About

Deborah R Kaye, MD, MS, leads the Oncology Decision Insights Group within the Department of Urology at Duke University. The group is dedicated to using both quantitative and qualitative research methods to assess healthcare costs, utilization, adherence, and decision-making among individuals with cancer, with a particular focus on urologic malignancies. Their research aims to evaluate, develop, and implement local and national interventions and policies to improve health outcomes. The group's collaborations include Duke-Margolis Institute for Health Policy, Duke’s Clinical Research Institute, Department of Population Health Sciences, Fuqua School of Business, and Duke’s School of Nursing. Current research efforts include characterizing costs of cancer treatments, investigating economic and non-economic factors influencing clinician decision-making for systemic therapy in advanced prostate cancer, creating cost transparency interventions to reduce patient out-of-pocket burden, understanding disparities in cancer diagnosis and treatment, exploring the psychology behind cancer drug decision-making, and utilizing Artificial Intelligence to enhance cancer care delivery.

Research topics

• Surgery
• Medicine
• Engineering
• General surgery
• Mechanical engineering
• Internal medicine

Selected publications

• Does Variable Clamping Pressure Endanger Urologic Prosthetic Tubing?

  SSRN Electronic Journal · 2025-01-01

  preprintOpen accessSenior author
  PublisherDOI

• (016) ONE CLICK OR THREE: THE IMPACT OF CLAMPING FORCE ON UROLOGIC PROSTHESIS TUBING

  The Journal of Sexual Medicine · 2024

  Senior authorCorresponding
  • Medicine
  • Engineering
  • Surgery

  Abstract Introduction It is a well-established guideline that urologic prosthesis tubing (UPT) should be clamped with a rubber-shod hemostat (RSH) using a single click to minimize potential damage. This recommendation is specifically emphasized in the instructional materials provided by implant manufacturers. However, in practice, tubing is sometimes clamped with multiple clicks. Additionally, there is considerable variability in hemostat brands, models, and the pressures they exert. This variability has led our group to investigate the impact of clamp pressure on UPT integrity, particularly when heavier hemostats, multiple clicks, or unshodded clamps are inadvertently used. Objective To evaluate the effect of RSH technique and pressure variability between surgical instruments on UPT integrity, we conducted in-vitro UPT stress tests under various conditions. Methods Boston Scientific kink-resistant tubing was trimmed to a standard length of 23 cm before being randomly sorted into one of four groups: control, RSH one-click, RSH three-click, or bare hemostat one-click. UPT segments were filled with dyed water to improve leak detection. Both ends of the UPT were secured into 10 cm loops with a wire rope clip to allow for the application of linear force. A 3 cm experimental section was left between each loop. All experimental groups were clamped for 60 seconds in the center of the experimental section at the point of intervention (POI). Linear tension was applied to the tubing, beginning at 0 newtons (N), and increased at a rate of 19.8 +/- 1.4 N/min (2 kg/min of downward force) until the UPT separated into 2 pieces. Force at the time of failure (FF), location of the tear, and incidence of leakage before tearing were recorded. Analysis of variance and Chi-squared test were used for analysis of FF and location of separation between groups, respectively. Scanning electron microscope (SEM) images were captured to subjectively evaluate for UPT damage from each intervention. Results The protocol was completed 10 times per group (40 total). Median FF was 99.4 N (range: 79.9-106.5), 104.8 N (range: 78.1-111.0), 97.2 N (range: 74.6-106.5), and 98.1 N (range: 87.9-107.4) for control, RSH one-click, RSH three-click, and bare hemostat one-click, respectively (P = 0.34). Tear location appeared random for all groups other than the bare hemostat one-click group, which tore at the POI in 6 of 10 (60%) experiments (p = 0.000082, Fig. 1). Only the bare hemostat one-click intervention caused leaking before a complete tear in 2 of 10 (20%) experiments. On SEM imaging, the bare hemostat damages the surface of the UPT while there is no appreciable difference between the remaining groups (Fig. 2). Conclusions The durability of UPT is not significantly compromised by RSH clamp pressures; however, bare hemostats cause surface damage, resulting in a loss of material integrity. Although minimal clamp pressures are advised, applying 2-3 clicks with an RSH may not constitute a significant surgical error. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast Corporation; Boston Scientific Corporation.

