Evan Myers

Overview:

My research interests are broadly in the application of quantitative methods, especially mathematical modeling and decision analysis, to problems in women's health. Recent and current activities include integration of simulation modeling and systematic reviews to inform decisions surrounding cervical, ovarian, and breast cancer prevention and control, screening for postpartum depression, and management of uterine fibroids.    We are also engaged in exploring methods for integrating guidelines development and research prioritization.    In addition, I have ongoing collaborations using the tools of decision analysis with faculty in other clinical areas  Research is conducted through the Division of Reproductive Sciences in the Department of Obstetrics and Gynecology, the Evidence Synthesis Group in the Duke Clinical Research Institute, and the Duke Cancer Institute.  I'm also the course director for CRP 259, "Decision Sciences in Clinical Research", in Duke's Clinical Research Training Program.

Positions:

Walter L. Thomas Distinguished Professor of Obstetrics and Gynecology in the School of Medicine

Community Outreach & Education Division
School of Medicine

Professor of Obstetrics and Gynecology

Community Outreach & Education Division
School of Medicine

Core Faculty Member, Duke-Margolis Center for Health Policy

Duke - Margolis Center For Health Policy
Institutes and Provost's Academic Units

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Member in the Duke Clinical Research Institute

Duke Clinical Research Institute
School of Medicine

Education:

M.D. 1988

University of Pennsylvania

M.P.H. 1992

University of North Carolina - Chapel Hill

House Staff - Resident, Ob/Gyn

Duke University

Associate, Ob/Gyn

Duke University

Grants:

Pregnancy and Response to Antiretroviral Therapy in South Africa

Administered By
Duke Global Health Institute
Awarded By
National Institutes of Health
Role
Advisor
Start Date
End Date

Genomics Tests for Ovarian Cancer Detection and Management

Administered By
Institutes and Centers
Awarded By
Agency for Healthcare Research and Quality
Role
Principal Investigator
Start Date
End Date

Comparison of Operative to Medical Endocrine Therapy (COMET) for Low Risk DCIS

Role
Investigator
Start Date
End Date

Topic Refinement 2015

Administered By
Duke Clinical Research Institute
Awarded By
Patient Centered Outcomes Research Institute
Role
Co Investigator
Start Date
End Date

PCORI_Triage and FR Prioritization - Amendment #3

Administered By
Duke Clinical Research Institute
Awarded By
Patient Centered Outcomes Research Institute
Role
Co Investigator
Start Date
End Date

Publications:

Core feature sets: not just for outcomes, not just for research.

Authors
MLA Citation
Myers, Evan R. “Core feature sets: not just for outcomes, not just for research.Am J Obstet Gynecol, vol. 226, no. 5, May 2022, pp. 605–06. Pubmed, doi:10.1016/j.ajog.2022.03.001.
URI
https://scholars.duke.edu/individual/pub1520754
PMID
35500999
Source
pubmed
Published In
American Journal of Obstetrics and Gynecology
Volume
226
Published Date
Start Page
605
End Page
606
DOI
10.1016/j.ajog.2022.03.001

Cost comparison of using reusable versus disposable equipment for retinopathy of prematurity screening rounds.

Retinopathy of prematurity (ROP) screening rounds have been linked to pathogen transmission and serious adverse outcomes in neonatal intensive care units (NICUs). Using Monte Carlo simulations, we found that it is more likely less expensive to use reusable than disposable equipment in NICUs of all levels for maintaining sterile equipment on ROP screening rounds.
Authors
Chang-Wolf, JM; Myers, ER; Freedman, SF; Prakalapakorn, SG
MLA Citation
Chang-Wolf, Jennifer M., et al. “Cost comparison of using reusable versus disposable equipment for retinopathy of prematurity screening rounds.J Aapos, vol. 26, no. 2, 2022, pp. 82–84. Pubmed, doi:10.1016/j.jaapos.2021.10.006.
URI
https://scholars.duke.edu/individual/pub1497574
PMID
35085757
Source
pubmed
Published In
J Aapos
Volume
26
Published Date
Start Page
82
End Page
84
DOI
10.1016/j.jaapos.2021.10.006

Development and validation of DeciBHAL-US: A novel microsimulation model of hearing loss across the lifespan in the United States.

