Residents/Fellows Awards, Honors & Publications
Recent Honors, Awards, Appointments and Publications
(Listed by date)
Dr. Francys Verdial, General Surgery Chief Resident, published two articles: “Multidisciplinary Team–Based Management of Incidentally Detected Lung Nodules,” published in CHEST Journal, April 2020.
Over 1.5 million Americans are diagnosed with an incidentally detected lung nodule each year. While practice guidelines attempt to balance the benefit of early detection of lung cancer with the risks of diagnostic testing, adherence to these guidelines is low. Our research group sought to better understand lung nodule care delivery in the context of a multidisciplinary specialty clinic. Weasked, “What is the rate of guideline adherence in our multidisciplinary lung nodule clinic and when do we deviate from guidelines? Can our experience be used as a model for navigating complex care decisions?” We found that guideline–concordant care was recommended in approximately two–thirds of patients and that the most common reason for recommending guideline–discordant care was concern for two different diagnoses that would each benefit from early detection and treatment. Our data suggest that a multidisciplinary nodule clinic may serve as a system–level intervention to promote guideline–concordant care, while also providing a multidisciplinary basis by which to deviate from guidelines to address the needs of this heterogeneous patient population.
“Safety and Costs of Endobronchial Ultrasound–Guided Nodal Aspiration and Mediastinoscopy,” published in CHEST Journal, March 2020.
There remains debate over the best invasive diagnostic modality for evaluating mediastinal nodal pathology and stage lung cancer. We compared the risks and costs of endobronchial ultrasound (EBUS)–guided nodal aspiration and mediastinoscopy in a large national cohort. We found that, when performed as isolated procedures, EBUS is associated with lower risks and costs compared with mediastinoscopy. In this study, we focused on one side of the coin, risk and cost, to better understand how these procedures compare in these two important areas in the real world. Future studies comparing the effectiveness of EBUS versus ediastinoscopy in the community at large will help determine which procedure is superior or if trade–offs exist.
(February 2020) Dr. Dara Horn, Research Resident, published “Predictors of Mortality, Limb Loss, and Discharge Disposition at Admission Amongst Patients With Necrotizing Skin and Soft Tissue Infections” in the Journal of Trauma and Acute Care Surgery, published February, 24, 2020.
Using the Harborview Medical Center’s Necrotizing Skin and Soft Tissue (NSTI) registry, Dr. Horn sought to validate a number of previously identified predictors of mortality. In addition, because mortality in NSTI has declined over time, she also sought to identify risk factors for outcomes pertinent to patient quality of life, including limb loss and skilled nursing facility discharge. She found patient characteristics and comorbidities, laboratory data, and infection site and etiology were important indicators of adverse outcome. Of note, she demonstrated that patients with perineal NSTI had significantly lower odds of death compared to those without perineal involvement. She also found that among limb NSTI, patients who were transferred from another institution had significantly greater odds of amputation. She hopes this study will further inform triage and operative decisions and help guide future goals of care discussions.
(February 2020) Dr. John Monu, Division of General Surgery (R4), published "Evaluating Knowledge, Attitudes, and Beliefs About Lung Cancer Screening Using Crowdsourcing" in the Journal CHEST, published February 7, 2020.
Dr. Monu examines the multifaceted problem of underutilization of lung cancer screening. Lung cancer screening is recommended by the United States Preventive Services Task Force (USPSTF) for high-risk current and former smokers. Using an online crowdsourcing platform to recruit individuals eligible for lung cancer screening according to USPSTF criteria, Dr. Monu explores various factors to develop an understanding of how they contribute to low screening rates. This study assesses high-risk individuals’ knowledge, attitudes towards, and beliefs related to lung cancer screening. Dr. Monu found that a minority of individuals at high risk for lung cancer are aware of screening, however, the majority believe that early detection of cancer saves lives. Additionally, these individuals would pursue screening if it was recommended by their primary care physician. These findings suggest that patient and physician-facing interventions to increase knowledge pertaining to lung cancer screening, in combination with continued provision of smoking cessation information, may increase willingness to screen among individuals at high-risk for lung cancer.
Beyond Demographics: Missing Sociodemographics in Surgical Research
American Journal of Surgery | July 2019
Reporting sociodemographic data in research is critical to describe participants, and to identify contributing factors for patient experience, outcomes and heterogeneity of treatment effect (HTE). Social determinants of health and clinical health characteristics are important drivers of outcomes, and prospective studies collecting participant-reported data offer an opportunity to report these sociodemographics and evaluate for associations with outcomes. Clinical trials have underreported these factors previously, but reporting has not been examined in surgical research. MORE
(July 2019) Dr. Kirsten Concha-Moore, Division of Vascular Surgery (R1), was selected as one of the 2019 Patricia Numann Outstanding Medical Student Award recipients on behalf of the Association of Women Surgeons (AWS) and the AWS Foundation. This award is named in honor of the founder of AWS and established to encourage and support female medical students pursuing a career in surgery. Awardees are chosen based on their potential leadership qualities or research contributions to the field of surgery.
The award will be presented to Dr. Concha-Moore at the AWS Foundation Awards Dinner in October 2019 where individuals who have made a difference for women in surgery are celebrated.