  PublisherDOI

• 136 Small Diameter Penile Implants: A Survey on Current Utilization and Review of Literature

  The Journal of Sexual Medicine · 2022 · 2 citations

  Senior authorCorresponding
  • Medicine
  • Surgery
  • General surgery

  ABSTRACT Introduction The small diameter penile implant (SDPI) is a modified IPP with a smaller diameter cylinder utilized in cases of anatomically small corpora or severe corporal fibrosis. SDPIs allow for patients to obtain useable erections, sometimes with the intent to upsize in the future. There is a dearth of literature on the optimal clinical scenarios for utilization of SDPIs, volume of SDPIs placed nationwide, and patient satisfaction results. Objective Our aim is to identify current usage patterns and perceived patient satisfaction of SDPIs among urologic prosthetic surgeons. Methods A 23-question online survey was distributed via email to physician members of the Sexual Medicine Society of North America (SMSNA) and Society of Urologic Prosthesis Surgeons (SUPS). The survey included questions regarding surgeon experience and volume, frequency of SDPI utilization, indications for SDPI, surgical strategy in the setting of SDPI (approach, use of concordant modeling/grafting), reservoir and pump management, and perceived infection risk and patient satisfaction. Results 50 individuals responded to the survey, 48 of whom routinely utilized SDPIs. The most common indication for SDPI placement was corporal fibrosis from prior infection, followed by anatomically small corpora and priapism. The most common maximal dilation diameter was 10 mm (47%), with an additional 23% of respondents utilizing SDPI with 11 mm dilation. 75.4% of respondents sometimes or always intended to upsize to standard diameter cylinders in the future. 68.8% of surgeons routinely counseled patients on the possibility of reduced girth and rigidity with SDPI. Patient satisfaction was perceived to be comparable to standard diameter cylinders in 56.3% of respondents, while the remaining 43.6% believed it to be lower than traditional cylinders. Conclusions SDPI are utilized by prosthetic surgeons in a variety of clinical situations and are frequently effective. Future research is needed to better characterize patient satisfaction and define which patients are best suited for SDPI. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast and Boston Scientific

  PublisherDOI

• 235 Penile Invagination and Corporal Excavation for Penile Prosthesis Placement in Severe Corporal Fibrosis

  The Journal of Sexual Medicine · 2022

  Senior authorCorresponding
  • Medicine
  • Surgery
  • Internal medicine

  ABSTRACT Introduction The penile prosthesis is a standard treatment for men with erectile dysfunction refractory to vacuum, medical, or injection therapies. In patients with virgin tissue planes and normal anatomy, prosthesis placement can be technically straight forward and associated with minimal morbidity. Patients with corporal fibrosis present a unique surgical challenge for implantation and there is no standardized approach to care. Selection of the appropriate surgical technique can vary depending on the extent of corporal fibrosis and surgeon experience. In this case, our patient's corporal fibrosis resulted from two episodes of prolonged priapism as well as two distal shunts and a failed attempt at inflatable penile prosthesis placement resulting in a prolonged wound infection. Objective We present our unique surgical approach for penile prosthesis implantation in the most severe cases of corporal fibrosis. Methods Video demonstration of corporal excavation and penile prosthesis placement via a perineal incision with complete penile invagination. Results Comprehensive pre-operative planning guided our decision to utilize a malleable prosthesis given the severe degree of corporal fibrosis and higher risk of complications with a three-piece IPP. Our penile invagination technique allowed us to achieve complete longitudinal corporal exposure while avoiding multiple incisions or overlapping incisions near the corporotomy and cylinders. Tachosil or other biologic grafts should be available for use in cases where primary corporotomy closure is not possible. Conclusions We demonstrated that penile invagination, corporal excavation, and implantation with a malleable prosthesis is a safe and effective treatment for patients with the most severe corporal fibrosis. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast and Boston Scientific

  PublisherDOI

• Silicone elastomer implant failure

  Journal of the American Podiatric Medical Association · 1987-01-01

  letter1st authorCorresponding
  PublisherDOI

Frequent coauthors

• A Allkanjari

  Duke University

  2 shared

• C Kim

  Duke University

  2 shared

• S Campbell

  Duke University

  2 shared

• Gregory Barton

  Duke University

  1 shared

• BD Nosé

  Duke University Hospital

  1 shared

• JP Selph

  University of Alabama at Birmingham

  1 shared

• A. Townsend Peterson

  University of Kansas

  1 shared

• Matthew J. Salvino

  Duke University

  1 shared

Awards & honors

• Center of Excellence distinction from Coloplast
• Center of Excellence distinction from Boston Scientific