Investigator Su-Ying Liang, Ph.D.

Su-Ying Liang, Ph.D., is Research Economist at the Palo Alto Medical Foundation Research Institute (PAMFRI). She also holds appointments as a research health economist (since 2000) and adjunct professor at the University of California, San Francisco (since 2011). Previously, she was an assistant professor at Arizona State University.

Dr. Liang’s research applies economics and quantitative methods to examine policy issues in health care delivery and organization. Her research interests are medical care utilization and its impact on clinical care, with an emphasis on personalized medicine, genetic testing, and cancer screening procedures), physician compensation arrangements, and women’s health.

Her work has been published in peer-reviewed journals such as American Journal of Managed Care, Cancer, Contraception, Health Services and Outcomes Research Methodology, Health Services Research, JAMA, Medical Care, Medical Care Research and Review, and Nature Biotechnology. Dr. Liang serves as an ad hoc reviewer for ten journals. She is a former member of the scientific review committee for the International Health Economics Association (2009 and 2011).

Prior to joining PAMFRI, Dr. Liang served on the leadership team for the UCSF Center for Translational and Policy Research on Personalized Medicine (TRANSPERS). In this capacity, she provided expertise in economics, with particular skill in working with secondary data. Dr. Liang earned her doctorate in economics from the University of Washington. She holds a bachelor’s degree in economics from National Taiwan University.

Sutter Health Research Enterprise
795 El Camino Real
Ames building
Palo Alto, CA, 94301-2302
(650) 691-6432
liangs2@sutterhealth.org

Primary Research Interests

Publications

Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality.

Policies reducing gene expression profiling disparities should address low-inequality areas and, in unequal places, practice settings serving low-income patients.

Utilization of cardiac monitoring tests in women with non-metastatic breast cancer treated with trastuzumab.

Cardiac monitoring testing in breast cancer patients on trastuzumab was variable, and opportunities to improve quality and reduce cost are evident.

Economic perspectives on personalized health care and prevention.

Pprovide an overview of economic evaluation of personalized medicine, focusing on the use of cost-effectiveness analysis and other valuation methods.

User characteristics and out-of-pocket expenditures for progestin-only versus combined oral contraceptives.

Progestin-only pill (POP) use is very low in US. POP users obtained fewer packs per purchase compared with combined oral contraceptive users.

The economic value of personalized medicine tests: what we know and what we need to know.

Many personalized medicine tests have been found to be relatively cost-effective, although fewer have been found to be cost saving.

Genomic testing & therapies for breast cancer in clinical practice.

Given likely proliferation of testing & treatment strategies for cancer, a better understanding of the utilization patterns of HER2 testing & GEP are important.

Women’s out-of-pocket expenditures and dispensing patterns for oral contraceptive pills between 1996 and 2006.

Women paid substantial out-of-pocket for OCPs and dispensing limits remained, although these improved over time. Better insurance coverage of contracep

Tradeoffs of using administrative claims and medical records to identify the use of personalized medicine for patients with breast cancer.

Describe agreement, sensitivity & specificity of admin claims compared with medical records for two pairs of targeted tests and treatments for breast cancer.

Capacity building for assessing new technologies: approaches to examining personalized medicine in practice.

This article focuses on how we can use existing data to develop the capacity to improve the evidence base on personalized medicine technologies.

The Healthcare Systems Research Network (HCSRN) as an environment for dissemination and implementation research: a case study of developing a multi-site research study in precision medicine.

IMPULSS study is an example of how HCSRN strengths make it an excellent environment for research on implementing evidence-based precision medicine in healthcare

Contextual conditions and performance improvement in primary care.

Findings encourage evaluation of clinic characteristics and capacity to effectively implement redesigns, helping leaders select appropriate Lean interventions.

Implementing universal Lynch syndrome screening (IMPULSS): protocol for a multi-site study to identify strategies to implement, adapt, and sustain genomic medicine programs in different organizational contexts.

Goal is to combine our data with theories & tools from implementation science to create an organizational toolkit to facilitate implementation of LS screening.

Patient experiences after implementing lean primary care redesigns

Lean primary care redesigns on patient satisfaction with care and timeliness of care received.

Implementing lean quality improvement in primary care: impact on efficiency in performing common clinical tasks

Lean redesigns led to improvements in timely completion of 3 out of 4 common clinical tasks.

Selecting new upfront regimens for advanced ovarian cancer with biomarker guidance.

We have evaluated three clinical decision points with biomarker guidance that must be made in the upfront treatment of ovarian cancer.

How, when, and why individuals with stage IV cancer seen in an outpatient setting are referred to palliative care: a mixed methods study.

We found high rates of referral for palliative care in stage 4 ovarian cancer. Referrals vary in timing, reason, usefulness to pts, families, & clinical teams.

Insights from a temporal assessment of increases in US private payer coverage of tumor sequencing from 2015 to 2019.

Our study is a step toward systematic temporal research of coverage for precision medicine, which will inform policy and affordability assessments.

Primary care physician practice styles and quality, cost, and productivity.

Max-packing behavior yields desirable outcomes at lower overall cost but involves more conventionally uncompensated PCP time.

Population-based registry linkages to improve validity of electronic health record-based cancer research.

Leveraging linkages with cancer registries when using EHRs for research helps improve validity and generalizability.

Research Studies

Coverage, Price, and Reimbursement for Multigene Tests for Cancer and Related Conditions

Our objective is to examine “coverage, price, and reimbursement” for multigene tests broadly and for cancer-related indications.

Investigator: Su-Ying Liang Ph.D., Research Economist

COVID-19 Impacts on Cancer Care Management, Patient Experience and Care Costs

Project goals: To understand impacts of COVID-19 on cancer care management (detection, diagnosis, treatment), pt-reported experience, and cancer care costs.

Investigators: Su-Ying Liang Ph.D., Research Economist, Cheryl Stults Ph.D., Assistant Scientist, Monique de Bruin M.D., MPH

Impact of COVID-19 on Cancer Care Management

Study will enhance understanding of cancer care management due to COVID-19.

Investigators: Su-Ying Liang Ph.D., Research Economist, Monique de Bruin M.D., MPH

Implementing Universal Lynch Syndrome Screening Across Multiple Healthcare Systems: Identifying Strategies to Facilitate and Maintain Programs in Different Organizations Contexts

To describe and explain variations in Lynch syndrome (LS) screening implementation across healthcare systems and create a toolkit for implementing LS screening.

Investigators: Su-Ying Liang Ph.D., Research Economist, External PI Principal Investigator, Monique de Bruin M.D., MPH

Improving Cancer Care

Project will provide information about referrals to palliative care and way to enhance goals of care discussions for patients diagnosed with stage IV cancer.

Investigators: Ellis C. Dillon Ph.D., Assistant Scientist, Su-Ying Liang Ph.D., Research Economist, Harold (Hal) Luft Ph.D., Senior Scientist

Improving Outcomes for Breast Cancer Patients: A PAMF-Stanford Research Collaboration

This study examines the "trajectories" of breast cancer patients from diagnosis through treatment within and across these two delivery systems.

Investigators: Su-Ying Liang Ph.D., Research Economist, Harold (Hal) Luft Ph.D., Senior Scientist

Lung Cancer in Never Smokers: Incidence, Risk Factors and Molecular Characteristics in Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Women

The goal of this project is to document incidence and risk factors for lung cancer by smoking status, among AANHPIs, focusing especially on female never smokers.

Investigators: Su-Ying Liang Ph.D., Research Economist, Harold (Hal) Luft Ph.D., Senior Scientist, External PI Principal Investigator

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