About

Shivan J. Mehta, MD, MBA, MSHP, is an Associate Professor of Medicine (Gastroenterology) at the Hospital of the University of Pennsylvania and the Veteran's Administration Medical Center. His clinical expertise includes general gastroenterology, colorectal cancer screening, and electronic consultation. His research focuses on improving the quality of and access to population-based colorectal cancer screening, leveraging behavioral economics, new technology, and care redesign to enhance population health outcomes, and conducting pragmatic trials of healthcare delivery innovation. Dr. Mehta is affiliated with several institutions and programs, including the University of Pennsylvania Center for Health Incentives and Behavioral Economics, the Leonard Davis Institute of Health Economics, and the Penn Center for Cancer Care Innovation. He also serves as Co-Director of the Quality Improvement and Delivery Science (QUIDS) Program and is involved in various initiatives aimed at healthcare improvement and patient safety.

Research topics

• Medicine
• Internal medicine
• Family medicine
• Gastroenterology
• Surgery
• Nursing
• Virology

Selected publications

• Gynecologic oncology referral rates of adnexal masses suspicious for ovarian cancer in an academic health system: A cohort study.

  Journal of Clinical Oncology · 2025-05-28

  article

  5544 Background: Ovarian-Adnexal Reporting Data System (O-RADS) is an international lexicon and risk stratification tool. O-RADS 4 or 5 lesions are complex adnexal masses that a 10-90% risk of malignancy, and national guidelines recommend gynecologic oncology referral. Our objective was to examine patient, clinician, and imaging factors associated with referral to gynecologic oncology for complex adnexal masses. Methods: This retrospective cohort study was exempt from IRB review. We identified all patients with O-RADS 4 or 5 lesions on ultrasound (US) or MRI from July 1, 2020 to December 31, 2023. Our primary outcome was referral to gynecologic oncology. We gathered patient demographic data and ordering clinician characteristics from electronic health records. We performed descriptive statistics and multivariate logistic regression of patient demographics and ordering clinician characteristics associated with gynecologic oncology referral. Results: Our cohort included 373 patients with O-RADS 4 or 5 lesions and no prior gynecologic oncology care. The referral rate to gynecologic oncology was 68%, and referral within 30 days of abnormal imaging was 43%. Time from abnormal imaging to referral ranged from 0 to 407 days (mean 15.3, median 4 days). In multivariate analyses, the likelihood of referral to gynecologic oncology was higher among patients with repeat abnormal imaging compared to those with single instance of abnormal imaging (aOR 20.61, 95%CI 2.63-161.6), O-RADS 5 lesions compared to O-RADS 4 lesions (aOR 9.15, 95%CI 3.47-24.85) and detection on MRI compared to US (aOR 7.79, 95%CI 1.57-38.65). The likelihood of referral to gynecologic oncology was lower among non-white patients (aOR 0.24, 95%CI 0.08-0.76). There were no differences by Hispanic ethnicity, rurality, insurance, or language. Referral was higher among patients whose imaging was ordered by an internal medicine clinician (aOR 3.89, 95%CI 1.48-10.20) compared to ob/gyn. Conclusions: One-third of patients with complex adnexal masses were not referred to gynecologic oncology. Disparities in referral to gynecologic oncology for complex adnexal masses rates based on patient race and ordering clinician specialty highlight the need for system-based approaches including clinician education or automated referrals. Gynecologic oncology referral after O-RADS 4/5. Multivariate OR (95%CI) Postmenopausal (≥55 years) 1.89 (0.95-3.74) Race - White Reference - Black 0.57 (0.27-1.21) - Asian 1.03 (0.30-3.58) - Some other race 0.24 (0.08-0.76) Ordering specialty - Obstetrics/Gynecology Reference - Emergency Medicine 0.93 (0.33-2.62) - Internal Medicine 3.89 (1.48-10.20) - Family Medicine 1.62 (0.66-3.98) - Other specialty 0.87 (0.27-2.76) Has PCP 1.66 (0.81-3.42) O-RADS - 4 Reference - 5 9.15 (3.27-24.85) Imaging - MRI 7.79 (1.57-38.65) - US Reference Repeat abnormal imaging 20.61 (2.63-161.79)

  PublisherDOI

• Colorectal Cancer and Quality of Life: A Medicare Advantage Study by Race, Ethnicity, and Language