BACKGROUND: Hearing loss affects over 50% of people in the US across their lifespan and there is a lack of decision modeling frameworks to inform optimal hearing healthcare delivery. Our objective was to develop and validate a microsimulation model of hearing loss across the lifespan in the US. METHODS: We collaborated with the Lancet Commission on Hearing Loss to outline model structure, identify input data sources, and calibrate/validate DeciBHAL-US (Decision model of the Burden of Hearing loss Across the Lifespan). We populated the model with literature-based estimates and validated the conceptual model with key informants. We validated key model endpoints to the published literature, including: 1) natural history of sensorineural hearing loss (SNHL), 2) natural history of conductive hearing loss (CHL), and 3) the hearing loss cascade of care. We reported the coefficient of variance root mean square error (CV-RMSE), considering values ≤15% to indicate adequate fit. FINDINGS: For SNHL prevalence, the CV-RMSE for model projected male and female age-specific prevalence compared to sex-adjusted National Health and Nutrition Examination Survey (NHANES) data was 4.9 and 5.7%, respectively. Incorporating literature-based age-related decline in SNHL, we validated mean four-frequency average hearing loss in the better ear (dB) among all persons to longitudinal data (CV-RMSE=11.3%). We validated the age-stratified prevalence of CHL to adjusted NHANES data (CV-RMSE=10.9%). We incorporated age- and severity-stratified time to first hearing aid (HA) use data and HA discontinuation data (adjusted for time-period of use) and validated to NHANES estimates on the prevalence of adult HA use (CV-RMSE=10.3%). INTERPRETATION: Our results indicate adequate model fit to internal and external validation data. Future incorporation of cost and severity-stratified utility data will allow for cost-effectiveness analysis of US hearing healthcare interventions across the lifespan. Further research might expand the modeling framework to international settings. FUNDING: This study was funded by the National Institute on Deafness and Other Communication Disorders and the National Institute on Aging (3UL1-TR002553-03S3 and F30 DC019846).
Authors
Borre, ED; Myers, ER; Dubno, JR; O'Donoghue, GM; Diab, MM; Emmett, SD; Saunders, JE; Der, C; McMahon, CM; Younis, D; Francis, HW; Tucci, DL; Wilson, BS; Ogbuoji, O; Schmidler, GDS
MLA Citation
Borre, Ethan D., et al. “Development and validation of DeciBHAL-US: A novel microsimulation model of hearing loss across the lifespan in the United States.Eclinicalmedicine, vol. 44, Feb. 2022, p. 101268. Pubmed, doi:10.1016/j.eclinm.2021.101268.
URI
https://scholars.duke.edu/individual/pub1506366
PMID
35072020
Source
pubmed
Published In
Eclinicalmedicine
Volume
44
Published Date
Start Page
101268
DOI
10.1016/j.eclinm.2021.101268

Estimated Prevalence of Risk Factors for Preeclampsia Among Individuals Giving Birth in the US in 2019.

