Clinical and Translational Science
For more information about our Clinical and Translational Science programs, please reach out to Associate Vice-Chair for Clinical Science, Dr. Sean Mackey.
Researchers
Our laboratory's current transformative research efforts focus on studying immune health in the context of surgery and anesthesia. Our interest stems from previous work elucidating the modulation of inflammatory responses by anesthetic and analgesic drugs.
The aim of studying immunity in patients undergoing surgery is to identify immune phenotypes predictive of aversive postoperative outcomes including protracted recovery and infection. Our major working hypotheses are that 1) specific immune phenotypes will predict the risk for developing postoperative complications, 2) immune phenotyping will lead to the discovery of mechanisms aggravating or alleviating such risk, and 3) gained knowledge will allow devising immune-modulatory strategies mitigating such risk. Mass cytometry (CyTOF), proteomics, and functional ex-vivo immune assays are the major molecular tools for the systems-based numerical and functional exploration of the circulating immune system.
The SPADE tree depicts the immune architecture in blood of a patient undergoing hip surgery. SPADE is an unsupervised clustering algorithm that distills multidimensional single cell data (mass cytometry; CyTOF) down to interconnected clusters on the basis of cell surface markers. The approach conveys the relationship between cell clusters as each node of cells is connected to its phenotypically most similar node and enables identification of known as well as unexpected cell types. A) White frames depict specific immune cell compartments. The tree is colored for expression of the cell surface marker CD4. The color scale indicates the median intensity of the CD4+ T cell signal for each cell node. The size of a node indicates relative cell frequency. B) The tree is colored to reflect signal intensity (phosphorylation) of the transcription factor STAT3 for each cell node before and 1h, 24h, 72h, and 4 wks after surgery. Activation of STAT 3 was highly structured as it followed a specific temporal pattern in distinct cell subsets. Figure courtesy of Dr. Brice Gaudilliere.
Dr. Bateman’s scholarship focuses on the study of medication safety in pregnancy and on predictors and management of maternal morbidity. To address questions in these areas, Dr. Bateman and collaborators at Harvard helped pioneer the use of advanced epidemiological techniques applied to large, routinely collected healthcare utilization data. This research has been funded by multiple R01 grants from the NIH and by grants from the FDA and has been published in leading clinical journals including JAMA, NEJM, BMJ, Lancet, Annals of Internal Medicine, JAMA Pediatrics, JAMA Psychiatry, and Obstetrics and Gynecology. Dr. Bateman’s bibliography contains over 200 publications. This research is frequently cited in clinical reviews and guidelines and has prompted both the FDA and EMA to make labelling changes to medications regarding use in pregnancy. Dr. Bateman is also a founding member of the International Pregnancy Safety Study Consortium (InPress) which is a collaborative effort between investigators from the US and each of the five Nordic countries to pool data for studies evaluating the safety of medications.
As the Director of Psychology Services for the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University Medical Center, I treat the psychological problems of children with complex pain problems. I also conduct clinical research to improve patient care in this area. For example, my team is using the newly developed Health Registry database called Peds-CHOIR (Pediatric Collaborative Health Outcomes Information Registry). Peds-CHOIR is a novel, open-source outcome-tracking learning health system (LHS) that allows us to collect the data we need to make decisions about the best treatments for children who experience chronic pain. Until now, a way to collect and analyze this data has been lacking. Specific clinical research goals under study are: understand variables to help optimize patient and clinician resources, learn how a LHS helps actively engage patient and caregivers in treatment, track longitudinal outcomes, understand the predictors of persistent pain into adulthood, and describe the phenotype of patients that tend to be responders versus non responders to treatment so that early interventions can improve treatment efficacy.
I am also the director of the Pediatric Pain Psychology Fellowship Program and, in collaboration with others around the country, am developing the educational curriculum for pediatric pain psychology fellowship training. Recently published commentary in the Pediatric Pain Letter details efforts to formalize the training process.
