Clinical Outcomes Research

TMary Kate Bryant, MD MSCR, focuses on quality improvement and health services research on the bariatric population. Specifically, her projects target why certain patients succeed and others have less favorable outcomes after bariatric surgery. She has ongoing projects around clinical outcomes in bariatric surgery for the adolescent and young adult population. Additionally, she has interest in the impact of bariatric surgery on esophageal motility and GERD.

Recent/ongoing projects: • Weight Loss Velocity Predicts Poor Clinic Adherence in Adolescents and Young Adults after Bariatric Surgery • A Target for Intervention: Poor Adherence to Follow-Up after Bariatric Surgery in Adolescents and Young Adults • Dissemination of the 2022 ASMBS and IFSO Guidelines for Bariatric Surgery: what has reached primary care providers? • Analyzing the MBSAQIP database for bariatric surgery outcomes and trends over time

Past projects: • Preoperative esophageal testing predicts postoperative reflux status in sleeve gastrectomy patients - https://pubmed.ncbi.nlm.nih.gov/37264227/ • The environmental impact of surgical telemedicine: life cycle assessment of virtual vs. in-person preoperative evaluations for benign foregut disease - https://pubmed.ncbi.nlm.nih.gov/37237107/ • Telemedicine Use Decreases the Carbon Footprint of the Bariatric Surgery Preoperative Evaluation - https://pubmed.ncbi.nlm.nih.gov/37407773/ • Laparoscopic Heller myotomy with Toupet fundoplication: revisiting GERD in treated achalasia - https://pubmed.ncbi.nlm.nih.gov/38102398/

Thomas Curran, M.D., MPH research interests focus on mitigation of health disparities and optimization of care delivery in colon and rectal surgery, particularly colorectal cancer and inflammatory bowel disease (IBD). This includes work evaluating the effectiveness of a patient centered medical home (PCMH) in the care of IBD at MUSC. Through his work as a Hollings Cancer Center Clinical Scholar for 2022-2024, his project to evaluate an equity focused intervention to improve utilization in guideline concordant extended venous thromboembolism prophylaxis after major cancer surgery was recently funded by the National Cancer Institute as part of the Early-Stage Surgeon Scientist Program. Clinical Scholar

Link: https://hollingscancercenter.musc.edu/research/education/clinical-scholar/hollings-clinical-scholars

Pubmed Link: https://pubmed.ncbi.nlm.nih.gov/34553754/

Heather L. Evans M.D., MS, completed pilot work in post-surgical remote wound monitoring, creating digital health care coordination protocols for other surgical services across MUSC regional health partners. She mentors students and residents in surgical infection clinical outcomes and quality improvement investigations. Dr. Evans also collaborated on a paper with Aaron P. Lesher, M.D., MSCR, who developed a novel smartphone application which improves at-home burn care delivery for patients and their families.

JSR Link:Surgery and the Smartphone: Can Technology Improve Equitable Access to Surgical Care?

Pubmed Links:Patient and Provider Preferences for Monitoring Surgical Wounds Using an mHealth App: A Formative Qualitative Analysis & Improving Antibiotic Stewardship in Acute Appendicitis through Risk-Based Empiric Treatment Selection.

Dr. Engelhardt's current research projects include:

• Leveraging institutional Society of Thoracic Surgeons data to improve cancer delivery locally. This includes participation in the nationwide quality improvement collaborative for Standard 5.8 for Lung Cancer
• Database analysis for lung transplant outcomes and disparities, using nationwide UNOS data
• Using novel AI methods to predict clinical outcomes such as visceral pleural invasion and nodal upstaging for lung cancer
• Analyzing nationwide SEER-Medicare data to describe factors associated with outcomes after lung cancer surgery and factors associated with high quality care delivery for patients with esophageal cancer
• Development of a peer review curriculum and subsequent assessment of feasibility and acceptability of the curriculum among surgical residents
• Assessment of nationwide trends in clinical management of lung cancer in the setting of rapidly changing treatment guidelines
• Implementation of a shared decision tool for patients with early stage lung cancer deciding between surgery and radiation
• Development of a novel shared decision making tool to facilitate provider understanding of patient care goals and tolerance of disease states

• Database analyses for lung transplant outcomes, using the UNOS database
• Database analyses for lung cancer and esophageal cancer care delivery, using the National Cancer Database
• 3 scoping reviews:
  • For patients considering surgery for a thoracic oncologic disease, do shared decision making interventions improve decision outcome (as measured by decisional regret, decision quality, etc.) as compared to standard care?
  • For patients making healthcare decisions, do shared decision interventions facilitate sharing patient-level information (care goals, tolerance of disease states, advanced directives, etc.) with the provider, as compared to standard care?
  • What evaluation tools are used to assess the outcome of a shared decision making intervention?
• Implementation of a shared decision tool for patients with early stage lung cancer deciding between surgery and radiation
• Development of a novel shared decision making tool to facilitate provider understanding of patient care goals and tolerance of disease states

As Director of the Chest Wall Injury and Reconstruction Center at MUSC, Evert Eriksson, M.D. and his research group published 11 peer-reviewed research articles, with six more under review. They also published an article on an innovative technique in surgical rib fixation. His research team had three podium presentations and six abstracts presented at the Chest Wall Injury Society annual meeting. In addition, he was awarded the CWIS President’s Award for excellence in patient care, research and mentoring. Dr. Laswi, surgical critical care fellow, was awarded the best research presentation at the CWIS.

