HSR&D Senior Research Career Scientist Award

高铁

• 批准号: 10209964
• 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/10209964
• 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; Deimplementation; 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; 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; risk stratification; 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卫生服务研究领域，都与VA相关 卫生保健。 1）开发，验证和实施手术预测模型 治疗及其替代方案。 Sox-Harris博士正在领导HSR＆D资助的项目（IIR 13-051-3） 开发和验证短期并发症的预测模型和长期结局 接受总髋关节或膝关节置换术的患者。这个项目产生了最准确的 全部关节置换术后的手术并发症的预测模型，团队在 生产模型以预测哪些患者将经历最多和最少的过程 这种对骨关节炎的常见治疗方法的改善。此程序的下一步 研究是测试将这些预测整合到知情同意书的方法中的方法 进行和风险分层以及可修改风险因素的识别和管理 改善患者的结局。他还在2018年秋季提交了两项新赠款 开发和验证（a）非特异性下背痛的候选治疗的预测模型 （b）持续的术后疼痛。 2）开发，验证和评估 潜水医疗状况的医疗保健质量措施。 Sox-Harris博士领导了几个 项目（例如07-092-1，IIR10-370-2）着重于现有成瘾的有效性和影响 治疗质量指标。这项研究的结果引起了广泛的兴趣和辩论 成瘾领域，并通过提高对方法论文献的认识 生态谬误（即，从汇总数据分析中得出关于个人的误导性结论） 它与质量测量验证和解释有关。总体而言，他的工作改变了景观 成瘾治疗质量的测量及其他质量的测量，并已被认可 几个国家奖项。他扩大了这一研究方面的影响力的影响（例如 IIR 15-436-2，IIR 16-239），他的质量测量研究计划继续发生了变化 临床重点是手术是主要治疗选择的条件（例如，腕管 综合征，总关节置换术）； 3）实施和实施研究。 Sox博士 - 哈里斯有两个由VA资助的项目（SDP 11-411最近完成，IIR 16-216）。 实施证据支持的治疗（例如，对酒精使用障碍的药物治疗） 以及不安全，无效或低价值处理和实践的实施（例如，低价值） 术前测试低风险程序）。他目前在这一领域的计划工作是主要的 专注于与手术程序相关的目标（例如，手术后的低价值测试，常规使用 当存在较小的风险/昂贵的选择时，全身麻醉）和手术是主要的条件 治疗选择（例如，慢性下背痛）。 这些研究领域背后的统一主题是它们代表了重大的未解决问题 在VA医疗保健系统及其他地区。 Sox-Harris博士的驾驶动机是确定高影响力 以及卫生服务研究可能的VA医疗保健系统中的持续问题 提供基本的见解和创新。他有成功的赠款申请记录（15 赠款为Pi，18岁，共同投资者），发表在科学期刊上（185个手稿，H-Index，40），， 以及早期职业和其他研究人员。承认他对进行的承诺 直接告知医疗保健提供和成果的研究，Sox-Harris博士接受了 2015年首届VA HSR＆D系统影响奖，该计划的研究计划是“直接的 对VA医疗保健系统中的临床实践或临床政策的重要影响。”