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Tracy A. Lieu, MD, MPH

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Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3407 (phone)
tracy.lieu@kp.org
Kaiser Permanente Researcher Profiles


Tracy Lieu, MD, MPH, is Director of the Division of Research, Kaiser Permanente Northern California. She leads a group of 600 people who conduct studies in clinical effectiveness, delivery science, and epidemiology to enhance the health of Kaiser Permanente members and society at large. Her national roles have included membership on the U.S. Preventive Services Task Force and the Advisory Committee on Immunization Practices and the chair of the Health Services Organization and Delivery study section of the National Institutes of Health. Before this role, Dr. Lieu was a professor and the founding director of the Center for Child Health Care Studies in the Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School.  

Dr. Lieu is a practicing pediatrician who has led nationally recognized work in vaccine safety and policy and childhood asthma. She completed education and training at the University of California campuses in San Francisco, Berkeley, and Los Angeles, and at the Children’s Hospital of Philadelphia. She was elected to the National Academy of Medicine for her research in decision sciences and economic evaluation.

Current Position(s):

  • Director, Division of Research, Kaiser Permanente Northern California

Section Affiliations:

Primary Research Interests:

  • Child health services research
  • Effectiveness and delivery of primary care
  • Decision sciences, including decision analysis
  • Patient and parent preferences for outcomes of care
  • Economic evaluation
  • Vaccine safety, economics, and delivery
  • Asthma and lung diseases
  • Health policy and family-centered outcomes

Related Website(s):

Email Management Strategies and Stress Among Primary Care Physicians

Email between patients and physicians has enhanced health care service but has made many primary care physicians feel overloaded. Many physicians multitask throughout the day by responding to email while seeing patients for in-person, telephone, and video visits. Many gaps in understanding exist about how to reduce stress associated with email in health care settings. The aims of this study are to 1) examine observed patterns of email management and multitasking based on computerized data, 2) describe the range of strategies physicians report using to manage email via a qualitative study, and 3) evaluate the extent to which email management patterns and strategies are associated with stress, as measured by self-report on a structured survey and heart-rate monitoring. This study's results will offer guidance on how physicians may reduce stress associated with email management. The findings will also inform the design of a future interventional study to facilitate effective email management.
Investigator: Lieu, Tracy
Funder: The Permanente Medical Group

Kaiser Permanente and Strategic Partners Patient Outcomes Research to Advance Learning (PORTAL)

This network participates in PCORI's Clinical Data Research Network (CDRN) program to enhance the nation's capacity to conduct comparative effectiveness research by creating a national electronic data infrastructure. This program promotes the development of data networks and engages patients, clinicians, and health care systems in the research process. Kaiser Permanente's 7 regions have joined together with Group Health Cooperative, HealthPartners (Minnesota), and Denver Health to form the PORTAL Network. We are developing governance and data infrastructure approaches, conducting patient engagement activities, and developing innovative new methods to support patient engagement in research. Cohorts of patients that are formed around three conditions — colorectal cancer, congenital heart disease, and obesity — will be surveyed to establish priorities for patient-centered research.
Investigator: Lieu, Tracy
Funder: Patient-Centered Outcomes Research Institute

CESR Regional Data Infrastructure Support and Website Maintenance

The Regional Data Infrastructure Support (RDIS) Budget covers the costs associated with a number of Virtual Data Warehouse (VDW) tasks, to be conducted under the direction of the CESR Data Coordinating Center (DCC) in the Northwest.
Investigator: Lieu, Tracy
Funder: Center for Effectiveness and Safety Research

