For two decades, my research program has designed and implemented diverse methods to capture patient-reported health outcomes from national samples of patients and integrated these data with clinical and administrative data to generate real-world evidence. These integrated, longitudinal patient-centered data support quality improvement and research in learning health systems. Today, as MPI for the ACCELERAT K12 in Learning Health Systems (AHRQ; K12HS026385), I contribute to the training of the next generation of embedded patient-centered outcomes researchers.


Following a residency in Preventive Medicine, I completed a fellowship in Health Services and Outcomes Research emphasizing large database analysis to understand patient outcomes in chronic conditions. This training laid the foundation for a career in quality leadership (Medical Director for Quality) and outcomes research. While serving in health system leadership, I supervised the electronic data warehouse staff to translate EHR data to quality metrics and research. Analytic dashboards informed quality improvement priorities. In the last decade, with a primary focus on research, I serve as Principal Investigator of a P50 (FORCE-TJR; AHRQ P50HS018910-01) for comparative effectiveness research in total joint replacement (TJR). The FORCE-TJR cohort includes 30,000 aging adults in 28 states with knee and hip osteoarthritis who report longitudinal pain and physical function. Early patient reported data (PROs) were collected on more than 80% of patients. Collection of 5-year outcomes was recently completed. Real-time, patient data are trended, compared with benchmarks, and available for clinic use. A 2018 National Academy of Medicine report highlights FORCE-TJR as a patient-centered “learning health system” that supports over $19 million in federally funded ancillary research. Of note, these ancillary awards are in collaboration with 9 junior investigators who successfully received their first federal awards (R01, R21, R03).


In addition to the FORCE-TJR program and faculty training, current research includes:


PI, PCORI IHS 1507-31714; Arthritis for Shared Knowledge (A.S.K.)- cluster randomized trial of tailored predictive outcome reports to inform shared decisions for 6000 knee and hip osteoarthritis patients.


PI, NIAMS R01AR071048; predictive analytics of real-world physical therapy interventions to achieve optimal TJR outcomes


Co-I, NIAMS R01AR078342; sociodemographic and geographic predictors of variation in TKR use and outcomes


Co-I, PCORI 1504-30198; pragmatic comparative effectiveness trial of three anti-thrombotic medications in TJR


Co-I, NIAMS R01AR069557; evaluation of the use of opioids after TJR


Co-I, NIAMS 5R21MD013542; cultural adaptation of arthritis PROs for Vietnamese immigrants


Co-I, NIAMS P30AR072579-01; methods core member to inform design of innovative clinical and population health research methods, including patient-reported outcome measures.


Mentor; Fogarty D43TW010946 training researchers in Tanzania