I am currently interested in hematological and hemostatic changes in pregnancy which are relevant to obstetric anesthetic practice.There are important hematological changes that occur in the peripartum period,and I am interested in the mechanisms by which anesthetic interventions affect these hematological changes with concomitant effects on maternal outcomes. We are also investigating the use of point-of-care systems (such as thromboelastography) to assess coagulation and hemostatic changes in the peri and postpartum period. Previous research has included: the assessment of hypothermia and shivering in patients undergoing Cesarean delivery; the effect of fluid preloading on coagulation; assessments of anesthetic interventions for patients undergoing vaginal twin delivery.
Dr. Caruso is a pediatric anesthesiologist and medical educator whose research focuses on the intersection of immersive technologies and healthcare. He is a co-founder and co-Director of the Stanford Chariot Program at Lucile Packard Children's Hospital. Utilizing tools such as virtual reality, augmented reality, and mixed reality, the Chariot Program improves anxiety, reduces pain perception, optimizes rehabilitation, and enhances patient and provider education
- I am a pediatric cardiac anesthesiologist, clinical researcher, and empirical bioethics researcher at Lucile Packard Children's Hospital and Stanford University. My focus is on improving the lives of infants, children, and adults with complex congenital cardiac disease and supporting the well-being of their caregivers and families. My research also focuses on identifying and addressing ethical concerns arising with implementation of next generation technologies to bedside clinical care for all patients, including genomic testing, artificial intelligence/machine learning, and mechanical circulatory support.
- Stanford Profile
- Lab Website
Dr. Chu’s research focuses on 3 main areas: mechanisms of physiologic adaptations to chronic opioid exposure, innovation in medical education, and a recent new focus on patient-centered innovation in clinical research and quality improvement.
Mechanisms of physiologic adaptations to chronic opioid exposure
Opioids are the cornerstone medication for the treatment of moderate to severe pain. Analgesic tolerance, physical dependence and opioid-induced hyperalgesia are known sequelae of chronic opioid exposure that may complicate the use of opioid analgesic drugs for the treatment of chronic painful conditions.
Dr. Chu’s work in this area spans nearly 10 years and has resulted in numerous publications that have examined changes in pain sensitivity and the central nervous system in humans associated with chronic opioid exposure. Dr. Chu’s work has been supported by RO1 and KO2 research grants from the National Institutes of Health. His most recent publication in this field is:
Lin JC, Chu LF, Stringer EA, Baker KS, Sayyid ZN, Sun J, Campbell KA, Younger JW. One month of oral morphine decreases gray matter volume in the right amygdala of individuals with low back pain: confirmation of previously reported Magnetic Resonance Imaging results. Pain Medicine, 2015 Dec 26; 0: 1-8.
Dr. Chu was the senior author of this paper, in which decreased gray matter volume was observed in several reward- and pain-related regions in the morphine group, including the bilateral amygdala, left inferior orbitofrontal cortex, and bilateral pre-supplementary motor areas.
Innovation in Medical Education
As founder and Director of the Stanford Anesthesia Informatics and Media lab, Dr. Chu has an international reputation as a leader in medical education innovation. He has conducted seminal work in understanding the unique learning needs of millennial postgraduate anesthesiology learners and used this knowledge to create blended and online learning for anesthesiology residents. Dr. Chu’s educational programs (START, STARTprep, and Learnly) are used by 40% of all anesthesiology residents in the United States and many more around the globe.
Dr. Chu also conducted seminal design work in co-creating the Stanford Emergency Manual, which is a book of emergency aid checklists used by anesthesiologists worldwide. Dr. Chu developed a productive collaboration with Stanford computer scientists to scientifically study the role of design in effective use and implementation of dynamic computer-generated emergency aids. Dr. Chu also founded and directs the world’s most-discussed academic conference on the future of medical education: Medicine X | ED. Dr. Chu’s scholarship in medical education has been published in leading medical journals. One of his many publications in this field is:
Lighthall G, Harrison TK, Chu LF. Laryngeal Mask Airway in Medical Emergencies. New England Journal of Medicine.2013; 369 (20)
Dr. Chu was the senior author of this paper, which demonstrates the use of mask airways for the ventilation of patients in cardiac arrest using both video and text.
