Audrey D. Zhang
@audreydzhang.bsky.social
Primary care physician and health services researcher. General medicine fellow at Harvard/BIDMC. Studying how to improve quality of care for older adults. https://linktr.ee/audreydzhang
Pinned
Audrey D. Zhang
@audreydzhang.bsky.social
· Jun 27
Treatment Burden Among Older Adults in the United States, 2022
Background Treatment burden refers to the patient-perceived effort of managing health and health care, which impacts quality of life and engagement in care. International studies of treatment burden...
agsjournals.onlinelibrary.wiley.com
🚨 New paper: As a PCP, I often hear from patients that managing their health care feels like a full-time job. To understand this better, we analyzed the first nationally-representative US survey of older adults’ self-reported treatment burden: agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
🚨 New paper: As a PCP, I often hear from patients that managing their health care feels like a full-time job. To understand this better, we analyzed the first nationally-representative US survey of older adults’ self-reported treatment burden: agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
Treatment Burden Among Older Adults in the United States, 2022
Background Treatment burden refers to the patient-perceived effort of managing health and health care, which impacts quality of life and engagement in care. International studies of treatment burden...
agsjournals.onlinelibrary.wiley.com
June 27, 2025 at 10:09 PM
🚨 New paper: As a PCP, I often hear from patients that managing their health care feels like a full-time job. To understand this better, we analyzed the first nationally-representative US survey of older adults’ self-reported treatment burden: agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
ICYMI, out in print this week. While we framed this Viewpoint with optimism, it can conversely be said that eroding health survey infrastructure means we’re flying a little more blind each day on priorities like chronic disease, maternal health, and substance use: jamanetwork.com/journals/jam...
Enhancing Health Survey Infrastructure for Chronic Disease
This Viewpoint discusses an opportunity to promote safeguarding, expanding, and modernizing the national health survey infrastructure as a crucial part of a comprehensive approach to address chronic d...
jamanetwork.com
June 24, 2025 at 10:27 PM
ICYMI, out in print this week. While we framed this Viewpoint with optimism, it can conversely be said that eroding health survey infrastructure means we’re flying a little more blind each day on priorities like chronic disease, maternal health, and substance use: jamanetwork.com/journals/jam...
Reposted by Audrey D. Zhang
NSDUH is one of the only ways we can track trends in substance use in the US. NSDUH is one of the only ways we can track adolescent mental health problems in the US.
We cannot afford to fly blind on these critical issues.
We cannot afford to fly blind on these critical issues.
The entire SAMHSA staff that manages the National Survey on Drug Use and Health has been terminated. This is the only survey that tracks mental health and substance use trends in the US.
We really are flying blind now.
We really are flying blind now.
April 1, 2025 at 7:54 PM
NSDUH is one of the only ways we can track trends in substance use in the US. NSDUH is one of the only ways we can track adolescent mental health problems in the US.
We cannot afford to fly blind on these critical issues.
We cannot afford to fly blind on these critical issues.
Reposted by Audrey D. Zhang
One big thing that AHRQ does is run the Medical Expenditures Panel Survey. This may sound like a trivial thing if you are outside the field. But the Congressional Budget Office relies on this information when modeling health policy changes. That is a huge deal.
Missed this story last night portending something bad for AHRQ
AHRQ fills a hugely important void in the medical and health care research space: it funds work that doesn't map cleanly to a disease, body part, or special population (e.g., older Americans)
www.politico.com/news/2025/03...
AHRQ fills a hugely important void in the medical and health care research space: it funds work that doesn't map cleanly to a disease, body part, or special population (e.g., older Americans)
www.politico.com/news/2025/03...
March 19, 2025 at 2:25 PM
One big thing that AHRQ does is run the Medical Expenditures Panel Survey. This may sound like a trivial thing if you are outside the field. But the Congressional Budget Office relies on this information when modeling health policy changes. That is a huge deal.
Many more pieces like this could be written to show the impact of sustained federal investment in US biomedical research. This one has a great table highlighting the role of NIH funding in some of our greatest gains against chronic disease in the past 80 years. www.ahajournals.org/doi/full/10....
February 20, 2025 at 5:24 PM
Many more pieces like this could be written to show the impact of sustained federal investment in US biomedical research. This one has a great table highlighting the role of NIH funding in some of our greatest gains against chronic disease in the past 80 years. www.ahajournals.org/doi/full/10....
Reposted by Audrey D. Zhang
1. Today the NIH director issued a new directive slashing overhead rates to 15%.
I want to provide some context on what that means and why it matters.
grants.nih.gov/grants/guide...
I want to provide some context on what that means and why it matters.
grants.nih.gov/grants/guide...
