Andrew Lloyd
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Andrew Lloyd A Driving Force in Patient-Centered Outcomes Research John F.P. Bridges1 and Christopher I. Carswell2 1 2
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Wolters Kluwer Health | Adis, Auckland, New Zealand
application of patient-centered methods to realworld problems. Over his career he has focussed on issues such as human error, ergonomics, decision making, heuristics, and perceptual bias, but his current focus is on topics such as the assessment of health-related quality of life, medical decision making, and patients’ perception of risk related to treatment alternatives. 1. Academic Background
While outcomes research too often focuses on issues of scarcity, rationing, and the payer’s perspective, a small but growing number of researchers remind us that our primary focus of attention should be placed on the patient.[1] While patient-centered outcomes research is very much an evolving discipline,[2] topics such as patient-reported outcomes, patient preferences, health-state valuation, satisfaction, psychometrics, and utility estimation all play an important role. When we look at the breadth of these topics, one researcher stands out as playing an important role in the application of these methods in the practice of outcomes research – Andrew Lloyd. An applied researcher with a background in cognitive psychology, Andrew continues to define patient-centered outcomes research in a non-confrontational and constructive way. Rather than focusing on methods for methods sake, or using tools such as conjoint analysis to criticize current utilitybased methods, Andrew has been a pioneer in the
Andrew’s primary background is in cognitive psychology, having completed his DPhil in Psychology at the University of York, looking at the role of cognitive heuristics in speech and language comprehension. This theoretical work was designed to address from a new perspective the problem of dysphasia following stroke. Most of the research in this area has tried to understand the loss of speech following stroke in terms of the processing of speech sounds, words, or syntax. Andrew’s thesis work[3] was concerned with trying to determine if some problems with comprehension are caused by a loss of the heuristics that guide comprehension. The impact of stroke emerged as an area of interest following this early research work and Andrew pursued this interest by working with vascular surgeons at the University of Leicester Medical School, Leicester, UK. The work was concerned with understanding the cognitive outcomes from carotid surgery in patients at risk of ischemic stroke. In this project, it became clear to Andrew and the rest of the team, that measuring outcomes purely in terms of cognitive function did not present a true
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picture of the patients’ status. This led to an interest in measuring health-related quality of life. Recovery from stroke is mediated by many factors related to the patients’ social environment and thei
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