Importance: Low-dose aspirin (LDA) is one of the few evidence-based interventions for preventing preeclampsia, which is a leading cause of maternal or fetal morbidity and mortality. Current guidelines recommend LDA based on the presence of risk factors for preeclampsia, but the population-based prevalence of these factors is unknown. Objective: To estimate population-level prevalence of preeclampsia risk factors used in prophylactic LDA guidelines for pregnant patients and the association of these risk factors with reported rates of pregnancy-related hypertension. Design, Setting, and Participants: A retrospective cohort study was conducted using National Center for Health Statistics birth certificate data to describe the frequency of pregnant individuals with moderate to high-risk factors for preeclampsia and pregnancy-related hypertension rates. The study used all birth records in the United States for the 2019 calendar year. Exposures: Documentation of preeclampsia risk factors: multifetal gestation, pregestational diabetes, chronic hypertension (high-risk factors) and nulliparity, a body mass index greater than 30, African American race, a maternal age 35 years or older, an interval of more than 10-years since last birth, and having low socioeconomic status (moderate risk factors). Main Outcomes and Measures: Prevalence of each risk factor alone and in combinations leading to a recommendation for LDA; incidence of pregnancy-related hypertension by risk factor and combinations of risk factors. Results: There were 3 695 019 pregnancies in 2019, including 528 778 with no risk factors, 169 540 with 1 or more high-risk factors, and 2 996 701 with 1 or more moderate-risk factors. The mean (SD) of the cohort was 29.1 (5.8) years. Multifetal gestation was the most common high-risk factor and found in 123 995 pregnancies (3.4%), and low socioeconomic status was the most common moderate-risk factor and present in 1 732 729 pregnancies (46.9%). Based on 2021 criteria (a single high- or moderate-risk factors for preeclampsia), 3 166 241 pregnant patients (85.7%) were eligible for LDA. The incidence of pregnancy-related hypertension increased with the number of moderate-risk factors. The 2021 guidelines suggest considering or recommend LDA in 92.3% of pregnancies diagnosed with pregnancy-related hypertension. Conclusions and Relevance: These data support the recently published guidelines and suggest further simplified guidelines recommending LDA to patients with any single moderate-risk factors.
Authors
Wheeler, SM; Myers, SO; Swamy, GK; Myers, ER
MLA Citation
Wheeler, Sarahn M., et al. “Estimated Prevalence of Risk Factors for Preeclampsia Among Individuals Giving Birth in the US in 2019.Jama Netw Open, vol. 5, no. 1, Jan. 2022, p. e2142343. Pubmed, doi:10.1001/jamanetworkopen.2021.42343.
URI
https://scholars.duke.edu/individual/pub1505991
PMID
34982156
Source
pubmed
Published In
Jama Network Open
Volume
5
Published Date
Start Page
e2142343
DOI
10.1001/jamanetworkopen.2021.42343

Mortality reduction and cost-effectiveness of performing hysterectomy at the time of RRSO for prophylaxis against serous/serous-like uterine cancers in BRCA1 mutation carriers

MLA Citation
Havrilesky, L. J., et al. “Mortality reduction and cost-effectiveness of performing hysterectomy at the time of RRSO for prophylaxis against serous/serous-like uterine cancers in BRCA1 mutation carriers.” Gynecologic Oncology, vol. 145, Elsevier BV, 2017, pp. 45–45. Crossref, doi:10.1016/j.ygyno.2017.03.114.
URI
https://scholars.duke.edu/individual/pub1474136
Source
crossref
Published In
Gynecologic Oncology
Volume
145
Published Date
Start Page
45
End Page
45
DOI
10.1016/j.ygyno.2017.03.114

Research Areas:

Cervix Uteri
Cesarean Section
Clinical Trials as Topic
Cohort Studies
Comparative Effectiveness Research
Computer Simulation
Controlled Clinical Trials as Topic
Cost Savings
Cost effectiveness
Cost of Illness
Cost-Benefit Analysis
Cross-Sectional Studies
Decision Making
Decision Trees
Diagnostic Techniques, Obstetrical and Gynecological
Direct Service Costs
Evidence-Based Medicine
Fertility
Fertility Agents, Female
Genital Diseases, Female
Genital Neoplasms, Female
Gynecologic Surgical Procedures
Gynecology
Health Care Costs
Health Expenditures
Health Policy
Health Services Research
Hospital Costs
Hysterectomy
Infertility, Female
Intraoperative Complications
Leiomyoma
Markov Chains
Mass Screening
Mass Vaccination
Models, Economic
Models, Statistical
Monte Carlo Method
Outcome Assessment (Health Care)
Papillomavirus Vaccines
Pelvic Neoplasms
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Preventive Health Services
Prognosis
Research Design
Sensitivity and Specificity
Technology Assessment, Biomedical
Urogenital Surgical Procedures
Women's Health