EPI and Health Outcomes
The following describes some of the ongoing research in the Division of Immunology and Rheumatology.
My research uses large longitudinal data banks of patients with chronic diseases, particularly rheumatic diseases, and senior individuals undergoing the aging process and related infirmities to perform studies of natural history of disease, toxicity of medications, identification of subsets of patients with special characteristics, prediction of high risk individuals, elaboration of treatment strategies, computation and the costs of care for chronic diseases, development of risk factor models for osteoarthritis and musculoskeletal aging, and other clinical epidemiologic subjects.
The central resource is ARAMIS (Arthritis Rheumatism and Aging Medical Information System) which involves 17 centers in the United States and Canada and has just been refunded by the National Institutes of Health for years 26-30. Fellows are trained for academic positions in rheumatology or clinical epidemiology.
Approximately 60 projects are underway at any given time and an excess of 900 peer reviewed publications have been published from the ARAMIS group of investigators. Related to the ARAMIS endeavors is the Post-Marketing Surveillance Program, which works with the AHCPR, the FDA, and industry to provide information on drug toxicities and drug benefits which were not well-documented or understood at the time of drug release. The studies employ pharmacoeconomic and pharmacoepidemiologic techniques.
Information science applications are pursued by a technical computer programming staff. The ARAMIS staff includes clinicians, epidemiologists, biostaticians, health economists, and health service researchers.
I am a clinical epidemiologist. My long-term goal is to develop ways and means of disease prevention in the context of rheumatic diseases. Currently, my core investigative areas are:
- Cardiovascular impact of inflammatory arthritis
- Healthcare utilization of populations
- Methodological innovations for improvement of individual and population phenotyping and health outcome measurement
- Health outcomes in extreme old age
Research interests include epidemiologic studies, translational studies and clinical trials on connective tissue diseases, including systemic sclerosis (SSc), dermatomyositis/polymyositis, and systemic lupus erythematosus.
In particular, my research focuses on the cutaneous and pulmonary features of these diseases. Clinical trials include investigations of novel therapeutic agents for the treatment of Raynaudís phenomenon, cutaneous sclerosis in SSc, interstitial lung disease in SSc, digital ulcers in SSc, pulmonary arterial hypertension in SSc, and inflammatory myopathies.