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David Bruce Matchar

Professor

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Professor David B. Matchar, MD, is the Inaugural Director of the Programme in Health Services and Systems Research (HSSR) (2008-2018). He is also Professor of Medicine at Duke University in the United States. He received his AB in Statistics from Princeton University. After completing his MD degree and residency training he served as fellow in the Department of Internal Medicine at Duke.

Professor Matchar has worked in clinical research for over 35 years; his work primarily relates to stroke and other chronically disabling neurological disorders, as well as clinical and public policy analysis. He served as Director of the Duke Center for Clinical Health Policy Research and established the Duke Evidence-based Practice Center, which was responsible for analysis in support of coverage policy for the US Centers for Medicare and Medicaid Services, as well as guidelines for medical professional societies.

In August 2009, Dr. Matchar was awarded the prestigious STaR Investigator Award by the Singapore Ministry of Health’s (MOH) National Medical Research Council (NMRC) and the Agency for Science, Technology and Research (A*STaR), for developing a systems model to address crucial strategic and operational challenges presented by a rapidly ageing population. He is the Principal Investigator of several other MOH HSR grants including: Multifactorial, evidence-based program of screening, risk modification and physical therapy to prevent falls among vulnerable elderly recently discharged from hospital to the community, A randomised control trial to improve the uptake of and adherence to outpatient rehabilitation services among stroke patients and Defining and evaluating norms for health and social service use for population health segments. Industry sponsored grants include: Assessment of the feasibility of utilizing the SingHealth healthcare cluster to improve patient care and clinical outcomes for asthma and COPD patients through real world data linkages and analytics and Management of noncommunicable diseases in Cambodia.

Most recently, Professor Matchar was awarded a 3 year grant to assess the impact of enhanced primary care services for Singaporeans with chronic health conditions.  Professor Matchar will approach this challenge using a simulation model linked to new and existing data sources. The model will represent the dynamic phenomena that promote or inhibit development of enhanced primary care, and will allow stakeholders to engage in in-silico experiments to consider the implications of various policy options.

While the content of Professor Matchar’s research spans the range of clinical medicine, the essential nature of his work has involved integration of researchers from multiple disciplines under a common conceptual framework, to address important and complex healthcare issues. His overarching goal has been to promote the use of best evidence to support clinical and public policy decision making. A fundamental challenge is how to bridge the gap between analysts and decision makers —a challenge made more difficult when the issues involve multiple stakeholders, competing priorities, and are complex in detail and dynamics (involve potential undesirable consequences due to feedback or time delays). For this work, Singapore has been an especially receptive environment for innovation in health services research.

Ultimately, Professor Matchar’s objective is to facilitate the work of the programme faculty, to enhance health services research in SingHealth and other healthcare clusters, and to establish a robust education program in Health Services and Systems Research that will serve Singapore and the region into the future.

Research Interest

My scientific contributions relate innovative use of evidence to inform clinical and public policy decision making.  My early work centered on stroke prevention and treatment (questionable value of carotid testing in low risk individuals, underuse and poor quality of use of anticoagulation for stroke prevention, the value of aggressive anticoagulation monitoring including the use of patient self-testing strategies, and the unappreciated role of rehabilitation in stroke care.)  In cognitive impairment, my contribution has been to clarify the role of diagnostic testing for Alzheimer’s disease, the importance of early diagnosis on planning and avoidance of unnecessary testing and evaluation.  In chronic kidney disease, I have guided a series of projects aimed at developing evidence-based tailored strategies for improving conformance to guidelines.  More recently, my work has applied simulation modeling to clarify the challenges of a rapidly aging population, including future prevalence of disability and the impact of education the trajectory of prevalence, understanding the role of different forms of long-term care services in alleviating caregiver burden, and estimating health care manpower requirements under alternative models of care. This work has led to the formulation of a needs-based framework for healthcare delivery and the development, validation and application of the Simple Segmentation Tool (SST), a simplified inventory of patient-level health service needs, different combinations of which can be mapped to different appropriate means for addressing these needs. I have extended this effort from developed countries (US, Singapore, and Switzerland) to low/middle income countries (Cambodia, Thailand).

Simple Segmentation Tool (SST) ©

To find out more about the SST, click here.

Research Team

Asst Prof Kenny Jing Xu
kenny.xu@duke-nus.edu.sg

Patricia Loh
Executive (PA to Prof David Matchar)
patricialoh@duke-nus.edu.sg

Ashish Kumar
Principal Research Scientist
ashish.kumar@duke-nus.edu.sg

Rakhi

Rakhi Vashishtha
Research Fellow
rakhi.vashishtha@duke-nus.edu.sg

Nirmali Ruth Sivapragasam
Senior Research Associate
nirmali@duke-nus.edu.sg

Rita Sim Siew Choo
Senior Research Associate
rita.sim@duke-nus.edu.sg

Shilpa Surendran

Shilpa Surendran
Research Associate
shilpa.s@nus.edu.sg

JoannPoh

Joann Poh
Research Associate
joann.poh@duke-nus.edu.sg

  1. Malhotra R, Chei CL, Menon EB, Chow WL, Quah S, Chan A, Shweta Ajay, Matchar DB. Trajectories of positive aspects of caregiving among family caregivers of stroke-survivors: the differential impact of stroke-survivor disability. Topics in Stroke Rehabilitation. 2018 May;25(4):261-268. doi: 10.1080/10749357.2018.1455369.
  2. Wong TH, Nadkarni NV, Nguyen HV, Lim GH, Matchar DB, Seow DCC, King NKK, Ong MEH. One-year and three-year mortality prediction in adult major blunt trauma survivors: a National Retrospective Cohort Analysis. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2018 Apr 18;26(1):28. doi: 10.1186/s13049-018-0497-y.
  3. Zhou K, Vidyarthi A, Matchar D, Cheung YB, Lam SW, Ong M. The relationship between workload and length of stay in Singapore. Health Policy. 2018 Apr 30. pii: S0168-8510(18)30078-2. doi: 10.1016/j.healthpol.2018.04.002.
  4. Ansah JP, Matchar DB, Koh V, Schoenenberger L. Mapping the dynamic complexity of chronic disease care in Singapore: using group model building in knowledge elicitation. Systems Research and Behavioral Science. 2018 Jun 28. Doi: 10.1002/sres.2517.
  5. Matchar DB, Chang L, Wong CH, Sivapragasam N, Tew C, Ang Y, Ginting M. From hospital to home: The impact of a transitional care program on hospital utilisation, mortality and cost. Journal of the American Geriatrics Society. 2017 Nov. (In press)