Shelby Reed


Shelby D. Reed, PhD, is Professor in the Departments of Population Health Sciences and Medicine at Duke University’s School of Medicine.  She is the director of the Center for Informing Health Decisions and Therapeutic Area leader for Population Health Sciences at the Duke Clinical Research Institute (DCRI).  She also is core faculty at the Duke-Margolis Center for Health Policy. Dr. Reed has over 20 years of experience leading multidisciplinary health outcomes research studies. Dr. Reed has extensive expertise in designing and conducting trial-based and model-based cost-effectiveness analyses of diagnostics, drugs and patient-centered interventions. In 2016, she co-founded the Preference Evaluation Research (PrefER) Group at the DCRI, and she currently serves as its director. She and the group are frequently sought to conduct stated-preference studies to inform regulatory decisions, health policy, care delivery, value assessment and clinical decision making with applied projects spanning a wide range of therapeutic areas. She served as President for ISPOR in 2017-2018, and she currently is Past-Chair of the Society’s Health Science Policy Council.



Areas of expertise: Health Economics, Health Measurement, Stated Preference Research, Health Policy, and Health Services Research


Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Professor in Medicine

Medicine, General Internal Medicine
School of Medicine

Associate of the Duke Initiative for Science & Society

Duke Science & Society
Institutes and Provost's Academic Units

Executive Core Faculty Member, Duke-Margolis Center for Health Policy

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

Member in the Duke Clinical Research Institute

Duke Clinical Research Institute
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine


Ph.D. 1998

University of Maryland, Baltimore


Tissue and Data Acquisition Activity for the Study of Gynecologic Disease

Administered By
Obstetrics and Gynecology, Gynecologic Oncology
Awarded By
Henry M. Jackson Foundation
Start Date
End Date

Thyrogen Utilization Patterns in the Treatment of Thyroid Cancer

Administered By
Duke Clinical Research Institute
Awarded By
Genzyme Corporation
Co Investigator
Start Date
End Date

Nationwide Utilization of Cardiac Imaging In Cancer Patients

Administered By
Duke Clinical Research Institute
Awarded By
BC Cancer Research Centre
Co Investigator
Start Date
End Date

IPA--Shelby Reed

Administered By
Population Health Sciences
Awarded By
Durham Veterans Affairs Medical Center
Research Associate
Start Date
End Date

Incentivizing Behavior Change Skills to Promote Weight Loss

Administered By
School of Nursing
Awarded By
National Institutes of Health
Co Investigator
Start Date
End Date


Factors associated with gene mutation testing in United States veterans with metastatic castration-resistant prostate cancer.

<jats:p> 47 </jats:p><jats:p> Background: Practice guidelines have been modified to recommend hereditary and tumor gene mutation testing in patients with metastatic castration-resistant prostate cancer (mCRPC) to identify patients for molecularly targeted therapies. Identifying appropriate candidates for testing can be challenging in electronic health records and claims data. In this study, we used natural language processing (NLP) algorithms to identify veterans with mCRPC, reported gene mutation testing rates and identified factors associated with testing. Methods: This is a retrospective observational cohort study using NLP to identify veterans diagnosed with mCRPC between 2016 and 2020. Patient and facility characteristics were reported descriptively. Chi-square and t-tests were used to determine whether differences were statistically significant at a significance level of 0.05 based on receipt of testing. Generalized linear mixed models with binomial error distributions and logit links accounting for clustering by facility were used to determine which factors were independently associated with testing. Results: 9,282 veterans were diagnosed with mCRPC between 2016 and 2020, as determined by NLP algorithms identifying diagnosis of metastatic disease and castration-resistant disease. Among these patients, 381 died within 45 days of their diagnosis, and were excluded from analysis. In the analytic cohort of 8,901 veterans, 1,282 (14%) patients received testing. Of these, 1,041 (81%) received tumor tissue testing and 292 (23%) received hereditary testing. In bivariate analyses, age, race, ethnicity, Commission on Cancer (COC) facility certification, and facility complexity rating differed between veterans who received the test versus who did not (mean age of 73 versus 77, p &lt; 0.0001; 30% versus 24% Black, p &lt; 0.0001; 93% versus 92% non-Hispanic, p = 0.04; 64% versus 63% COC-certified facility, p = 0.04; and 59% versus 52% most complex facility, p &lt; 0.0001). In multivariate analyses, older age and lower facility complexity rating were associated with lower odds of testing (for every 10-year increase in age, adjusted odds ratio [aOR], 95% confidence interval [CI]: 0.54, 0.50-0.58; Mid-high and low complexity facilities compared to highest complexity facilities: aOR, 95% CI: 0.52, 0.32-0.85 and 0.39, 0.22-0.71, respectively). Conclusions: Gene mutation testing in veterans with mCRPC is underutilized. Older age and being seen in a lower complexity facility are independently associated with a lower odds of testing. Patient and facility barriers to testing should be identified to improve guideline concordant care. </jats:p>
Hung, A; Li, Y; Candelieri, D; Alba, P; Anglin-Foote, T; Lee, KM; Agiri, F; Perez, C; Li, W; Amin, S; Jiang, S; DuVall, SL; Wong, Y-N; Reed, SD; Lynch, JA
MLA Citation
Hung, Anna, et al. “Factors associated with gene mutation testing in United States veterans with metastatic castration-resistant prostate cancer.Journal of Clinical Oncology, vol. 40, no. 6_suppl, American Society of Clinical Oncology (ASCO), 2022, pp. 47–47. Crossref, doi:10.1200/jco.2022.40.6_suppl.047.
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Published Date
Start Page
End Page