Chest wall injury centers-how we did it - PubMed

Surgical stabilization of severe chest wall injury following cardiopulmonary resuscitation: https://pubmed.ncbi.nlm.nih.gov/34629459/

My research program focuses primarily on development, evaluation, and dissemination of culturally tailored, technology-enhanced behavioral health interventions and resources for vulnerable and clinically underserved populations in the context of trauma with a goal of increasing access to services and improving outcomes. This includes first responders, survivors of traumatic injuries and burns, and disaster survivors. I have developed and am currently directing the Burn Behavioral Health program housed within MUSC’s comprehensive Burn Center to support mental, physical, and social rehabilitation of burn patients to improve well-being and quality of life post-burn. Research opportunities include assisting with a randomized control trial of an mHealth application for burn patients and their families, quality improvement initiatives specific to evaluation and dissemination of stepped-care services for burn patients, optimizing inpatient and outpatient patient screening across multiple burn centers, and increasing patient satisfaction with care.

Ashley B. Hink, M.D., MPH, examines risk factors for firearm injury, outcomes after violence, the influence of social determinants of health on injury and health outcomes, and implementing violence reduction and intervention strategies in healthcare. Dr. Hink is funded by the National Collaborative for Gun Violence Research (NCGVR) with a team of investigators from the American College of Surgeons Committee on Trauma (ACS COT).

Pubmed Links: https://pubmed.ncbi.nlm.nih.gov/35224633/ and https://pubmed.ncbi.nlm.nih.gov/34119719/

Dr. Kilic leads a large research team with a data manager, biostatistician, AI scientists, and >30 residents and students.

• Clinical outcomes research in cardiac surgery and heart failure
• Quality improvement projects in cardiac surgery
• Artificial intelligence and machine learning research

Implementation of a protocol to increase the academic productivity of cardiothoracic surgery resident physicians - PubMed

Heart Transplantation for Peripartum Cardiomyopathy: Outcomes Over 3 Decades: PubMed

The impact of changes in renal function during waitlist time on outcomes after heart transplantation: PubMed

In 2023, Arman Kilic, M.D. had a very successful year for clinical outcomes research in cardiothoracic surgery. Here are some highlights:

• Built an outcomes research team of ~ 30 residents, students, biostatistician, data manager, and data science Masters / Ph.D.students
• Published >100 peer-reviewed manuscripts
• Our residents and students presented >10 abstract presentations at major cardiac surgery meetings
• Jennie Kwon, M.D. PGY-Research, was a Philip Caves Award finalist at ISHLT and presented a plenary talk at AAST on DCD heart transplantation.
  • Dr. Kilic served as mentor and first author for both papers.

Aaron P. Lesher, M.D., MSCR main research efforts are focused on pediatric patients who are being treated for burn injury. His work has been supported by a K23 from the National Institute of Child Health and Human Development. His second avenue of research involves collaborative projects with neonatology on improving clinical outcomes in premature babies with necrotizing enterocolitis as well as a predictive model for improved identification of infants who require tube gastrostomy.

A quality improvement initiative to standardize time to initiation of enteral feeds after non-surgical necrotizing enterocolitis using a consensus-based guideline PubMed

Virtual Visits for Outpatient Burn Care During theCOVID-19 Pandemic.PubMed

& Surgery and the Smartphone: Can Technology Improve Equitable Access to Surgical Care? PubMed

Dave Taber, PharmD, MS, is a health services researcher and epidemiologist.  He conducts research in comparative effectiveness surrounding the development and testing of therapeutic and health services interventions.  He is mainly interested in developing and testing methods to optimize medication safety using technology and addressing racial disparities in access and outcomes in transplantation. He leads the Surgical Outcomes and Research Innovation Nucleus (SORIN) within the MUSC Department of Surgery.  SORIN has an active portfolio of clinical research studies across 7 divisions totaling more than 60 active studies.  Dr. Taber has several active research grants funding randomized clinical trials in transplantation.  He also has active and previous federal funding from VA HSR&D, NIH NIIDDK, and AHRQ.  He has an active clinical practice in transplantation at the Ralph H Johnson VAMC.

Pubmed Link: https://pubmed.ncbi.nlm.nih.gov/34197699/ and https://pubmed.ncbi.nlm.nih.gov/33931415/