NOT-OD-25-068: Supplemental Guidance to the 2024 NIH Grants Policy Statement: Indirect Cost Rates
NIH Funding Opportunities and Notices in the NIH Guide for Grants and Contracts: Supplemental Guidance to the 2024 NIH Grants Policy Statement: Indirect Cost Rates NOT-OD-25-068. OD
grants.nih.gov
February 8, 2025 at 12:18 AM
1. Today the NIH director issued a new directive slashing overhead rates to 15%.
I want to provide some context on what that means and why it matters.
grants.nih.gov/grants/guide...
I want to provide some context on what that means and why it matters.
grants.nih.gov/grants/guide...
Reposted by Audrey D. Zhang
We just launched a 16TB archive of every dataset that has been available on data.gov since November. This will be updated day by day as new datasets appear. It can be freely copied, and we're sharing the code behind it to help others make their own archives of data they depend on.
Announcing the Data.gov Archive | Library Innovation Lab
Today we released our archive of data.gov on Source Cooperative. The 16TB collection includes over 311,000 datasets harvested during 2024 and 2025, a complet...
lil.law.harvard.edu
February 6, 2025 at 9:23 PM
We just launched a 16TB archive of every dataset that has been available on data.gov since November. This will be updated day by day as new datasets appear. It can be freely copied, and we're sharing the code behind it to help others make their own archives of data they depend on.
The intensity and seriousness of cancer care has prompted attention to the wide-ranging impact of "time toxicity" of care on patients and caregivers. We would benefit from improved understanding of such burdens and their tradeoffs in other areas as well: jamanetwork.com/journals/jam...
Patient, Caregiver, and Clinician Perspectives on Time Burdens of Cancer Care
This qualitative analysis explores time-consuming aspects of cancer care that were perceived as burdensome, identifies the individuals most affected by the time burdens of cancer care, and evaluates t...
jamanetwork.com
January 14, 2025 at 7:11 PM
The intensity and seriousness of cancer care has prompted attention to the wide-ranging impact of "time toxicity" of care on patients and caregivers. We would benefit from improved understanding of such burdens and their tradeoffs in other areas as well: jamanetwork.com/journals/jam...
"If someone had asked us in the summer of 2021 what we most needed to facilitate Mom’s healing and well-being, our wish list would have been modest."
So often our health care system fails to live up to its name of providing care: www.healthaffairs.org/doi/full/10....
So often our health care system fails to live up to its name of providing care: www.healthaffairs.org/doi/full/10....
The Idea Of A Good Daughter | Health Affairs Journal
A public health professor and her mother failed to receive long-term care support from the health care system when they needed it most.
www.healthaffairs.org
January 13, 2025 at 3:39 PM
"If someone had asked us in the summer of 2021 what we most needed to facilitate Mom’s healing and well-being, our wish list would have been modest."
So often our health care system fails to live up to its name of providing care: www.healthaffairs.org/doi/full/10....
So often our health care system fails to live up to its name of providing care: www.healthaffairs.org/doi/full/10....
Reposted by Audrey D. Zhang
Want to see if your research has had an impact on public policy?
Enter your info in SagePolicyProfiles to see the citations of your own publications in policy documents.
You get a profile page. Here is mine as an example: policyprofiles.sagepub.com/profile/5920...
Enter your info in SagePolicyProfiles to see the citations of your own publications in policy documents.
You get a profile page. Here is mine as an example: policyprofiles.sagepub.com/profile/5920...
December 27, 2023 at 3:49 PM
Want to see if your research has had an impact on public policy?
Enter your info in SagePolicyProfiles to see the citations of your own publications in policy documents.
You get a profile page. Here is mine as an example: policyprofiles.sagepub.com/profile/5920...
Enter your info in SagePolicyProfiles to see the citations of your own publications in policy documents.
You get a profile page. Here is mine as an example: policyprofiles.sagepub.com/profile/5920...
Reposted by Audrey D. Zhang
I didn't know any of this policy story - worth the read. TL;DR 1980s regulatory changes enabled monopsony behavior by big chains, basically destroying the small local grocer.
1. The conventional explanation for food deserts—that these places are too poor or too rural to generate enough spending on groceries, or too Black to overcome racist corporate redlining — fail to grapple with a key fact: food deserts didn’t used to exist. My new piece in The Atlantic.
The Mystery of Food Deserts
They didn’t materialize around the country for no reason. Something happened.
www.theatlantic.com
December 2, 2024 at 1:26 PM
I didn't know any of this policy story - worth the read. TL;DR 1980s regulatory changes enabled monopsony behavior by big chains, basically destroying the small local grocer.
Reposted by Audrey D. Zhang
As the baby boom generation enters its prime years for long-term care needs, its difficult to come up with a more challenging backdrop than an immigration system about to be cut off at its knees (think: nursing home aides) and states having to fill in funding gaps from Medicaid spending shortfalls.
