Peter Rudd, MD

Clinical Focus

• Internal Medicine
• Hypertension

Administrative Appointments

• Member, SHC Quality Improvement and Patient Safety Committee (2003 - 2008)
• Chair, Clinical Science Affinity Group; School of Medicine Curricular Reform Project (2002 - 2003)
• Senator-At Large, Stanford University School of Medicine Faculty Senate (2002 - 2005)
• Member, Stanford Hospital & Clinics Care Review Committee (1998 - 2008)
• Director, Department of Medicine Quality Assurance and Quality Improvement Programs (1998 - 2008)

Honors and Awards

• Phi Beta Kappa, Amherst College (1966)
• Diplomate, National Board of Medical Examiners (1971)
• Diplomate, American Board of Internal Medicine (1975)
• Fellowship, W.K. Kellogg Foundation; Hospital Research and Education Trust (1977)
• Fellowship, Andrew W. Mellon Foundation (1977-81)

Professional Education

Graduate & Fellowship Program Affiliations

• Health Services Research

Internet Links

• Personal Web site

Industry Relationships

Stanford is committed to ethical and transparent interactions with our industrial and other commercial partners. It is our policy to disclose payments (exclusive of travel support) from, and/or equity in, companies or other commercial entities to Stanford faculty of $5,000 or more in total value, as well as any equity in a privately held company, when the faculty member also has institutional responsibilities related to his or her interactions with the company. View Full Information

Current Research Interests

Quality improvement (QI) efforts seek to make medical care the “best it can be” rather than merely “good enough” to avoid censure. Focus on improving the average performance usually produces more net benefit than eliminating outliers, often by simplification, standardization, and specification. We have worked with electronic medication monitors, clinical databases, and computerized physician order entry systems for better clinical outcomes. We have also developed training modules for students, house officers, and clinicians for enhanced professionalism and accountability.
Recent work has emphasized optimizing among cost, quality and access, using examples of common internal medicine problems (e.g., community acquired pneumonia, diabetes mellitus, blood product transfusion). QI project teams arose in both inpatient and outpatient settings. The optimal results occur from combining didactic training and practical applications via projects with plan-do-study-act rapid cycles of change. We have also examined the relative impact of patient versus physician behaviors as well as system factors in determining clinical outcomes for control of elevated cholesterol.
In prior work, we explored medication adherence. Medication-taking represents a complex behavior integral to optimal outcomes in much of ambulatory medical care. We have helped develop and test electronic medication monitors capable of dynamic tracking of medication dispensing events over time. The technology offers a time-based matrix by which to interpret, understand, and improve clinical outcomes that depend on patients' medication-taking behavior.
Using the electronic monitor technology, we have studied
a) Normative patterns of medication-taking among subgroups of patients on chronic cardiovascular medications
b) Dose-response relationships among established and investigational antihypertensive medications for misinterpretations of optimal dosing recommendations
c) Critical evaluation of reported adverse drug reactions, based on dosing errors that involve omission, commission, or misscheduling
d) Clinical protocols useful for assessing apparent secondary resistance to treatment after initial clinical responsiveness
e) Cost-effectiveness of the incremental information about precise medication-taking events, patterns, and distortions.

Publications

• How personal is the personal health record?: comment on "the digital divide in adoption and use of a personal health record". Rudd P, Frei T. Arch Intern Med. 2011; 171 (6): 575-6
• Placebo adherence and its association with morbidity and mortality in the studies of left ventricular dysfunction Avins AL, Pressman A, Ackerson L, Rudd P, Neuhaus J, Vittinghoff E. J Gen Intern Med. 2010; 25 (12): 1275-81
• Diuretics were superior to calcium-channel blockers and short-term ACE inhibitors for reducing heart failure in hypertension. Rudd P, ACP J Club. 2007 Jan-Feb; 146 (1): 16
• Review: beta-blockers are less effective than other antihypertensive drugs for reducing risk for stroke in primary hypertension. Rudd P, ACP J Club. 2006 May-Jun; 144 (3): 67
• Review: Beta blockers are less effective than other antihypertensive drugs for reducing risk of stroke in primary hypertension. Rudd P, Evid Based Med. 2006; 11 (3): 85