Patient-centered Research in Clinical Research and Quality Improvement
In 2011, Dr. Chu founded Stanford Medicine X, the world’s most-discussed academic medical conference. This conference, now a year-round academic program at Stanford, focuses on innovation in medicine at the intersection of emerging technologies and patient-centered care.
Dr. Chu has an international reputation as a health care innovator and is frequently invited to give talks on the role of emerging technology, precision medicine, and patient-centered care at medical conferences worldwide. The Stanford Medicine X conference reaches over 5,500,000 individuals in 60 countries around the world. This global community closely follows the innovative work and Everyone Included™ co-creation and leadership models for working with patients that Dr. Chu has established through his groundbreaking work at Medicine X. Dr. Chu received an R13 grant from the Agency for Healthcare Research Quality to establish Medicine X at Stanford. Under his leadership, the program has developed scholarship in engaging and bringing patients into academic medicine to help improve clinical research and quality. In recognition of Dr. Chu’s international stature in this new field, he was recently appointed to the editorial board of The BMJ. Furthermore, his most recent article in this field has been accepted at The BMJ:
Everyone Included: moving beyond patients included. Chu LF, Utengen A, Kadry B, Kucharski SE, Campos H, Crockett J, Dawson N, Clauson K. Provisional acceptance, submission in revision. The British Medical Journal; 2016.
Here, Dr. Chu describes the importance of patient involvement in academic medical conferences and how meaningful participation from everyone will be required in order to improve the health care industry. The Everyone Included model, developed by Dr. Chu, is increasingly influencing policy and academic medicine. For example, 3 of President Obama’s Precision Medicine Initiative patient research design principles derived directly from Stanford Medicine X and Dr. Chu’s Everyone Included co-creation principles.
My body of scientific work is dedicated to elucidating the primary influence of psychological factors on the experience of pain; specifically targeting psychological factors (pain catastrophizing) as a pathway to reduce pain, improve response to medical treatment (including surgery), and reduce reliance on prescription opioids; and addressing unmet needs for pain psychology services in the U.S. I have a specific interest in integrating pain psychology and pain catastrophizing interventions into the perioperative setting to enhance recovery after surgery. I secured roughly $5.2M in research funding in 2015.
Current NIH Grants
- Co-PI on an NIH R01 from NCCIH focusing on mechanisms of catastrophizing, and a comparative effectiveness trial of a targeted single session class that treats pain catastrophizing (see Darnall BD, et al 2014 J Pain Res). Co-PI Dr. Sean Mackey; 2015-2020.
- I am the Stanford Site-PI for a multisite R01 that is investigating the intergenerational transmission of pain in at-risk children of mothers with chronic pain. Overall PI Dr. Anna Wilson, OHSU; 2015-2020.
- I am Co-Investigator for a program project center grant (P01 AT006651; PD is Dr. Sean Mackey), the Stanford Center for Back Pain, which is studying cognition and emotion regulation, and the distinct and shared mechanisms of 3 evidence-based treatments (MBSR, CBT, and acupuncture) in chronic pain.
- I am Co-Investigator for a study of Sex/Gender-Specific Brain Risks for Prescription Opioids in Chronic Low Back Pain (PI: Dr. Sean Mackey).
Current Stanford Grants
- Spectrum-Stanford Health Care Innovation Challenge Grant
I am Co-I for this project in which we are integrating the Collaborative Health Outcomes Information Registry (CHOIR) into the Perioperative Clinic at Stanford. We are studying my pain psychology video intervention for catastrophizing as a demonstration project of the clinical utility of CHOIR as a platform to improve surgical outcomes. PI: Sean Mackey, MD, PhD; 2016. - Stanford Faculty Innovation Award (2015 2016)
I am Co-I for this project in which we are phenotyping patients at-risk for low patient satisfaction prior to their initial visit to the pain clinic and implementing a targeted, coordinated care model to optimize patient satisfaction. PI: Dr. Ming-Chih Kao.
