J. Robert Beck, MD
Fox Chase Programs
I serve as Deputy Director as well as Chief Academic and Administrative Officer for Fox Chase Cancer Center (FCCC). My role is akin to Provost or Academic Affairs Dean in a typical university setting. I supervise the activities of the Institutional Review Board, the current Chief Information Officer, the Facility Director of the Biostatistics and Bioinformatics Facility (BBF), and the Population Studies Facility (PSF). I mentor trainees and junior faculty, and support health services research with methodological work in decision science.
Upon joining Steve Pauker’s group in clinical decision making as a Fellow in 1981, we developed alternatives to the static utility formalism of decision trees. My first clinical decision consult established the paradigm of Markov state transition modeling of clinical outcomes, and I proceeded to develop the methodology and tutorials. The early Markov papers have been cited themselves over 1700 times, and the techniques are now part of standard texts and references in medical decision making. A PubMed search: Markov and (Decision or Cost-effectiveness) returns over 4500 papers.
Accompanying the Markov modeling work, we have pioneered new outcome measures for medical decision making. Clinical decision models of chronic diseases required a method of representing outcomes as life expectancies, modified by competing risks of mortality. We developed a convenient approximation of life expectancy that, before the advent of powerful computers, enabled useful and relatively accurate decision modeling. The Declining Exponential Approximation of Life Expectancy is still cited (over 600 total) and being improved.
As a clinical pathologist, our group blended applied mathematics and decision science training to advance applications of these technologies to laboratory diagnosis. Important papers in this arena included articles on ROC analysis and likelihood ratios, applied to clinical laboratory tests. As an academic chief information officer, my groups made contributions to a number of areas in medical informatics, including shared decision making, workstation development, biomedical informatics communities, and artificial intelligence. Projects with trainees have emphasized cost-effectiveness of cancer therapies and diagnostic procedures, especially when there are methodologic nuances.