Economic Outcomes of Rehabilitation Therapy in Older Patients With Acute Heart Failure in the REHAB-HF Trial: A Secondary Analysis of a Randomized Clinical Trial.

Importance: In the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial, a novel 12-week rehabilitation intervention demonstrated significant improvements in validated measures of physical function, quality of life, and depression, but no significant reductions in rehospitalizations or mortality compared with a control condition during the 6-month follow up. The economic implications of these results are important given the increasing pressures for cost containment in health care. Objective: To report the economic outcomes of the REHAB-HF trial and estimate the potential cost-effectiveness of the intervention. Design, Setting, Participants: The multicenter REHAB-HF trial randomized 349 patients 60 years or older who were hospitalized for acute decompensated heart failure to rehabilitation intervention or a control group; patients were enrolled from September 17, 2014, through September 19, 2019. For this preplanned secondary analysis of the economic outcomes, data on medical resource use and quality of life (via the 5-level EuroQol 5-Dimension scores converted to health utilities) were collected. Medical resource use and medication costs were estimated using 2019 US Medicare payments and the Federal Supply Schedule, respectively. Cost-effectiveness was estimated using the validated Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, which uses an individual-patient simulation model informed by the prospectively collected trial data. Data were analyzed from March 24, 2019, to December 1, 2020. Interventions: Rehabilitation intervention or control. Main Outcomes and Measures: Costs, quality-adjusted life-years (QALYs), and the lifetime estimated cost per QALY gained (incremental cost-effectiveness ratio). Results: Among the 349 patients included in the analysis (183 women [52.4%]; mean [SD] age, 72.7 [8.1] years; 176 non-White [50.4%] and 173 White [49.6%]), mean (SD) cumulative costs per patient were $26 421 ($38 955) in the intervention group (excluding intervention costs) and $27 650 ($30 712) in the control group (difference, -$1229; 95% CI, -$8159 to $6394; P = .80). The mean (SD) cost of the intervention was $4204 ($2059). Quality of life gains were significantly greater in the intervention vs control group during 6 months (mean utility difference, 0.074; P = .001) and sustained beyond the 12-week intervention. Incremental cost-effectiveness ratios were estimated at $58 409 and $35 600 per QALY gained for the full cohort and in patients with preserved ejection fraction, respectively. Conclusions and Relevance: These analyses suggest that longer-term benefits of this novel rehabilitation intervention, particularly in the subgroup of patients with preserved ejection fraction, may yield good value to the health care system. However, long-term cost-effectiveness is currently uncertain and dependent on the assumption that benefits are sustained beyond study follow-up, which needs to be corroborated in future trials in this patient population.
Chew, DS; Li, Y; Zeitouni, M; Whellan, DJ; Kitzman, D; Mentz, RJ; Duncan, P; Pastva, AM; Reeves, GR; Nelson, MB; Chen, H; Reed, SD
MLA Citation
Chew, Derek S., et al. “Economic Outcomes of Rehabilitation Therapy in Older Patients With Acute Heart Failure in the REHAB-HF Trial: A Secondary Analysis of a Randomized Clinical Trial.Jama Cardiol, vol. 7, no. 2, Feb. 2022, pp. 140–48. Pubmed, doi:10.1001/jamacardio.2021.4836.
Published In
Jama Cardiol
Published Date
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End Page

Patient preferences pertaining to treatment options for drug-resistant focal epilepsy.