Perioperative Research
In addition to the Spectrum-Stanford Health Care Innovation Grant (above), we are conducting a pilot RCT study of an internet-based perioperative pain psychology/ catastrophizing treatment I developed. We are examining effects on catastrophizing, post-surgical pain and function in multiple surgical groups at Stanford University, including women undergoing surgery for breast cancer.
My research focuses on the pharmacokinetic and pharmacodynamic (PKPD) evaluation of commonly used sedatives and anesthetics, as well as in the PKPD and mathematical foundations of closed-loop control of anesthesia using EEG-derivative indices as the controlled variables. In particular, I am interested in identifying disease-related or other patient phenotypes, which are associated with alterations in the clinical pharmacology of anesthetics and could affect perioperative outcomes. Currently, I study the effect of sleep-disordered (SDB) breathing on pain processing before and after the administration of opioids in patients suffering from SDB and in healthy volunteers. Also, in the same area of research we investigate the effect of obstructive sleep apnea on postoperative neurobehavioral and medical outcomes in patients undergoing bariatric surgery. In particular, we are interested in identifying metabolic and genetic markers for suboptimum neurobehavioral outcomes and correlate those with the severity of nocturnal hypoxia in this patient population. In collaboration with the Department of Computer Science in Texas Tech University we develop a new system to control anesthesia using the bispectrum of the EEG (BIS) as the controlled variable. This control strategy is based on a method of unsupervised learning called reinforcement learning (RL) and has already demonstrated an excellent performance in simulation studies. The application of RL-based anesthetic control in human subjects is upcoming.
My research interest is in clinical research on the pharmacokinetics and pharmacodynamics of drugs. Medications studied are those commonly used for anesthesia and analgesia. Additionally, other drugs are studied if they have unique characteristics that require intensive or specialized monitoring. Particular effort is used to obtain quality real-time data from intensive pharmacokinetic - pharmacodynamic studies to enable mathematical modeling of drug effect on the human body. Mathematical modeling of data is mainly performed with NONMEMâ. Where possible, research projects use the electroencephalogram to quantitate pharmacodynamic effect and develop mathematical models to relate pharmacokinetics to pharmacodynamic response. The main interest of my research projects is to develop novel ways to model and describe clinical pharmacology relationships.
My research is focused on the relationship between pain, mental health, and addiction. Specifically, my interests include identification of psychological risk factors for persistent opioid use and pain after surgery, and development of novel interventions to reduce the incidence of persistent postoperative opioid use. I have a particular focus on preoperative psychological optimization, and my current NIH-funded work, the Mood And Perioperative Pain (MAP-Pain) Study involves preoperative psychological screening and postoperative extended longitudinal follow-up. I have conducted numerous clinical trials to reduce the burden of persistent postoperative pain and opioid cessation. Additional research interests include the use of neuromodulation, both invasive and non-invasive, to treat chronic pain conditions. As director of the Stanford Pelvic Pain Program, I am particularly interested in interventions to treat chronic pelvic pain conditions including pudendal neuralgia, vulvodynia, endometriosis, and interstitial cystitis. As co-chair of the U.S. section of the World Academy of Pain Medicine Ultrasonography, I am also interested advancing the evidence-base for ultrasound-guided interventions to treat chronic pain conditions.
Dr. Heifets directs both clinical and basic neuroscience research programs. His work bridges neuroscience, psychiatry and anesthesiology in pursuit of highly effective, safe and scalable treatment strategies for psychiatric disease. The nexus of these fields, and the focus of his research group, is the emerging class of rapid-acting psychiatric therapies, like ketamine, MDMA and psilocybin, which can trigger profound and lasting changes in nervous system function, behavior, and therapeutic outcomes. Through parallel human and animal experiments, his group is deconstructing the neural mechanisms responsible for these compounds’ neuroplastic potential, and working to develop more precise therapeutic strategies. Major projects in his research group include:
- 1) defining the neural circuitry responsible for MDMA’s prosocial therapeutic effects using brain-wide activity mapping and mouse behavioral models
- 2) unraveling the effect of “set and setting” for psychedelics and MDMA through brain imaging and behavioral analysis
- 3) using anesthetic drugs and induction of dream states to test the relationship between psychedelic experiences and therapeutic outcomes
- 4) testing new indications for psilocybin and MDMA, including a trial of psilocybin therapy for chronic low back pain, and MDMA for OCD, in close partnership with investigators at Stanford, UCSF and UC Berkeley.