Optimizing Personalized Care Using Economic Studies of Genomic Testing

Personalized medicine uses diagnostic tests to improve patient outcomes and reduce harms of therapy. This project's objective is to develop methods for optimizing the use of such tests using a multi-criteria decision analysis framework. Using breast cancer as the focal case, we will: Phase 1: Extend a multi-cohort population simulation model to compare several scenarios for the use of genomic testing for breast cancer recurrence risk; Phase 2: a) Use computerized data to analyze use of genomic testing in two large populations: Kaiser Permanente Northern California, and patients in Washington State's SEER; b) Draw a sample of oncologists and patients from these populations, and conduct structured surveys to measure perceptions and propensity to use genomic tests; Phase 3: Integrate data from phase 2 into the simulation model to compare: a) genomic testing based on clinical trial and guideline-recommended care vs. b) actual patterns of testing from the community populations.
Investigator: Lieu, Tracy
Funder: Patient-Centered Outcomes Research Institute

Applied Research and Development in Health Care - Time for a Frameshift

Author(s): Lieu TA; Platt R

N Engl J Med. 2017 Feb 23;376(8):710-713.

PubMed abstract

Geographic Clusters in Underimmunization and Vaccine Refusal

Author(s): Lieu TA; Ray GT; Klein NP; Chung C; Kulldorff M

Pediatrics. 2015 Feb;135(2):280-9. Epub 2015-01-19.

PubMed abstract

Real-time vaccine safety surveillance for the early detection of adverse events

Author(s): Lieu TA; Kulldorff M; Davis RL; Lewis EM; Weintraub E; Yih K; Yin R; Brown JS; Platt R; for the Vaccine Safety Datalink Rapid Cycle Analysis Team

Med Care. 2007 Oct;45(10 Supl 2):S89-95.

PubMed abstract

Cultural competence policies and other predictors of asthma care quality for Medicaid-insured children

Author(s): Lieu TA; Finkelstein JA; Lozano P; Capra AM; Chi FW; Jensvold N; Quesenberry CP; Farber HJ

Pediatrics. 2004 Jul;114(1):e102-10.

PubMed abstract

Projected cost-effectiveness of pneumococcal conjugate vaccination of healthy infants and young children

Author(s): Lieu TA; Ray GT; Black SB; Butler JC; Klein JO; Breiman RF; Miller MA; Shinefield HR

JAMA. 2000 Mar 15;283(11):1460-8.

PubMed abstract

The impact of gene expression profile testing on confidence in chemotherapy decisions and prognostic expectations

Author(s): Panattoni L; Lieu TA; Jayasekera J; O'Neill S; Mandelblatt JS; Etzioni R; Phelps CE; Ramsey SD

Breast Cancer Res Treat. 2018 Oct 10.

PubMed abstract

Data Enclaves for Sharing Information Derived From Clinical and Administrative Data

Author(s): Platt R; Lieu T

JAMA. 2018 Aug 28;320(8):753-754.

PubMed abstract

Cost Effectiveness of Gene Expression Profile Testing in Community Practice

Author(s): Chandler Y; Schechter CB; Jayasekera J; Near A; O'Neill SC; Isaacs C; Phelps CE; Ray GT; Lieu TA; Ramsey S; Mandelblatt JS

J Clin Oncol. 2018 Jan 08:JCO2017745034.

PubMed abstract

Racial disparities in family-provider interactions for pediatric asthma care

Author(s): Trivedi M; Fung V; Kharbanda EO; Larkin EK; Butler MG; Horan K; Lieu TA; Wu AC

J Asthma. 2017 Jul 14:1-6.

PubMed abstract

Applied Research and Development in Health Care - Time for a Frameshift

Author(s): Lieu TA; Platt R

N Engl J Med. 2017 Feb 23;376(8):710-713.

PubMed abstract

The impact of preterm birth

Author(s): Lakshmanan A; Agni M; Lieu T; Fleegler E; Kipke M; Friedlich PS; McCormick MC; Belfort MB

Health Qual Life Outcomes. 2017 Feb 16;15(1):38. Epub 2017-02-16.

PubMed abstract

Evaluating Frameworks That Provide Value Measures for Health Care Interventions

Author(s): Mandelblatt JS; Ramsey SD; Lieu TA; Phelps CE

Value Health. 2017 Feb;20(2):185-192.

PubMed abstract

Parental weighting of seizure risks vs. fever risks in vaccination tradeoff decisions

Author(s): Zikmund-Fisher BJ; Wittenberg E; Lieu TA

Vaccine. 2016 Dec 7;34(50):6123-6125. Epub 2016-11-3.

