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Natasha K. Stout

I am a Decision Scientist and Health Services Researcher.

Natasha K. Stout

Harvard Pilgrim Health Care, Inc.

For breast cancer screening, the growing recognition of anxiety and stress related to false positive test results and unnecessary biopsies highlights how more is not necessarily better. Decision modeling coupled with population-based data on real world outcomes can help us understand the benefits and risks associated with different screening approaches, as well as identify effective strategies to improve population health.

The primary theme of Dr. Stout's research is the evaluation of cancer prevention and control policies using mathematical models and decision-analytic methods informed by real-world data. This research theme began with her broad interest in operations research and quantitative modeling techniques for medical decision making. This theme evolved through her work experience at Epic Systems, which provided her with a greater understanding of data available within electronic health records and their potential application for improving health and health care. Dr. Stout's work in cancer screening and control began with her doctoral research, which focused on the development and application of a population-based simulation model of breast cancer. Currently, she is a member of the NCI-funded Cancer Intervention and Surveillance Modeling Network (CISNET) Breast Working Group and the NCI-funded Breast Cancer Surveillance Consortium. Her work with these consortiums has included numerous comparative and cost effectiveness analyses of breast and cervical cancer screening policies and informed US Preventive Services Task Force breast cancer screening recommendations.

For her current study, Dr. Stout is evaluating the impact of recent laws in 31 states that now require women to be notified if they have "mammographically dense breasts" at the time of their screening mammogram, and, in many cases, to encourage affected women to obtain supplemental screening. Dense breast tissue, a characteristic that over 40 percent of women have, may modestly increase breast cancer risk and reduce the ability of mammograms to detect breast cancers. Supplemental breast cancer screening tests such as ultrasound may improve early detection of breast cancer for these women; however, they may also increase the chance that a woman without breast cancer will undergo additional diagnostic testing and unnecessary biopsies due to false positive findings. At present, effects of density laws on breast cancer screening patterns, and, more importantly, breast cancer outcomes, are unknown. Dr. Stout will use 2 large nationally representative databases covering all 50 states for 17 years from 2001-2017 to examine the impact of these state-specific laws on breast cancer screening use, associated downstream work-up, out-of-pocket costs for women, and breast cancer detection rates in the United States. The study will describe the types and extent of imaging and diagnostic workup that women may face following screening; these results paired with information about potential quality of life effects (e.g., anxiety, stress) may be useful for informing screening decisions. Findings will serve to guide future density notification policies, both in the remaining 19 states and at the federal level.

Grant Listing
Project Title Grant Number Program Director Publication(s)
Advanced Breast Imaging: Trends and Outcomes Associated with Recent Breast Density Reporting Legislation
Joan Warren Publish File

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Last Updated: 11/15/2017 03:00:18