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RCS 14-232 – HSR Study

 
RCS 14-232
HSR&D Career Scientist
Alexander H.S. Sox-Harris, PhD MS
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, CA
Funding Period: October 2014 - September 2031
BACKGROUND/RATIONALE:
Dr. Sox-Harris has three major research areas, all with high relevance to VA healthcare: 1) Surgical health services research, especially the development and validation of predictive models of surgical outcomes for use in preoperative processes (informed consent, shared decision making, risk stratification) and the identification and management of modifiable risk factors (e.g., alcohol misuse, smoking) to improve the outcomes for surgical procedures. 2) Health care quality measurement and management; 3) Quality improvement science (implementation and de-implementation research), primarily focused on targets relevant to surgery

OBJECTIVE(S):
1) Surgical Health Services Research: Conducting a HSR&D-funded study to develop and validate a risk and benefit prediction model for VA patients who are considering knee or hip replacement.


2) Quality Metrics: In collaboration with the American Society for Surgery on the Hand, developing an AHRQ proposal to develop and validate new quality measures for carpal tunnel syndrome.

2) Improvement Science: Conduct recently funded study to describe the extent and drivers of low value preoperative testing in VA with the goal of reducing low value testing


METHODS:
1) Surgical Health Services - risk and benefit modeling

2) Quality Metrics: Development and validation of quality metrics including developing methods to detect unintended consequences. Also examining the utility of patient-reported outcomes for quality measurement purposes

3) Improvement Science - develop and test a strategy to reduce low value preoperative testing.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
Dr. Sox-Harris recently published : (1) A paper evaluating the access-safety trade-offs in enforcing a BMI cutoff for total joint replacement. This work was published in the flagship orthopedics journal and presented a the prestigious Knee Society. 2) A paper questioning the validity of a popular surgical risk calculator; and 3) Prediction models for total joint arthtoplasty in the VHA.

(1) Giori NJ, Amanatullah DF, Gupta S, Bowe T, Harris AHS. (2018). Risk Reduction Compared with Access to Care: Quantifying the Trade-Off of Enforcing a Body Mass Index Eligibility Criterion for Joint Replacement. J Bone Joint Surg April 4;100(7):539-545.

(2) Harris AHS, Kuo AC, Bozic KJ, Lau E, Bowe T, Gupta S, Giori, NG (2018). American Joint Replacement Registry Risk Calculator Does Not Predict 90-day Mortality in Veterans Undergoing Total Joint Replacement. Clinical Orthopaedics & Related Research. Sept; 476(9): 1869-1875.

(3) Harris, AHS, Kuo, A, Nordin, D, Bowe, T, Gupta, S, Giori, NG (2018). Prediction Models for 30-Day Mortality and Complications Following Total Knee and Hip Arthroplasty for Veteran Health Administration Patients with Osteoarthritis. Journal of Arthroplasty, 33(5), 1539-1545.


External Links for this Project

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PUBLICATIONS:

None at this time.


DRA: Mental, Cognitive and Behavioral Disorders, Aging, Older Veterans' Health and Care
DRE: none
Keywords: Capacity Building
MeSH Terms: none

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