PubMed abstract

Parents' Perspectives on How to Improve the Childhood Vaccination Process

Author(s): Lieu TA; Zikmund-Fisher BJ; Chou C; Ray GT; Wittenberg E

Clin Pediatr (Phila). 2016 May 8.

PubMed abstract

Breast cancer multigene testing trends and impact on chemotherapy use

Author(s): Ray GT; Mandelblatt J; Habel LA; Ramsey S; Kushi LH; Li Y; Lieu TA

Am J Manag Care. 2016;22(5):e153-60. Epub 2016-05-01.

PubMed abstract

Building Data Infrastructure to Evaluate and Improve Quality: PCORnet

Author(s): Corley DA; Feigelson HS; Lieu TA; McGlynn EA

J Oncol Pract. 2015 May;11(3):204-6.

PubMed abstract

Asthma Treatments and Mental Health Visits After a Food and Drug Administration Label Change for Leukotriene Inhibitors

Author(s): Lu CY; Zhang F; Lakoma MD; Butler MG; Fung V; Larkin EK; Kharbanda EO; Vollmer WM; Lieu T; Soumerai SB; Chen Wu A

Clin Ther. 2015 Apr 25.

PubMed abstract

A Vaccine Study Design Selection Framework for the Postlicensure Rapid Immunization Safety Monitoring Program

Author(s): Baker MA; Lieu TA; Li L; Hua W; Qiang Y; Kawai AT; Fireman BH; Martin DB; Nguyen MD

Am J Epidemiol. 2015 Apr 15;181(8):608-18. Epub 2015-03-13.

PubMed abstract

Parents' Choices and Rationales for Alternative Vaccination Schedules: A Qualitative Study

Author(s): Saada A; Lieu TA; Morain SR; Zikmund-Fisher BJ; Wittenberg E

Clin Pediatr (Phila). 2015 Mar;54(3):236-43. Epub 2014-09-07.

PubMed abstract

Primary Adherence to Controller Medications for Asthma is Poor

Author(s): Wu AC; Butler MG; Li L; Fung V; Kharbanda EO; Larkin EK; Vollmer WM; Miroshnik I; Davis RL; Lieu TA; Soumerai SB

Ann Am Thorac Soc. 2015 Feb;12(2):161-6.

PubMed abstract

Geographic Clusters in Underimmunization and Vaccine Refusal

Author(s): Lieu TA; Ray GT; Klein NP; Chung C; Kulldorff M

Pediatrics. 2015 Feb;135(2):280-9. Epub 2015-01-19.

PubMed abstract

Responding to Vaccine Safety Signals during Pandemic Influenza: A Modeling Study

Author(s): Maro JC; Fryback DG; Lieu TA; Lee GM; Martin DB

PLoS ONE. 2014;9(12):e115553. Epub 2014-12-23.

PubMed abstract

Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids

Author(s): Wu AC; Li L; Fung V; Kharbanda EO; Larkin EK; Vollmer WM; Butler MG; Miroshnik I; Rusinak D; Davis RL; Hartert T; Weiss ST; Lieu TA

J Allergy Clin Immunol Pract. 2014 Sep-Oct;2(5):607-13. Epub 2014-07-25.

PubMed abstract

Developing a data infrastructure for a learning health system: the PORTAL network

Author(s): McGlynn EA; Lieu TA; Durham ML; Bauck A; Laws R; Go AS; Chen J; Feigelson HS; Corley DA; Young DR; Nelson AF; Davidson AJ; Morales LS; Kahn MG

J Am Med Inform Assoc. 2014 Jul-Aug;21(4):596-601. Epub 2014-05-12.

PubMed abstract

Intussusception Risk after Rotavirus Vaccination in U.S. Infants

Author(s): Yih WK; Lieu TA; Kulldorff M; Martin D; McMahill-Walraven CN; Platt R; Selvam N; Selvan M; Lee GM; Nguyen M

N Engl J Med. 2014 Feb 6;370(6):503-12. Epub 2014-01-14.

