Research & Publications
I conduct research focusing on the process of care and outcomes related to HIV infection, including the effects of aging, medical treatment and adherence, provider characteristics, and psychiatric comorbid illness. I am currently Director of Biostatistics for: 1) Veterans Aging Cohort Study (VACS; www.vacohort.org) an NIAAA funded multi-site prospective cohort study examining the role of alcohol use and abuse in determining outcomes among veterans aging with HIV infection and comparing this role to age-race-site matched HIV negative veterans, and 2) the VHA funded Pain Research, Informatics, Medical comorbidities and Education study (PRIME), a project to promote access, continuity, and sustainability of safe and effective interventions for pain and pain-related disability for veterans.
Specialized Terms: HIV; Psychiatric comorbidity; Substance abuse disorders; Clustering algorithms; Longitudinal statistical models
Extensive Research Description
I am the Director of the Methodology and Biostatistics core of the VA’s Pain Research, Informatics, Multi-morbidities, and Education (PRIME) HSR&D Center of Innovation, and PI of VA funded administrative data-based studies including the Musculoskeletal Diagnoses Cohort: Examining Pain and Pain Care in the VA. My research interests focus on the impact of mental health disorders on the course of care and outcomes for Veterans with comorbid medical conditions. I have extensive experience applying advanced statistical methods to answer health services related questions using VA administrative and clinical data sources. My statistical interests are in longitudinal analysis, latent-class models, and clustering algorithms. I have been involved in the design and conduct of several large-scale cohort studies of Veterans using VA data sources supplemented by patient surveys on topics including Complementary Health, HIV, women Veteran’s health, and musculoskeletal disorders. Projects that I lead or am co-investigator on include: the Musculoskeletal Disorders cohort which examines demographic, clinical, temporal, and geographic variation in pain and pain treatment; the Women Veterans Cohort Study, which seeks to identify factors associated with gender disparities in health care utilization and outcomes among OEF/OIF/OND Veterans in the VA system; and the Veterans Aging Cohort Study, a prospective, observational cohort study of HIV- positive and age/race/site matched control group of HIV- negative veterans in VA care. I will participate in Dr. Karras’ project as an expert in observational data analysis. My experience working with a diverse group of VA and affiliated researchers for nearly 20 years in the analysis of such data to answer health services and clinical questions makes me well suited to this role. I have contributed to the conceptual and empirical literature of relevance to the study. I will ensure that the research agenda is informed by the most relevant and up-to-date statistical methodology.
Algorithms; Mental Disorders; Health Services Research; Longitudinal Studies; Psychiatry; Statistics as Topic; Veterans; Comorbidity; Informatics; Biostatistics