Associate Professor, Medicine – Geriatrics
Director, ACCORDS Program for Patient Centered Decisions
Core Lead, D2V University of Colorado School of Medicine
Dr. Matlock’s research is aimed at fundamentally changing and improving how patients make decisions around invasive interventions. This includes an NIH RO1 and three current or previous PCORI grants studying the implementation and effectiveness
of decision aids for implantable cardioverter–defibrillators (ICD) and Left Ventricular Assist Devices (LVAD). He directs the Program for Patient Centered Decisions at ACCORDS where a broad view of shared decision making is undertaken, acknowledging
that decisions are hard and influenced by many factors beyond cognitive information. There is a strong user-centered design focus to the development of decision aids for the purpose of enhanced implementation.
1. Why is your area of science important?
Our health care system is messed up in several ways. The one that drives my research passions is the fact that it often does things to patients rather than with them. Consequently, patients often receive interventions or procedures that are
not consistent with their goals or values. However, how to fix this – how to help patients understand their health condition, their options, and the pros and cons of those options is fraught with scientific challenges. There are
a host of multi-level factors that must be overcome in order to improve our health care system to provide truly patient-centered care. Our research in the Colorado Program for Patient Centered Decisions aims to conduct work that broadly addresses
these challenges through basic science (psychology and sociology), clinical science (intervention and decision aid development), and implementation science (how do you get folks to really do this?).
2. What are the major take home messages your current research provides?
Pretty clearly, we’ve shown in multiple studies that current practice is not ideal. While obvious, it was important
to demonstrate that in a rigorous way and we’ve done that using a host of methods form qualitative research, survey research, and epidemiology. More recently, we’re showing that we can make changes with the development of decision aids
and interventions. We work closely with lots of clinicians and clinical societies like the American College of Cardiology to make sure that we aren’t just designing tools for patients but that we’re also designing for clinicians.
3. What are your goals or areas for future research?
While we’re pretty confident we can make tools that address needs for the majority of decisions. We’re much less confident that we can actually convince folks to use these tools. I think the future for us (and for the whole field
of shared decision making) is to demonstrate that interventions can actually be used in the real world.
4. What was important in your Health Services Research training?
This is hard to answer as there was so much. Thinking broadly, having a mentor (Jean Kutner) who really afforded me research autonomy to forge my own path was really important for me personally. Additionally, the structure of my training at ACCORDS
(or formerly COHO), the protected time, access to essential health services research infrastructure (biostats, analysis, qualitative etc.) and additional training were essential.
5. What advice do you have for researchers who want to work in this area? / What is the most important advice you have received from your mentors?
The best advice I’ve received was to work on things that really bug you. At the end of the day, writing papers and grants really stinks unless you really love and care about what you’re doing. It is fun to get a first grant and get a
first paper, but after a while, it just becomes work. When I’m doing the work that fits my passions as I discussed in the first question above, then it really is a labor of love and feels like it could be sustainable.