PubMed abstract

Post-licensure rapid immunization safety monitoring program (PRISM) data characterization

Author(s): Baker MA; Nguyen M; Cole DV; Lee GM; Lieu TA

Vaccine. 2013 Dec 30;31 Suppl 10:K98-112.

PubMed abstract

Statin Exposure is Associated with Decreased Asthma-Related Emergency Department Visits and Oral Corticosteroid Use

Author(s): Tse SM; Li L; Butler MG; Fung V; Kharbanda EO; Larkin EK; Vollmer WM; Miroshnik I; Rusinak D; Weiss ST; Lieu T; Wu AC

Am J Respir Crit Care Med. 2013 Nov;188(9):1076-82.

PubMed abstract

Some Families Who Purchased Health Coverage Through The Massachusetts Connector Wound Up With High Financial Burdens

Author(s): Galbraith AA; Sinaiko AD; Soumerai SB; Ross-Degnan D; Dutta-Linn MM; Lieu TA

Health Aff (Millwood). 2013 May;32(5):974-83. Epub 2013-04-17.

PubMed abstract

The experience of massachusetts shows that consumers will need help in navigating insurance exchanges

Author(s): Sinaiko AD; Ross-Degnan D; Soumerai SB; Lieu T; Galbraith A

Health Aff (Millwood). 2013 Jan;32(1):78-86.

PubMed abstract

Success Of Program Linking Data Sources To Monitor H1N1 Vaccine Safety Points To Potential For Even Broader Safety Surveillance

Author(s): Salmon D; Yih WK; Lee G; Rosofsky R; Brown J; Vannice K; Tokars J; Roddy J; Ball R; Gellin B; Lurie N; Koh H; Platt R; Lieu T; PRISM Program Group

Health Aff (Millwood). 2012 Nov;31(11):2518-27.

PubMed abstract

Risk of Confirmed Guillain-Barre Syndrome Following Receipt of Monovalent Inactivated Influenza A (H1N1) and Seasonal Influenza Vaccines in the Vaccine Safety Datalink Project, 2009-2010

Author(s): Greene SK; Rett M; Weintraub ES; Li L; Yin R; Amato AA; Ho DT; Sheikh SI; Fireman BH; Daley MF; Belongia EA; Jacobsen SJ; Baxter R; Lieu TA; Kulldorff M; Vellozzi C; Lee GM

Am J Epidemiol. 2012 Jun 1;175(11):1100-9. Epub 2012 May 11.

PubMed abstract

Active surveillance for adverse events: the experience of the Vaccine Safety Datalink project

Author(s): Yih WK; Kulldorff M; Fireman BH; Shui IM; Lewis EM; Klein NP; Baggs J; Weintraub ES; Belongia EA; Naleway A; Gee J; Platt R; Lieu TA

Pediatrics. 2011 May;127 Suppl 1:S54-64. Epub 2011 Apr 18.

PubMed abstract

The Vaccine Safety Datalink: a model for monitoring immunization safety

Author(s): Baggs J; Gee J; Lewis E; Fowler G; Benson P; Lieu T; Naleway A; Klein NP; Baxter R; Belongia E; Glanz J; Hambidge SJ; Jacobsen SJ; Jackson L; Nordin J; Weintraub E

Pediatrics. 2011 May;127 Suppl 1:S45-53. Epub 2011 Apr 18.

PubMed abstract

Healthcare utilization and cost of pneumococcal disease in the United States

Author(s): Huang SS; Johnson KM; Ray GT; Wroe P; Lieu TA; Moore MR; Zell ER; Linder JA; Grijalva CG; Metlay JP; Finkelstein JA

Vaccine. 2011 Apr 18;29(18):3398-412. Epub 2011 Mar 11.

