HSR&D Senior Research Career Scientist Award

高铁

• 批准号: 10194479
• 负责人: Alex Sox-Harris
• 金额: --
• 依托单位: VETERANS ADMIN PALO ALTO HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-10-01 至 2024-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10194479
• 关键词: Accountability; Address; Applications Grants; Area; Automobile Driving; Award; Awareness; Caring; Carpal Tunnel Syndrome; Chronic low back pain; Clinical; Data Aggregation; Degenerative polyarthritis; Ecological Bias; Ensure; Funding; General Anesthesia; Grant; Hand; Health; Health Services; Health Services Research; Healthcare; Healthcare Systems; Individual; Informed Consent; Internal Medicine; Joints; Journals; Literature; Low Back Pain; Manuscripts; Measurement; Measures; Medical; Mentors; Methodology; Methods; Modeling; Motivation; Operative Surgical Procedures; Orthopedics; Paper; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Policies; Postoperative Pain; Postoperative Period; Procedures; Process; Publishing; Quality of Care; Replacement Arthroplasty; Research; Research Personnel; Risk; Risk Factors; Risk stratification; Role; Scientist; Surgical Models; Surgical complication; System; Testing; Time; United States Agency for Healthcare Research and Quality; Validation; Work; addiction; alcohol abuse therapy; alcohol use disorder; bone; care outcomes; career; clinical practice; common treatment; cost; design; experience; falls; health care delivery; health care quality; hip replacement arthroplasty; implementation research; implementation science; improved outcome; indexing; innovation; insight; interest; knee replacement arthroplasty; mange; modifiable risk; next generation; precision medicine; predictive modeling; programs; scientific organization; shared decision making; substance abuse treatment; surgery outcome

Dr. Sox-Harris has three major health services research areas, all with high relevance to VA healthcare. 1) Developing, validating, and implementing predictive models for surgical treatments and their alternatives. Dr. Sox-Harris is leading a HSR&D-funded project (IIR 13-051-3) to develop and validate predictive models of short-term complications and long-term outcomes of patients receiving total hip or knee arthroplasty. This project has produced the most accurate predictive models of surgical complications following total joint arthroplasty and the team is in the process of producing models to predict which patients will experience the most and least improvements from this common treatment for osteoarthritis. The next step in this program of research is to test methods to integrate these predictions into informed consent, shared decision making, and risk stratification, as well as the identification and management of modifiable risk factors to improve the outcomes of patients. He is also submitting two new grants in the fall of 2018 to develop and validate prediction models for (a) candidate treatments for non-specific low back pain and (b) persistent postoperative pain. 2) Developing, validating, and evaluating the effects of health care quality measures for diverse medical conditions. Dr. Sox-Harris has led several projects (e.g., 07-092-1, IIR10-370-2) focused on the validity and effects of existing addiction treatment quality measures. Results from this research has generated wide interest and debate in the addiction field and contributed to the methodological literature by increasing awareness of the ecological fallacy (i.e., misleading conclusions about individuals from analyses of aggregated data) as it pertains to quality measure validation and interpretation. Overall, his work changed the landscape of addiction treatment quality measurement within VA and beyond, and has been recognized with several national awards. He has expanded the impact of this line of research in a mentoring role (e.g., IIR 15-436-2, IIR 16-239), and his program of quality measurement research continues with a shift in clinical focus to conditions for which surgery is a major treatment option (e.g., carpal tunnel syndrome, total joint arthroplasty); 3) Implementation and de-implementation research. Dr. Sox- Harris has two VA-funded projects (SDP 11-411 recently completed, IIR 16-216) focused on implementation of evidence-supported treatments (e.g., medication treatment of alcohol use disorder) and de-implementation of unsafe, ineffective, or low value treatments and practices (e.g., low value preoperative testing for low risk procedures). His current and planned work in this area is primarily focused on targets relevant to surgical procedures (e.g., low value testing after surgery, routine use of general anesthesia when less risky/costly options exist) and conditions for which surgery is a major treatment option (e.g., chronic low back pain). The unifying theme behind these research areas is that they represent significant unsolved problems in the VA health care system and beyond. Dr. Sox-Harris' driving motivation is to identify high-impact and persistent problems in the VA healthcare system for which health services research might provide essential insights and innovations. He has a record of successful grant applications (15 grants as PI, 18 as co-investigator), publishing in scientific journals (185 manuscripts, H-Index of 40), and mentoring early career and other researchers. In recognition of his commitment to conducting research that directly informs healthcare delivery and outcomes, Dr. Sox-Harris received the inaugural VA HSR&D System Impact Award in 2015, for a program of research that has had “a direct and important impact on clinical practice or clinical policy in the VA Healthcare System.”