  Journal of Surgical Oncology · 2025-01-13 · 1 citations

  article

  BACKGROUND AND METHODS: Colorectal cancer (CRC) treatment can influence health-related quality of life (HRQOL). This study examined HRQOL among older adults undergoing CRC treatment, and the conditional effects of race, ethnicity, and primary language. We conducted a retrospective cohort study of Medicare Advantage enrollees ≥ 65 years old who completed the Medicare Health Outcomes Survey (MHOS) (2016-2020). The exposure group answered "Yes" to the current CRC treatment and the control group answered "No." The primary outcomes were physical component summary (PCS) and mental component summary (MCS) scores. Conditional effects by race and ethnicity were analyzed using interaction terms. RESULTS: Among 184 486 adults, 676 (0.4%) reported current CRC treatment. Those receiving treatment had significantly lower PCS scores (β coefficient -1.98, p < 0.001) and lower MCS scores (β coefficient -0.81, p = 0.018), compared to nontreatment. In the treatment group, Hispanic respondents and Spanish speakers had higher PCS scores (β coefficient 1.96, p = 0.019 and 3.19, p = 0.023, respectively), and respondents identifying as American Indian or Alaska Native had higher MCS scores (β coefficient 8.72, p = 0.016). CONCLUSION: Individuals receiving CRC treatment exhibit worse HRQOL. Outcomes differed by race and ethnicity. This study suggests the need to invest in targeted interventions to improve overall HRQOL during treatment for CRC.

  PublisherDOI

• Default Bulk Ordering and Text Messaging to Enhance Outreach for Lipid Screening

  JAMA Cardiology · 2025-01-29

  articleOpen accessSenior author

  Importance: A comprehensive lipid panel is recommended by guidelines to evaluate atherosclerotic cardiovascular disease risk, but uptake is low. Objective: To evaluate whether direct outreach including bulk orders with and without text messaging increases lipid screening rates. Design, Setting, and Participants: Pragmatic randomized clinical trial conducted from June 6, 2023, to September 6, 2023, at 2 primary care practices at an academic health system among patients aged 20 to 75 years with at least 1 primary care visit in the past 3 years who were overdue for lipid screening. Data analysis was performed from September 2023 to May 2024. Interventions: Eligible patients were randomized in a 1:2:2 ratio to usual care (group 1), direct outreach and bulk orders (group 2), and bulk order outreach with additional text message reminders for scheduling assistance (group 3). In group 3, participants received an initial, follow-up, and reminder text message. Patients with electronic portal accounts were encouraged to schedule through them, while others received laboratory contact information. Any participant inquiries were answered either with automated responses for common questions or with study team support. Main Outcomes and Measures: Proportion of patients who completed a lipid panel within 3 months. Results: Among the 1000 participants, the median (IQR) age was 38 (28-55) years; 470 (47.0%) were female; and 22 (2.3%) were Asian, 38 (3.9%) were Black, 32 (3.2%) were Hispanic or Latino, and 862 (88.6%) were White (race and ethnicity were based on self-reported data). At 3 months, a lipid panel was completed by 12 of 202 patients (5.9%; 95% CI, 3.4% to 10.1%) receiving usual care (group 1) vs 62 of 394 patients (15.7%; 95% CI, 12.5% to 19.7%) receiving direct outreach and bulk order (group 2), a difference of 9.8 percentage points (95% CI, 4.6 to 15.0; P = .001). The panel was completed by 73 of 404 patients (18.1%; 95% CI, 14.6% to 22.1%) receiving outreach, bulk order, and text message reminders (group 3), for a difference of 2.4 percentage points (95% CI, -3.1 to 7.8; P = .43) vs outreach with bulk order alone (group 2). At 6 months, there were no significant differences in lipid screening between either group 1 vs group 2 or group 2 vs group 3. Conclusions and Relevance: Lipid screening among participants receiving bulk orders and outreach letters increased significantly compared with usual care at 3 months. However, there was no difference at 6 months. More than 80% of patients did not follow through with lipid screening despite the intervention, and there was no additional increase in lipid testing at 3 months among participants receiving bulk ordering and supplemental text messaging. Trial Registration: ClinicalTrials.gov Identifier: NCT05724615.

  PublisherOA PDFDOI

• Impact of Artificial Intelligence on the Gastroenterology Workforce and Practice

  Clinical Gastroenterology and Hepatology · 2025-05-13

  article
  PublisherDOI

• Modeling the Financial Viability of a Population Health Program: A Formidable Challenge for Health Systems

  NEJM Catalyst · 2025-07-16

  article
  PublisherDOI

• Clinician nudge to gynecologic oncology referral at suspected ovarian cancer diagnosis: A pilot study

  Gynecologic Oncology · 2025-09-01

  articleOpen access
  PublisherOA PDFDOI

• Mo1008: ASSOCIATION OF FOOD INSECURITY WITH FIVE GASTROINTESTINAL CONDITIONS AMONG UNITED STATES ADULTS

  Gastroenterology · 2025-05-01

  article
  PublisherDOI

• The Burden of Colorectal Cancer Treatment on Quality of Life: A Paired Longitudinal Analysis of Medicare Advantage Enrollees