PubMed abstract

Near real-time surveillance for influenza vaccine safety: proof-of-concept in the Vaccine Safety Datalink Project

Author(s): Greene SK; Kulldorff M; Lewis EM; Li R; Yin R; Weintraub ES; Fireman BH; Lieu TA; Nordin JD; Glanz JM; Baxter R; Jacobsen SJ; Broder KR; Lee GM

Am J Epidemiol. 2010 Jan 15;171(2):177-88. Epub 2009 Dec 4.

PubMed abstract

New vaccines against otitis media: projected benefits and cost-effectiveness

Author(s): O'Brien MA; Prosser LA; Paradise JL; Ray GT; Kulldorff M; Kurs-Lasky M; Hinrichsen VL; Mehta J; Colborn DK; Lieu TA

Pediatrics. 2009 Jun;123(6):1452-63.

PubMed abstract

Willingness to pay for a QALY based on community member and patient preferences for temporary health states associated with herpes zoster

Author(s): Lieu TA; Ray GT; Ortega-Sanchez IR; Kleinman K; Rusinak D; Prosser LA

Pharmacoeconomics. 2009;27(12):1005-16.

PubMed abstract

Community and patient values for preventing herpes zoster

Author(s): Lieu TA; Ortega-Sanchez I; Ray GT; Rusinak D; Yih WK; Choo PW; Shui I; Kleinman K; Harpaz R; Prosser LA

Pharmacoeconomics. 2008;26(3):235-49.

PubMed abstract

Real-time vaccine safety surveillance for the early detection of adverse events

Author(s): Lieu TA; Kulldorff M; Davis RL; Lewis EM; Weintraub E; Yih K; Yin R; Brown JS; Platt R; for the Vaccine Safety Datalink Rapid Cycle Analysis Team

Med Care. 2007 Oct;45(10 Supl 2):S89-95.

PubMed abstract

Cultural competence policies and other predictors of asthma care quality for Medicaid-insured children

Author(s): Lieu TA; Finkelstein JA; Lozano P; Capra AM; Chi FW; Jensvold N; Quesenberry CP; Farber HJ

Pediatrics. 2004 Jul;114(1):e102-10.

PubMed abstract

Use of asthma medication dispensing patterns to predict risk of adverse health outcomes: a study of Medicaid-insured children in managed care programs

Author(s): Farber HJ; Chi FW; Capra A; Jensvold NG; Finkelstein JA; Lozano P; Quesenberry CP Jr; Lieu TA

Ann Allergy Asthma Immunol. 2004 Mar;92(3):319-28.

PubMed abstract

A randomized controlled trial of test-and-treat strategy for Helicobacter pylori: clinical outcomes and health care costs in a managed care population receiving long-term acid suppression therapy for physician-diagnosed peptic ulcer disease

Author(s): Allison JE; Hurley LB; Hiatt RA; Levin TR; Ackerson LM; Lieu TA

Arch Intern Med. 2003 May 26;163(10):1165-71.

PubMed abstract

Misunderstanding of asthma controller medications: association with nonadherence

Author(s): Farber HJ; Capra AM; Finkelstein JA; Lozano P; Quesenberry CP; Jensvold NG; Chi FW; Lieu TA

J Asthma. 2003 Feb;40(1):17-25.

PubMed abstract

Racial/ethnic variation in asthma status and management practices among children in managed medicaid

Author(s): Lieu TA; Lozano P; Finkelstein JA; Chi FW; Jensvold NG; Capra AM; Quesenberry CP; Selby JV; Farber HJ

Pediatrics. 2002 May;109(5):857-65.

PubMed abstract

Variation in clinician recommendations for multiple injections during adoption of inactivated polio vaccine

Author(s): Lieu TA; Davis RL; Capra AM; Mell LK; Quesenberry CP; Martin KE; Zavitkovsky A; Black SB; Shinefield HR; Thompson RS; Rodewald LE

Pediatrics. 2001 Apr;107(4):E49.

PubMed abstract

Impact of the change in polio vaccination schedule on immunization coverage rates: a study in two large health maintenance organizations

Author(s): Davis RL; Lieu TA; Mell LK; Capra AM; Zavitkovsky A; Quesenberry CP Jr; Black SB; Shinefield HR; Thompson RS; Rodewald LE

Pediatrics. 2001 Apr;107(4):671-6.