As press reports continue to highlight the debate within GOP Congressional leaders as to whether they should block grant Medicaid to pay for their tax cuts, it is worth highlighting that there are 11.7 million seniors/PWD on Medicare + Medicare.
The so-called "Dual-eligibles".
The so-called "Dual-eligibles".
November 25, 2024 at 7:33 PM
As the baby boom generation enters its prime years for long-term care needs, its difficult to come up with a more challenging backdrop than an immigration system about to be cut off at its knees (think: nursing home aides) and states having to fill in funding gaps from Medicaid spending shortfalls.
A lot to think about in this review from a research perspective - what are the essential components of the underlying concept of "decision fatigue"? How do we operationalize that definition? How does this concept apply not only to clinicians, but to patients and caregivers?
1/🧵 Exploring #DecisionFatigue in 🏥 settings
I found this scoping review interesting. Although this topic is important, I hadn't given it much thought despite feeling its weight on many occasions while attending on clinical service #MedSky
shmpublications.onlinelibrary.wiley.com/doi/full/10....
I found this scoping review interesting. Although this topic is important, I hadn't given it much thought despite feeling its weight on many occasions while attending on clinical service #MedSky
shmpublications.onlinelibrary.wiley.com/doi/full/10....
Decision fatigue in hospital settings: A scoping review
Background “Decision Fatigue” (DF) describes the impaired ability to make decisions because of repeated acts of decision-making. Objectives We conducted a scoping review to describe DF in inpatien...
shmpublications.onlinelibrary.wiley.com
November 16, 2024 at 1:08 AM
A lot to think about in this review from a research perspective - what are the essential components of the underlying concept of "decision fatigue"? How do we operationalize that definition? How does this concept apply not only to clinicians, but to patients and caregivers?
#NewLitHighlights #HealthPolicy
Nurse practitioners and physician assistants are now responsible for over a quarter of outpatient visits in traditional Medicare - still a lot of room to understand how to optimize their role in clinical care: www.bmj.com/content/382/...
Nurse practitioners and physician assistants are now responsible for over a quarter of outpatient visits in traditional Medicare - still a lot of room to understand how to optimize their role in clinical care: www.bmj.com/content/382/...
October 27, 2023 at 1:30 AM
#NewLitHighlights #HealthPolicy
Nurse practitioners and physician assistants are now responsible for over a quarter of outpatient visits in traditional Medicare - still a lot of room to understand how to optimize their role in clinical care: www.bmj.com/content/382/...
Nurse practitioners and physician assistants are now responsible for over a quarter of outpatient visits in traditional Medicare - still a lot of room to understand how to optimize their role in clinical care: www.bmj.com/content/382/...
Great advice on making the most of the shifts between clinical and research time as a clinician-investigator, applicable to folks at multiple levels. Wish I'd seen some of these tips before learning them the hard way! (via @BryantShuey)
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Preparing to Attend on the Inpatient Medical Wards
Transitions are a way of life in academic medicine. While much has been written about these changes, less attention has been devoted to a more common shift: the
jamanetwork.com
October 10, 2023 at 11:27 PM
Great advice on making the most of the shifts between clinical and research time as a clinician-investigator, applicable to folks at multiple levels. Wish I'd seen some of these tips before learning them the hard way! (via @BryantShuey)
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Reposted by Audrey D. Zhang
If you've got any research (even in the pipeline) that might help better understand the effects of anti-obesity medications on health care and other federal spending, CBO wants to see it:
www.cbo.gov/publication/...
www.cbo.gov/publication/...
October 6, 2023 at 1:27 PM
If you've got any research (even in the pipeline) that might help better understand the effects of anti-obesity medications on health care and other federal spending, CBO wants to see it:
www.cbo.gov/publication/...
www.cbo.gov/publication/...
Not so many people here discussing #FDAPolicy #RxPolicy yet, but this one will be one to follow - for the first time, FDA exercises its FDORA power to expedite withdrawal of drugs initially approved via accelerated approval: www.bloomberg.com/news/article...
#HealthPolicy
#HealthPolicy
FDA Tests New Power to Pull Some Fast-Tracked Drugs Off Market
Its first target is a cancer treatment from Oncopeptides given accelerated approval in 2021, which has since faced a study questioning its effectiveness.
www.bloomberg.com
October 6, 2023 at 12:38 AM
Not so many people here discussing #FDAPolicy #RxPolicy yet, but this one will be one to follow - for the first time, FDA exercises its FDORA power to expedite withdrawal of drugs initially approved via accelerated approval: www.bloomberg.com/news/article...
