HSR&D Senior Research Career Scientist Award

高铁

• 批准号: 9772783
• 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/9772783
• 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博士有三个主要的卫生服务研究领域，都与VA高度相关 健康护理1)开发、验证和实施外科手术预测模型 治疗及其替代品。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和长期结局的预测模型， 接受全髋关节或全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， 生产模型的过程，以预测哪些患者将经历最多和最少 从这种常见的治疗骨关节炎的改进。该计划的下一步是 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，以及确定和管理可改变的风险因素 来改善患者的治疗效果。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）非特异性腰痛的候选治疗方法 和（B）持续的术后疼痛。2)开发、验证和评估 针对不同医疗条件的医疗保健质量措施。索克斯-哈里斯博士领导了几个 项目（例如，07-092-1，IIR 10 -370-2）侧重于现有成瘾的有效性和影响 治疗质量措施。这项研究的结果引起了广泛的兴趣和辩论， 成瘾领域，并通过提高对成瘾的认识， 生态谬误（即，从汇总数据分析中得出的关于个人的误导性结论）， 它涉及质量度量验证和解释。总的来说，他的工作改变了 成瘾治疗质量测量VA内外，并已被公认为 多个国家奖项。他以导师的身份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转向 临床聚焦于手术是主要治疗选择的病症（例如，腕管 综合征，全关节置换术）; 3）实施和反实施研究。索克斯医生- 哈里斯有两个VA资助的项目（SDP 11-411最近完成，IIR 16-216），重点是 实施有证据支持的治疗（例如，酒精使用障碍的药物治疗） 以及取消不安全、无效或低价值的治疗和做法（例如，低值 低风险手术的术前测试）。他目前和计划在这一领域的工作主要是 集中于与外科手术相关的目标（例如，术后低值检测，常规使用 存在风险/成本较低的选择时全身麻醉）和手术是主要治疗手段的情况 治疗选择（例如，慢性腰痛）。 这些研究领域背后的统一主题是，它们代表了重大的未解决问题 在退伍军人管理局的医疗保健系统和超越。索克斯-哈里斯博士的驱动力是识别高影响力 以及VA医疗保健系统中持续存在的问题，医疗服务研究可能 提供重要的见解和创新。他有成功申请资助的记录（15 作为主要研究者，18人作为共同研究者），在科学期刊上发表论文（185篇手稿，H指数为40）， 指导早期职业和其他研究人员。为了表彰他对指挥 直接告知医疗保健服务和结果的研究，Sox-Harris博士收到了 首届VA HSR&D系统影响奖在2015年，为研究计划，有“一个直接的 并对VA医疗保健系统的临床实践或临床政策产生重要影响。