Methodology Consultation Success Story: Dr. Alysse Wurcel

Dr. Alysse Wurcel is an infectious disease specialist and faculty member at Tufts University School of Medicine with a focus in HIV and hepatitis C (HCV) infection whose research interests closely align with her clinical work. Dr. Wurcel’s research is focused on the treatment of HCV in people who inject drugs (PWID), people in the criminal justice system and people living with HIV. While in the process of developing an application for an NIH-funded Center for AIDS Research Pilot Project grant, her mentor and CHERISH Investigator Dr. Benjamin Linas referred her to the CHERISH Methodology Consultation Service.

Dr. Wurcel’s pilot grant proposed to examine the costs of hospitalizations for inmates with HCV. The prevalence of HCV in prisons and jails is much higher than in the general population (about 20-30% depending on state, versus the average U.S. prevalence of about 1- 2%.) Prisons and jails have limited budgets that often do not allow for expensive new medications. Yet as a clinician, Dr. Wurcel has seen many inmates hospitalized several times for expensive complications of cirrhosis as a result of untreated HCV. She proposed to calculate the costs of hospitalizations for inmates with HCV and compare those costs to inmates without HCV. She also proposed to examine the costs of hospitalizations of inmates who are co-infected with HIV compared to inmates who are infected with HCV alone. To measure costs she proposed to use available data on diagnosis-related groups (DRGs) based in patient medical records.

Dr. Wurcel had not used health economics in any previous studies. Through her consultation with the CHERISH Methodology Core, she learned how to express her ideas in health economics language – for example, the differences between “costs” and “charges.” Her consultant also sent her articles explaining the development of the DRG unit and how to use DRG data in the proposed analysis. To make the most of the consultation, Dr. Wurcel recommends contacting the consultation service early in the grant writing process and with clear questions to guide the conversation. Although she has yet to apply the tools learned in the consultation in her project, she recommends the service to other researchers and hopes to get more comfortable using health economic methods as she executes the study analysis.

With the benefit of this consultation, Dr. Wurcel has now received the Center for AIDS Research Pilot Project grant. She and Dr. Linas have hired a research analyst and have begun working in the database. They have already found new research questions that need to be explored and she hopes the next steps for this research will include successful K-level grant funding and a partnership with the Massachusetts Department of Corrections to strategize on how to get more inmates treated for HCV.