10(1):e0117762.
- The clinical and economic impact of point-of-care CD4 testing in mozambique and other resource-limited settings: a cost-effectiveness analysis. Hyle EP, Jani IV, Lehe J, Su AE, Wood R, Quevedo J, Losina E, Bassett IV, Pei PP, Paltiel AD, Resch S, Freedberg KA, Peter T, Walensky RP. PLoS Med. 2014 Sep 16;11(9):e1001725. doi: 10.1371/journal.pmed.1001725. eCollection 2014 Sep
- Defining the Value of Future Research to Identify the Preferred Treatment of Meniscal Tear in the Presence of Knee Osteoarthritis. Losina E, Dervan EE, Paltiel AD, Dong Y, Wright RJ, Spindler KP, Mandl LA, Jones MH, Marx RG, Safran-Norton CE, Katz JN. PLoS One. 2015 Jun 18;10(6):e0130256. doi: 10.1371/journal.pone.0130256. eCollection 2015.
- Reducing sexual violence by increasing the supply of toilets in Khayelitsha, South Africa: a mathematical model. Gonsalves GS, Kaplan EH, Paltiel AD. PLoS One. 2015 Apr 29;10(4):e0122244. doi: 10.1371/journal.pone.0122244. eCollection 2015.
- Lifetime medical costs of knee osteoarthritis management in the United States: impact of extending indications for total knee arthroplasty. Losina E, Paltiel AD, Weinstein AM, Yelin E, Hunter DJ, Chen SP, Klara K, Suter LG, Solomon DH, Burbine SA, Walensky RP, Katz JN. Arthritis Care Res (Hoboken). 2015 Feb;67(2):203-15. doi: 10.1002/acr.22412.
- A marginal benefit approach for vaccinating influenza "superspreaders". A marginal benefit approach for vaccinating influenza "superspreaders". Skene KJ, Paltiel AD, Shim E, Galvani AP. Med Decis Making. 2014 May;34(4):536-49. doi: 10.1177/0272989X14523502.
- The lifetime medical cost savings from preventing HIV in the United States. Schackman BR, Fleishman JA, Su AE, Berkowitz BK, Moore RD, Walensky RP, Becker JE, Voss C, Paltiel AD, Weinstein MC, Freedberg KA, Gebo KA, Losina E. Med Care. 2015 Apr;53(4):293-301. doi: 10.1097/MLR.0000000000000308.
- The clinical role and cost-effectiveness of long-acting antiretroviral therapy. Ross EL, Weinstein MC, Schackman BR, Sax PE, Paltiel AD, Walensky RP, Freedberg KA, Losina E. Clin Infect Dis. 2015 Apr 1;60(7):1102-10. doi: 10.1093/cid/ciu1159. Epub 2015 Jan 12.
- Clinical impact and cost-effectiveness of making third-line antiretroviral therapy available in sub-Saharan Africa: a model-based analysis in Côte d'Ivoire. 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. J Acquir Immune Defic Syndr. 2014 Jul 1;66(3):294-302. doi: 10.1097/QAI.0000000000000166.
- Misinterpretation of HIV preexposure prophylaxis findings. Paltiel AD, Walensky RP, Freedberg KA. Clin Infect Dis. 2014 Jul 1;59(1):139-41. doi: 10.1093/cid/ciu240. Epub 2014 Apr 12.
- Cost-effectiveness of canine vaccination to prevent human rabies in rural Tanzania. Fitzpatrick MC, Hampson K, Cleaveland S, Mzimbiri I, Lankester F, Lembo T, Meyers LA, Paltiel AD, Galvani AP. Ann Intern Med. 2014 Jan 21;160(2):91-100
- Mobile HIV screening in Cape Town, South Africa: clinical impact, cost and cost-effectiveness. 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. PLoS One. 2014 Jan 22;9(1):e85197. doi: 10.1371/journal.pone.0085197. eCollection 2014.