Sox-Harris 博士拥有三个主要的健康服务研究领域，所有领域都与 VA 高度相关 1) 开发、验​​证和实施手术预测模型。 Sox-Harris 博士正在领导一个 HSR&D 资助的项目 (IIR 13-051-3)。 开发和验证短期并发症和长期结果的预测模型 接受全髋关节或膝关节置换术的患者该项目产生了最准确的结果。 全关节置换术后手术并发症的预测模型，该团队正在研究 生成模型来预测哪些患者经历最多和最少的过程 该计划的下一步是通过这种常见的骨关节炎治疗方法进行改进。 研究的目的是测试将这些预测整合到知情同意、共同决策中的方法 风险分层，以及可改变风险因素的识别和管理 为了改善患者的治疗效果，他还在 2018 年秋季向该项目提交了两项新资助。 开发并验证 (a) 非特异性腰痛候选治疗方法的预测模型 (b) 术后持续疼痛 2) 制定、验证和评估效果。 Sox-Harris 博士领导了多项针对不同医疗状况的医疗保健质量措施。 项目（例如 07-092-1、IIR10-370-2）侧重于现有成瘾的有效性和影响 这项研究的结果引起了人们的广泛兴趣和争论。 成瘾领域并通过提高人们对成瘾问题的认识为方法论文献做出了贡献 生态谬误（即通过汇总数据分析得出关于个体的误导性结论） 它涉及质量测量验证和解释总体而言，他的工作改变了景观。 VA 及其他地区的成瘾治疗质量测量，并已得到认可 他以指导作用扩大了这一研究领域的影响（例如， IIR 15-436-2、IIR 16-239），他的质量测量研究计划继续进行，并发生了转变 临床重点关注以手术为主要治疗选择的病症（例如腕管 3）Sox 博士的实施和取消实施研究。 哈里斯有两个 VA 资助的项目（SDP 11-411 最近完成，IIR 16-216），重点关注 实施有证据支持的治疗（例如酒精使用障碍的药物治疗） 取消不安全、无效或低价值的治疗和做法（例如，低价值的治疗和实践） 他目前和计划在该领域的工作主要是低风险手术的术前测试。 重点关注与外科手术相关的目标（例如，术后低值检测、常规使用 全身麻醉（当存在风险/成本较低的选择时）以及手术是主要的情况 治疗选择（例如慢性腰痛）。 这些研究领域背后的统一主题是它们代表了尚未解决的重大问题 Sox-Harris 博士在 VA 医疗保健系统及其他领域的工作动机是确定具有高影响力的项目。 以及 VA 医疗保健系统中持续存在的问题，卫生服务研究可能会解决这些问题 他拥有成功申请资助的记录（15）。 作为 PI 获得资助，18 名作为联合研究员），在科学期刊上发表论文（185 篇手稿，H 指数为 40）， 并指导早期职业和其他研究人员以表彰他对开展工作的承诺。 直接影响医疗保健服务和结果的研究，Sox-Harris 博士获得了 2015 年首次荣获 VA HSR&D 系统影响奖，表彰其“产生了直接影响”的研究项目 对 VA 医疗保健系统的临床实践或临床政策产生重要影响。”