HSR&D Senior Research Career Scientist Award

索克斯-哈里斯博士有三个主要的卫生服务研究领域，都与退伍军人管理局高度相关 医疗保健。1)开发、验证和实施外科手术的预测模型 治疗方法及其替代方案。索克斯-哈里斯博士正在领导一个由高铁和研发资助的项目(IIR 13-051-3) 建立和验证短期并发症和长期预后的预测模型。 接受全髋关节或膝关节置换术的患者。这个项目产生了最准确的 全关节置换术后手术并发症的预测模型，该团队正在 建立模型以预测哪些患者将经历最多和最少的过程 这是骨关节炎常用治疗方法的改进。该计划的下一步是 研究是测试将这些预测整合到知情同意、共享决策中的方法 制定、风险分层以及确定和管理可改变的风险因素 以改善患者的预后。他还将在2018年秋季提交两项新的赠款 开发和验证预测模型，用于(A)非特异性下腰痛的候选治疗 以及(B)持续的术后疼痛。2)开发、验证和评估以下项目的效果 针对不同医疗条件的医疗质量措施。索克斯-哈里斯博士已经领导了几个 项目(例如，07-092-1、IIR10-370-2)侧重于现有成瘾的有效性和影响 治理质量措施。这项研究的结果引起了人们的广泛兴趣和争论 并通过提高对成瘾的认识，为方法论文献做出了贡献 生态谬误(即，对聚合数据的分析得出关于个体的误导性结论) 它与质量测量、验证和解释有关。总体而言，他的工作改变了风景 在退伍军人事务部内外进行成瘾治疗质量评估，并已获得 几个国家级奖项。他以导师的角色扩大了这一系列研究的影响(例如， IIR 15-436-2，IIR 16-239)，他的质量测量研究计划继续转移到 临床重点关注手术是主要治疗选择的情况(例如，腕管 综合征，全关节置换术)；3)实施和取消实施研究。索克斯博士- 哈里斯有两个退伍军人管理局资助的项目(SDP 11-411最近完成，IIR 16-216)专注于 实施循证治疗(例如，酒精使用障碍的药物治疗) 以及不安全、无效或低价值的治疗和做法(例如，低价值 低风险程序的术前测试)。他目前和计划在这一领域的工作主要是 重点关注与手术程序相关的目标(例如，手术后低值检测、常规使用 风险较低/成本较低的选择时的全身麻醉)以及手术是主要的条件 治疗方案(例如，慢性腰背痛)。 这些研究领域背后的统一主题是，它们代表着重大的未解决问题 在退伍军人管理局的医疗保健系统和更远的地方。索克斯-哈里斯博士的驾驶动机是识别高影响力 以及退伍军人管理局医疗系统中持续存在的问题，卫生服务研究可能会针对这些问题 提供重要的见解和创新。他有成功申请赠款的记录(15 在科学期刊上发表论文(185篇手稿，40篇H指数)， 并指导早期职业生涯和其他研究人员。以表彰他致力于 直接通知医疗保健提供和结果的研究，Sox-Harris博士收到了 2015年首届退伍军人事务部HSR&D系统影响奖，表彰一项研究计划 并对退伍军人管理局医疗系统的临床实践或临床政策产生重要影响。

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.”