David Paltiel

View full profile on the Yale School of Public Health website

Education

• PhD , Yale University, 1992
• MBA , Yale University, 1985
• BA , McGill University, 1981

Achievements

• Connecticut Academy of Science and Engineering , Elected as Member, 2014
• Institute of Medicine, Committee on Valuing Community-Based, Non-Clinical Prevention Policies and Wellness Strategies , 2011
• Scientific Advisory Committee, French National Agency for Research on AIDS (ANRS), 2009-2013
• Institute of Medicine, Committee on Review of Priorities in the National Vaccine Plan , 2008-2009
• Institute of Medicine, Committee on Community Mitigation Strategies for Influenza Pandemic , 2006-2007
• Institute of Medicine, Committee on the President''s Emergency Plan for AIDS Relief (PEPFAR), 2005-2007
• Society for Medical Decision Making, Secretary-Treasurer and Executive Committee member , 2006-
• Institute of Medicine, Committee on the Ryan White CARE Act: Planning and Evaluation , 2002-2004

Research Summary

The objective that guides Dr. Paltiel's scholarly activities is to promote a reasoned approach to choices under uncertainty and resource scarcity in health and medicine. Trained in the field of Operations Research, Dr. Paltiel designs and implements model-based cost-effectiveness analyses of medical technologies and public health interventions. His published research, including more than 100 peer-reviewed papers, spans both methods development and applications to a wide range of disease areas and clinical specialties. He has a special interest and expertise in HIV/AIDS and has published broadly on the cost-effectiveness of testing, prevention, treatment, and care, both in the United States and around the world.

Among the many talented modelers at Yale, Dr. Paltiel's unique contribution lies in bringing a decision-analytic and cost-effectiveness overlay to public health policy and resource allocation. His expertise in both the theory of choice under uncertainty and its practical adaptation to policy-relevant applications provides substantial opportunity to mentor colleagues interested in promoting a more reasoned approach to clinical practice and priority setting in health and medicine.

Specialized Terms: Operations research; Disease simulation modeling

Extensive Research Description

1. Novel approaches to the design and evaluation of combination HIV prevention. The goals of this NIMH-funded grant project are to develop and illustrate three novel ways of thinking about HIV prevention program design and evaluation: viewing HIV prevention in terms of policy bundles; looking beyond program cost-effectiveness to program affordability; and designing financial incentives that translate into better long-term HIV outcomes. The broad objective that guides this research is to squeeze the greatest possible benefit out of every HIV prevention dollar.

2. Economic Modeling for HIV, Viral Hepatitis, STD, TB and School Health. The goal of this CDC-funded collaborative grant to the Harvard School of Public Health (Principal Investigator: Joshua Salomon) is to conduct health and economic modeling to inform decision-making on HIV, hepatitis, STD, TB and school health at national, state and local levels, in partnership with the National Center for HIV/AIDS Viral Hepatitis, STD and TB Prevention.

3. Cost-Effectiveness of Preventing AIDS Complications (CEPAC-US). The goal of this NIAID-funded collaborative grant to Massachusetts General Hospital (Principal Investigator: Kenneth Freedberg) is to develop a computer simulation model of advanced HIV disease and use to project the costs and consequences of alternative patient care strategies.

4. Optimizing HIV Care in Less Developed Countries (CEPAC-International). The goal of this NIAID-funded collaborative grant to Massachusetts General Hospital (Principal Investigator: Kenneth Freedberg) is to provide mentoring for young investigators in patient-oriented HIV research and use ongoing HIV simulation model in conjunction with mentoring efforts to address critical HIV clinical management questions in the US and internationally.

5. Making Better Decisions: Policy Modeling for AIDS & Drug Abuse. The goal of this NIDA-funded collaborative grant to Stanford University (Principal Investigator: Douglas Owens) is to develop and apply mathematical policy modeling techniques to the evaluation of AIDS‑related public health interventions.

6. Novel Methods to Inform HIV/TB Clinical Trial Development. The goals of this NIAID-funded collaborative grant (Principal Investigator: Rochelle Walensky) are to apply a mathematical simulation modeling framework, based on the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) Model, to the NIAID/ACTG clinical trials infrastructure. We propose to inform the development, design, and assessment of therapeutic, diagnostic, and 'strategy' clinical trials in HIV/TB care in international settings. The ultimate goal of this project is to apply novel scientific methods in a highly innovative fashion, to maximize trial investments. It will develop new scientific knowledge of value to HIV/TB investigators, as well as clinical trialists in many areas of medicine.

7. Typhoid modeling studies for typhoid conjugate vaccine cost effectiveness and for typhoid delivery strategy. The goals of this project, funded by a grant from the Bill & Melinda Gates Foundation (Principal Investigator: Virginia E. Pitzer), are to conduct research aimed toward the prevention of HIV infection and the reduction of the negative consequences of HIV disease in vulnerable and underserved populations in the U.S.

8. A unified intervention for young gay and bisexual men's minority stress, mental health, and HIV risk. The goals of this NIMH-funded grant (Principal Investigator: John Pachankis) are to address key sources of HIV risk among MSM, including stigma-related stress and associated mental health and substance use difficulties, and to use the intervention developed in this project to reduce HIV risk behavior among MSM and therefore the spread of HIV.

9. Improving HIV Prevention and Treatment in Ukraine through Innovations in Healthcare Integration for People Who Inject Drugs. The goals of this NIDA-funded grant (Principal Investigator: Frederick L. Altice) are to use a multi-level, implementation science framework and multi-site cluster design to compare Quality of Health Indicator outcomes in PWIDs treated in integrated primary care centers with those who receive standard of care.

Research Interests

Acquired Immunodeficiency Syndrome; France; Health Policy; Health Resources; HIV; India; Operations Research; South Africa

Public Health Interests

Health Care Management; HIV/AIDS

Selected Publications

• The cost-effectiveness of HIV testing: accounting for differential participation rates. Paltiel AD, Kaplan EH. The cost-effectiveness of HIV testing: accounting for differential participation rates. Medical Decision Making : An International Journal Of The Society For Medical Decision Making 1997, 17:490-5.

• Why training is the key to successful guideline implementation. Paltiel AD, Neumann PJ. Why training is the key to successful guideline implementation. PharmacoEconomics 1997, 12:297-302.

• A Monte Carlo simulation of advanced HIV disease: application to prevention of CMV infection. Paltiel AD, Scharfstein JA, Seage GR, Losina E, Goldie SJ, Weinstein MC, Craven DE, Freedberg KA. A Monte Carlo simulation of advanced HIV disease: application to prevention of CMV infection. Medical Decision Making : An International Journal Of The Society For Medical Decision Making 1998, 18:S93-105.

• Five minutes with the Governor. Paltiel AD. Five minutes with the Governor. Medical Decision Making : An International Journal Of The Society For Medical Decision Making 2000, 20:239-42.

• Remarks on the role of economic modeling. Paltiel AD. Remarks on the role of economic modeling. Sexually Transmitted Diseases 2000, 27:610-6.