#HealthPolicy
#HealthPolicy
Reposted by Audrey D. Zhang
PSA: deck.blue is basically a clone of Tweetdeck for BlueSky—it even lets you curate personal lists, independent of feeds
If you haven't used any bsky apps before, you need to create an "app password" (under Settings > Advanced) to log in
If you haven't used any bsky apps before, you need to create an "app password" (under Settings > Advanced) to log in
September 26, 2023 at 2:31 PM
PSA: deck.blue is basically a clone of Tweetdeck for BlueSky—it even lets you curate personal lists, independent of feeds
If you haven't used any bsky apps before, you need to create an "app password" (under Settings > Advanced) to log in
If you haven't used any bsky apps before, you need to create an "app password" (under Settings > Advanced) to log in
This looks like it will be an excellent opportunity to better understand how a wide and diverse range of people contribute to dementia care and its associated outcomes - I'll be looking forward to getting my hands in the data.
Working with the tremendous Dr. @joannespetz.bsky.social at UCSF, the survey pros UM SRC, and a superstar team of co-investigators, we have the extraordinary privilege of launching the National Dementia Workforce Study (NDWS).
You can read more at the other place:
x.com/dtmaust/stat...
You can read more at the other place:
x.com/dtmaust/stat...
New $81M NIH grant will help U.S. answer urgent need for better dementia care
National Dementia Workforce Study will survey those who work in homes, hospitals, clinics, assisted living facilities and nursing homes, yielding data to improve care and inform policy
ihpi.umich.edu
October 3, 2023 at 2:11 PM
This looks like it will be an excellent opportunity to better understand how a wide and diverse range of people contribute to dementia care and its associated outcomes - I'll be looking forward to getting my hands in the data.
#HiSciSky! I'm an #PrimaryCare physician and health services researcher studying prescribing and medication use to improve quality of care for older adults.
Interests include #GIM #Geriatrics #Deprescribing #RxEpi #HealthPolicy #RxPolicy.
Looking forward to connecting with friends old and new!
Interests include #GIM #Geriatrics #Deprescribing #RxEpi #HealthPolicy #RxPolicy.
Looking forward to connecting with friends old and new!
October 1, 2023 at 10:51 PM
#HiSciSky! I'm an #PrimaryCare physician and health services researcher studying prescribing and medication use to improve quality of care for older adults.
Interests include #GIM #Geriatrics #Deprescribing #RxEpi #HealthPolicy #RxPolicy.
Looking forward to connecting with friends old and new!
Interests include #GIM #Geriatrics #Deprescribing #RxEpi #HealthPolicy #RxPolicy.
Looking forward to connecting with friends old and new!
Reposted by Audrey D. Zhang
Any time you are tempted to dismiss descriptive research as unimportant, keep in mind: a medical diagnosis is a description. "You have lymphoma" seems like an important thing to know, right? Describing our world is important.
September 21, 2023 at 5:15 PM
Any time you are tempted to dismiss descriptive research as unimportant, keep in mind: a medical diagnosis is a description. "You have lymphoma" seems like an important thing to know, right? Describing our world is important.
Great to see our recent study covered in @statnews by @TaraBannow - we found over 1/3 of both physicians and APCs received industry payments in 2021: https://www.statnews.com/2022/10/31/advanced-practice-clinicians-industry-funding/
Advanced practice clinicians slightly more likely to take...
A slightly higher share of advanced practice clinicians t...
www.statnews.com
January 24, 2025 at 10:48 PM
Great to see our recent study covered in @statnews by @TaraBannow - we found over 1/3 of both physicians and APCs received industry payments in 2021: https://www.statnews.com/2022/10/31/advanced-practice-clinicians-industry-funding/
We know industry payments to physicians are common, but what about the nurse practitioners, physician assistants, and other APCs critical to patient care?
New paper out in @JAMA_current with @TimAndersonMD: https://jamanetwork.com/journals/jama/fullarticle/2798217
New paper out in @JAMA_current with @TimAndersonMD: https://jamanetwork.com/journals/jama/fullarticle/2798217
January 24, 2025 at 10:48 PM
We know industry payments to physicians are common, but what about the nurse practitioners, physician assistants, and other APCs critical to patient care?
New paper out in @JAMA_current with @TimAndersonMD: https://jamanetwork.com/journals/jama/fullarticle/2798217
New paper out in @JAMA_current with @TimAndersonMD: https://jamanetwork.com/journals/jama/fullarticle/2798217
"Recommendations for outcome measurement for deprescribing intervention studies" (@DeprescribeUS Measures Working Grp) - lack of standardization in deprescribing measures poses challenges to interpretation, with many opportunities for further development:...
January 24, 2025 at 10:48 PM
"Recommendations for outcome measurement for deprescribing intervention studies" (@DeprescribeUS Measures Working Grp) - lack of standardization in deprescribing measures poses challenges to interpretation, with many opportunities for further development:...