OBJECTIVE: To determine patient acceptability of benefit-risk trade-offs in selecting treatment options for drug-resistant mesial temporal lobe epilepsy, including open brain surgery, laser ablation (laser interstitial thermal therapy [LITT]), and continued medications. METHODS: A discrete-choice experiment survey was developed, consisting of 20 versions that were randomly assigned to respondents. Each version had 8 sets of constructed treatment alternatives, representing open brain surgery, LITT, or continued medical management. For each set, respondents indicated the treatment alternative they would choose first. Treatment alternatives were characterized by varying levels of chance of seizure freedom for at least 2 years (20-70%), risk of 30-day mortality (0-10%), and risk of neurological deficits (0-40%). Respondents' choices were analyzed using random-parameters logit models to quantify acceptable benefit-risk trade-offs. Preference heterogeneity was evaluated using latent-class analysis. RESULTS: The survey was administered to 2 cohorts of adult patients with drug-resistant epilepsy: a Duke cohort identified using diagnostic codes (n = 106) and a web-recruited panel with a self-reported physician diagnosis of drug-resistant epilepsy (n = 300). Based on mean preference weights, respondents who indicated a willingness to consider surgical intervention would accept a reduction in chance of seizure freedom from 70% to a minimum-acceptable benefit (MAB) of 23% if they could undergo LITT rather than open brain surgery. For a reduction in 30-day mortality from 1% to 0%, MAB was 52%. For a reduction in risk of long-term deficits from 10% to 0%, MAB was 39%. Latent-class analysis revealed additional choice patterns identifying respondent groups that more strongly favored continuing medications or undergoing surgery. CONCLUSION: Patients who are receptive to surgery would accept significantly lower treatment effectiveness to undergo a minimally invasive procedure relative to open brain surgery. They also were willing to accept lower treatment benefit to reduce risks of mortality or neurological deficits.
Sinha, SR; Yang, J-C; Wallace, MJ; Grover, K; Johnson, FR; Reed, SD
MLA Citation
Sinha, Saurabh R., et al. “Patient preferences pertaining to treatment options for drug-resistant focal epilepsy.Epilepsy Behav, vol. 127, Feb. 2022, p. 108529. Pubmed, doi:10.1016/j.yebeh.2021.108529.
Published In
Epilepsy Behav
Published Date
Start Page

Lifetime cost-effectiveness simulation of once-weekly exenatide in type 2 diabetes: A cost-utility analysis based on the EXSCEL trial.

AIMS: The Exenatide Study of Cardiovascular Event Lowering (EXSCEL) trial assessed once-weekly exenatide (EQW) vs. placebo, added to usual care in 14,752 patients with type 2 diabetes mellitus ( NCT01144338). We assessed the lifetime cost-effectiveness of adding EQW vs. usual care alone from a healthcare perspective. METHODS: Medical resource use and EQ-5D utilities were collected throughout the study. Within-trial results were extrapolated to a lifetime horizon using the UK Prospective Diabetes Study Outcomes Model version 2 (UKPDS-OM2), predicting predict cardiovascular and microvascular events. Cost-effectiveness was evaluated separately for US and UK settings, with outcomes measured in quality-adjusted life-years (QALYs). RESULTS: EQW plus usual care gained 0.162 QALYs at an additional cost of $41,545/patient, compared with usual care in a US setting. The incremental cost-effectiveness ratio (ICER) was $259,223/QALY. In a UK setting, the QALY gain was 0.151 at an additional cost of £6357: an ICER of £42,589/QALY. Sensitivity analyses ranged between $34,369-$269,571 and £3430-£46,560 per QALY gained. CONCLUSIONS: In a lifetime extrapolation, adding EQW to usual care increased QALYs and costs compared with usual care alone. The base-case ICERs exceeded the commonly-cited cost-effectiveness thresholds of $100,000/QALY and £20,000/QALY. However, ICERs were considerably lower in some subgroups, and in sensitivity analyses.
Becker, F; Dakin, HA; Reed, SD; Li, Y; Leal, J; Gustavson, SM; Wittbrodt, E; Hernandez, AF; Gray, AM; Holman, RR
MLA Citation
Becker, Frauke, et al. “Lifetime cost-effectiveness simulation of once-weekly exenatide in type 2 diabetes: A cost-utility analysis based on the EXSCEL trial.Diabetes Res Clin Pract, vol. 183, Jan. 2022, p. 109152. Pubmed, doi:10.1016/j.diabres.2021.109152.
Published In
Diabetes Res Clin Pract
Published Date
Start Page

Quantifying Benefit-Risk Preferences for Heart Failure Devices: A Stated-Preference Study.

