Ira Leeds, MD, FACS, FASCRS
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About
Research
Overview
The overarching context of my research focuses on preoperative decision making between surgeons and patients with the intent to identify where the inputs and outputs of these decisions do not readily align with patient, surgeon, and societal goals.
The publications below demonstrate a consistent record of surgeons and patients having difficulty at the time of decision-making being able to simultaneously assess the individualized risk factors for worse postoperative outcomes for a given patient and a specific disease. Our hypothesis is that there is too much signal noise in patient's histories and clinical data combined with a distracting clinical atmosphere that impairs effective shared decision-making.
Other publications below describe various interventions employed (data visualization schemes, clinical decision support tools, rapid psychosocial assessment techniques) to either improve the inputs needed for high quality decision-making (i.e., enhanced information assessment and organization) or facilitate the outputs of decision-making (i.e., clinical decision support to align available data with intended outcome).
The importance of effective decision-making has been routinely demonstrated for high-complication diseases such as colorectal cancer and inflammatory bowel disease. The premise of many of our proposed interventions emphasizes addressing decision points in highly morbid diseases in patients who are also high-risk due to comorbidities or low physiologic reserve (i.e., frailty).
Finally, we test our interventions using a variety of cost-effectiveness models such as decision analysis decision trees and Markov model simulations to ascertain whether the interventions and decisions being made meet conventional means test for overall benefit to society and population health.
Medical Subject Headings (MeSH)
Academic Achievements and Community Involvement
Clinical Care
Overview
Ira Leeds, MD, is a colorectal surgeon who says he listens to, counsels, and treats every patient he meets with the same expectations he would have for someone caring for a member of his own family.
He treats conditions of the small bowel, the colon, rectum, and anus, including colon and rectal cancer, inflammatory bowel disease (Crohn’s and ulcerative colitis), anorectal disease, hemorrhoids, and fissures.
Dr. Leeds’s clinical and research interests include figuring out how to help patients make difficult decisions when there is no easy “textbook” answer.
“I particularly enjoy helping patients work through difficult re-operative decision-making and determining the best surgical approach whether that be endoscopic, open, laparoscopic, or robotic surgery,” he says. “My research directly informs my practice where we identify risk factors associated with surgical outcomes and attempt to optimize those risks preoperatively to improve postoperative recovery.”
Dr. Leeds says he also appreciates the breadth of colorectal surgery. “It’s big, hefty cases that can be high risk, but high reward for appropriately selected patients,” he says. “But it’s also small, everyday cases that may take a small amount of time for a surgeon but dramatically improve a patient’s quality of life, and not just abstract clinical goals.”
With many of his patients, particularly those with inflammatory bowel disease and rectal cancer, Dr. Leeds says he relies on shared decision-making with his patients.
“Pelvic anatomy is one of the few areas of the body where both surgical approaches and function require a true three-dimensional awareness and understanding,” he says. “And there are heavyweight unanswered questions that remain, including best timing of surgery for inflammatory bowel disease, risks of rectal cancer surgery versus increasingly promising nonsurgical options, and preventative screening needs in anal cancer.”
The best part of his job, Dr. Leeds says, is meeting new people and working with an amazing team. “When my clinical day isn’t busy, an inspiring mountain of research-related work remains to continue to push our knowledge sphere of how to best care for both common and rare colorectal disease,” he says.
Clinical Specialties
Fact Sheets
Diverticulitis
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Board Certifications
Colon and Rectal Surgery
- Certification Organization
- AB of Colon and Rectal Surgery
- Original Certification Date
- 2022
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Yale School of Medicine
Colorectal Surgery, PO Box 208062
New Haven, CT 06520-8062
United States
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