  Journal of Surgical Oncology · 2025-06-02

  articleOpen access

  BACKGROUND AND OBJECTIVES: Treatment of colorectal cancer (CRC) can have prolonged effects on health-related quality of life (HRQOL). Using the Medicare Health Outcomes Survey (MHOS), this study examines HRQOL outcomes among those undergoing CRC treatment and those who completed CRC treatment. METHODS: We performed a paired longitudinal retrospective cohort study of Medicare Advantage enrollees ≥ 65 years of age who completed the baseline and follow-up MHOS from 2016 to 2020 and answered survey questions regarding current CRC treatment. Outcomes included Physical Component Summary (PCS) scores and Mental Component Summary (MCS) scores. Multivariable logistic regression analyses were used. RESULTS: 574 Respondents met the inclusion criteria. Those currently undergoing treatment for CRC had significantly lower PCS scores (β coefficient -3.08 points, p < 0.001) and significantly lower MCS scores (β coefficient -1.40 points, p = 0.008) at follow-up compared to when they were not undergoing CRC treatment at baseline. Respondents who completed CRC treatment had PCS and MCS scores that remained similar over time (β coefficient 0.54 points, p = 0.466 and 0.07 points, p = 0.924, respectively). DISCUSSION: Treatment of CRC negatively influences HRQOL. These findings emphasize the importance of informing patients of the long-term effects of CRC treatment and support the implementation of interventions aimed at providing sustained recovery throughout the survivorship continuum.

  PublisherOA PDFDOI

• Reply

  Gastroenterology · 2025-04-04

  letter
  PublisherDOI

• Behavioral Interventions Improve Mailed Colorectal Cancer Screening Among Overdue Patients in a Randomized Trial

  Clinical Gastroenterology and Hepatology · 2025-09-23 · 2 citations

  articleOpen access1st authorCorresponding

  BACKGROUND & AIMS: Mailed fecal immunochemical testing (FIT) can boost colorectal cancer screening (CRC) rates, but response rates remain limited. We evaluated if behavioral interventions increased response rates. METHODS: This pragmatic randomized trial with a 2 × 2 × 2 factorial design included primary care patients aged 50 to 74 years who were overdue for CRC screening. Patients were randomized 1:1 to receive a health system-branded blue box or a standard envelope. Patients were concurrently randomized 1:1 to receive or not receive text reminders. Patients were also concurrently randomized 1:1 to receive a reminder letter. The primary outcome was the proportion who completed a FIT within 4 months. RESULTS: Among 5244 patients included, the mean age was 59.6 years (standard deviation [SD], 7.3 years); 35.8% were Black and 53% were White. At 4 months, 17.8% (95% confidence interval [CI], 16.3%-19.2%) who received the box, compared with 18.0% (95% CI, 16.5%-19.5%) who received the standard envelope, completed FIT, an absolute difference of -0.2% (95% CI, -2.3 to 1.9%; P = .85). Among those who received text messaging, 21.2% (95% CI, 19.6%-22.8%) completed FIT compared with 14.6% (95% CI, 13.2%-15.9%) of those who did not, an absolute difference of 6.6% (95% CI, 4.6%-8.7%; P < .001). Among those that received the mailed reminder, 20.3% (95% CI, 18.7%-21.8%) completed FIT compared with 15.5% (95% CI, 14.1%-16.9%) of those who did not, an absolute difference of 4.8% (95% CI, 2.7%-6.9%; P < .001). CONCLUSIONS: Behaviorally informed text messaging and mailed reminders significantly increased screening completion, but the health system-branded box did not increase response rates. CLINICALTRIALS: gov, Number: NCT05341622.

  PublisherDOI

Recent grants

• Behavioral Economics and Population-based Colorectal Cancer Screening

  NIH · $1.3M · 2018–2023

Frequent coauthors

• David A. Asch

  180 shared

• Kevin G. Volpp

  University of Pennsylvania

  122 shared

• Christopher K. Snider

  University of Pennsylvania

  43 shared

• Catherine Reitz

  University of Pennsylvania

  41 shared

• Chyke A. Doubeni

  34 shared

• Shazia M. Siddique

  Allama Iqbal Medical College

  32 shared

• Andrea B. Troxel

  Harvard University

  32 shared

• Katharine A. Rendle

  Abramson Cancer Center

  28 shared

Awards & honors

• Senior Fellow, University of Pennsylvania Leonard David Inst…
• Co-Director, Quality Improvement and Delivery Science (QUIDS…
• Associate Chief Innovation Officer, University of Pennsylvan…
• Core Faculty, Center for Healthcare Improvement and Patient…
• Member, University of Pennsylvania Abramson Cancer Center