PubMed abstract

Quality of life measurement clarifies the cost-effectiveness of Helicobacter pylori eradication in peptic ulcer disease and uninvestigated dyspepsia

Author(s): Groeneveld PW; Lieu TA; Fendrick AM; Hurley LB; Ackerson LM; Levin TR; Allison JE

Am J Gastroenterol. 2001 Feb;96(2):338-47.

PubMed abstract

A comparison of health care experiences for medicaid and commercially enrolled children in a large, nonprofit health maintenance organization

Author(s): Newacheck PW; Lieu T; Kalkbrenner AE; Chi FW; Ray GT; Cohen JW; Weinick RM

Ambul Pediatr. 2001 Jan-Feb;1(1):28-35.

PubMed abstract

The hidden costs of infant vaccination

Author(s): Lieu TA; Black SB; Ray GT; Martin KE; Shinefield HR; Weniger BG

Vaccine. 2000 Aug 15;19(1):33-41.

PubMed abstract

Comparing the medical expenses of children with Medicaid and commercial insurance in an HMO

Author(s): Ray GT; Lieu T; Weinick RM; Cohen JW; Fireman B; Newacheck P

Am J Manag Care. 2000 Jul;6(7):753-60.

PubMed abstract

Costs of otitis media in a managed care population

Author(s): Capra AM; Lieu TA; Black SB; Shinefield HR; Martin KE; Klein JO

Pediatr Infect Dis J. 2000 Apr;19(4):354-5.

PubMed abstract

Projected cost-effectiveness of pneumococcal conjugate vaccination of healthy infants and young children

Author(s): Lieu TA; Ray GT; Black SB; Butler JC; Klein JO; Breiman RF; Miller MA; Shinefield HR

JAMA. 2000 Mar 15;283(11):1460-8.

PubMed abstract

The cost of health conditions in a health maintenance organization

Author(s): Ray GT; Collin F; Lieu T; Fireman B; Colby CJ; Quesenberry CP; Van Den Eeden SK; Selby JV

Med Care Res Rev. 2000 Mar;57(1):92-109.

PubMed abstract

Rehospitalization for respiratory syncytial virus among premature infants

Author(s): Joffe S; Escobar GJ; Black SB; Armstrong MA; Lieu TA

Pediatrics. 1999 Oct;104(4 Pt 1):894-9.

PubMed abstract

Computer-based models to identify high-risk adults with asthma: is the glass half empty of half full?

Author(s): Lieu TA; Capra AM; Quesenberry CP; Mendoza GR; Mazar M

J Asthma. 1999 Jun;36(4):359-70.

PubMed abstract

The cost of medical care for patients with cystic fibrosis in a health maintenance organization

Author(s): Lieu TA; Ray GT; Farmer G; Shay GF

Pediatrics. 1999 Jun;103(6):e72.

PubMed abstract

Issues in studying the effectiveness of health services for children

Author(s): Lieu TA; Newman TB

Health Serv Res. 1998 Oct;33(4 Pt 2):1041-58.

PubMed abstract

Computer-based models to identify high-risk children with asthma

Author(s): Lieu TA; Quesenberry CP; Sorel ME; Mendoza GR; Leong AB

Am J Respir Crit Care Med. 1998 Apr;157(4 Pt 1):1173-80.

PubMed abstract

Effectiveness and cost-effectiveness of letters, automated telephone messages, or both for underimmunized children in a health maintenance organization

Author(s): Lieu TA; Capra AM; Makol J; Black SB; Shinefield HR

Pediatrics. 1998 Apr;101(4):E3.

PubMed abstract

Varicella serology among school age children with a negative or uncertain history of chickenpox

Author(s): Lieu TA; Black SB; Takahashi H; Ray P; Capra AM; Shinefield HR; Adler NE

Pediatr Infect Dis J. 1998 Feb;17(2):120-5.

PubMed abstract