BACKGROUND: Regulatory and clinical decisions involving health technologies require judgements about relative importance of their expected benefits and risks. We sought to quantify heart-failure patients' acceptance of therapeutic risks in exchange for improved effectiveness with implantable devices. METHODS: Individuals with heart failure recruited from a national web panel or academic medical center completed a web-based discrete-choice experiment survey in which they were randomized to one of 40 blocks of 8 experimentally controlled choice questions comprised of 2 device scenarios and a no-device scenario. Device scenarios offered an additional year of physical functioning equivalent to New York Heart Association class III or a year with improved (ie, class II) symptoms, or both, with 30-day mortality risks ranging from 0% to 15%, in-hospital complication risks ranging from 0% to 40%, and a remote adjustment device feature. Logit-based regression models fit participants' choices as a function of health outcomes, risks and remote adjustment. RESULTS: Latent-class analysis of 613 participants (mean age, 65; 49% female) revealed that two-thirds were best represented by a pro-device, more risk-tolerant class, accepting up to 9% (95% CI, 7%-11%) absolute risk of device-associated mortality for a one-year gain in improved functioning (New York Heart Association class II). Approximately 20% were best represented by a less risk-tolerant class, accepting a maximum device-associated mortality risk of 3% (95% CI, 1%-4%) for the same benefit. The remaining class had strong antidevice preferences, thus maximum-acceptable risk was not calculated. CONCLUSIONS: Quantitative evidence on benefit-risk tradeoffs for implantable heart-failure device profiles may facilitate incorporating patients' views during product development, regulatory decision-making, and clinical practice.
Reed, SD; Yang, J-C; Rickert, T; Johnson, FR; Gonzalez, JM; Mentz, RJ; Krucoff, MW; Vemulapalli, S; Adamson, PB; Gebben, DJ; Rincon-Gonzalez, L; Saha, A; Schaber, D; Stein, KM; Tarver, ME; Bruhn-Ding, D
MLA Citation
Reed, Shelby D., et al. “Quantifying Benefit-Risk Preferences for Heart Failure Devices: A Stated-Preference Study.Circ Heart Fail, vol. 15, no. 1, Jan. 2022, p. e008797. Pubmed, doi:10.1161/CIRCHEARTFAILURE.121.008797.
Published In
Circ Heart Fail
Published Date
Start Page

Research Areas:

Academic Medical Centers
Alzheimer Disease
Ambulatory Care
Anemia, Sickle Cell
Angiotensin-Converting Enzyme Inhibitors
Anti-Bacterial Agents
Antifungal Agents
Antineoplastic Agents
Arthritis, Rheumatoid
Arthroplasty, Replacement, Knee
Bacterial Infections
Behavior Therapy
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Blood Transfusion
Brain Ischemia
Breast Neoplasms
Candida glabrata
Cardiac Surgical Procedures
Cardiovascular Diseases
Cardiovascular Surgical Procedures
Cerebrovascular Disorders
Chemotherapy, Adjuvant
Chronic Disease
Clinical Trial
Clinical Trials as Topic
Cohort Studies
Comparative Effectiveness Research
Continental Population Groups
Cost Savings
Cost of Illness
Cost-Benefit Analysis
Costs and Cost Analysis
Data Collection
Data Interpretation, Statistical
Decision Making
Decision Support Techniques
Decision Trees
Dermatitis, Atopic
Device Approval
Diabetes Mellitus
Diabetes Mellitus, Type 1
Diffusion of Innovation
Disease Management
Disease Progression
Disease-Free Survival
Drug Approval
Drug Costs
Drug Industry
Drug Prescriptions
Drug Therapy, Combination
Economics, Hospital
Economics, Pharmaceutical
Efficiency, Organizational
Evidence-Based Medicine
Exercise Therapy
Financial Management
Financing, Organized
Follow-Up Studies
Fractures, Bone
Gene Expression Profiling
Government Regulation
Health Care Costs
Health Care Rationing
Health Expenditures
Health Preference Research
Health Resources
Health Services
Health Services Research
Health Status
Heart Failure
Hospital Costs
Hospital Mortality
Insulin Infusion Systems
Kidney Failure, Chronic
Length of Stay
Linear Models
Lymph Node Excision
Medical Laboratory Science
Methicillin-Resistant Staphylococcus aureus
Models, Economic
Models, Statistical
Multivariate Analysis
Myocardial Infarction
Myocardial Ischemia
Neoplasm Metastasis
Neoplasm Recurrence, Local
Orthopedic Procedures
Outcome Assessment (Health Care)
Outcome and Process Assessment (Health Care)
Ovarian Neoplasms
Pancreatic Neoplasms
Patient Care Management
Patient Discharge
Patient Readmission
Patient-Centered Care
Peripheral Nervous System Diseases
Physician's Practice Patterns
Policy Making
Polymorphism, Genetic
Practice Patterns, Physicians'
Predictive Value of Tests
Program Evaluation
Proportional Hazards Models
Prostatic Neoplasms
Quality of Life
Radiotherapy, Adjuvant
Randomized Controlled Trials as Topic
Renal Dialysis
Research Design
Resource Allocation
Respiratory Function Tests
Risk Assessment
Risk Factors
Social Values
Socioeconomic Factors
Staphylococcal Infections
Staphylococcus aureus
Stem Cell Transplantation
Subarachnoid Hemorrhage
Surgical Procedures, Operative
Surgical Wound Infection
Surveys and Questionnaires
Terminal Care
Thyroid Neoplasms
Treatment Outcome
Ventricular Dysfunction, Left