Our research group collaborates extensively with investigators at Stanford in the departments of Anesthesiology, Perioperative and Pain Medicine; Psychiatry and Behavioral Sciences; and Radiology, and with research groups at UCSF, UC Berkeley and UC Irvine.
Dr. Macario is interested in the economics of health care, in particular the tradeoffs between costs and outcomes for patients having surgery and anesthesia. He has completed internationally recognized studies on the management of the operating room suite, as well as pioneering work on the cost-effectiveness of drugs and devices. He is Founder and Director of a Postgraduate Fellowship for physicians interested in applying quantitative tools to solve health services research questions. More recently, as Program Director for the anesthesia residency he is interested in education, core competencies of physicians in training, and innovations for clinical training.
Pain is the primary complaint resulting in physician visits and health care resource utilization. The importance of pain as a major worldwide health care problem has been recognized by the World Health Organization, and the need for further research into its mechanisms and control was recognized by the U.S. Congress in its declaration of the years 2001-2010 as the Decade of Pain Control and Research.
The presence of pain and its inadequate treatment in a variety of clinical settings has significant societal impact. Pain contributes to the overall economic burden of disease through increased direct medical costs caused by additional health care resource utilization. It has been estimated that in the United States the cost of health care, compensation, and litigation resulting from pain is more than $200 billion annually.
Historically, pain has been considered in relation to its etiologic or disease factors, such as the relationship between surgery and postoperative pain, herpes zoster and postherpetic neuralgia, and arthritis and painful joints. This has had the effect of addressing pain as a symptom of disease, and although much progress has been made in understanding the molecular and cellular mechanisms of disease, the resulting pain has not necessarily been alleviated. What is required, and has been missing from the evaluation, is an understanding of the underlying mechanisms responsible for the pain itself.
Dr. Mackey has focused his efforts on elucidating and characterizing these underlying mechanisms of pain. In particular, he has focused his efforts on characterizing the mechanisms of pain from the level of the network to behavior. He uses a systems neuroscience approach, which includes the integration of advanced neurobehavioral, psychophysical and neuroimaging techniques.
Some current research projects and themes
- Real-Time Brain Control for Pain
Attaining control over specific neural processes is the primary goal of neuropharmacology and neurostimulation; it is also a critical objective of biological psychiatry and psychology. Training people to be able to modulate specific neural processes has the potential to enable them to have greater control over the resulting behavior, cognition, or associated disease. Recently Dr. Mackey's lab has demonstrated that patients with chronic pain can learn to control a specific region of their brain – the rostral anterior cingulate cortex (rACC) – that is associated with pain processing and perception (PNAS, December 2005, 102:51; 18626-31). Importantly, they found in that study that the increased control in localized brain activity was associated with improvement in pain control. They are expanding this work to: (1) investigate learned control of specific brain networks, (2) determine the optimal brain regions for learned control, (3) characterize the long term effects of this unique methodology and (4) apply it to other neuroscience fields such as depression, addiction and cognitive development. This exciting and unique multidisciplinary collaboration brings together expertise from the fields of Pain, Radiology, Psychology, and Electrical Engineering. Stanford is currently the only institution in the world where this work is occurring. - Neuroimaging of the human spinal cord, brainstem and brain and characterization of reward systems, affective dimensions of pain and neural plasticity of pain.
- Personalized Pain Medicine
The last decade has seen a significant increase in the number and type of pharmacologic therapies for the treatment of chronic pain. Frustratingly, each medication produces pain relief for only a minority (typically 30%) of patients. Not surprisingly, few physicians have the patience required to persist in a strategy involving months of frustrating side-effect laden medication trials until the correct one is found. A method to identify which individual patient with a particular chronic pain problem will respond to a specific drug is needed. Dr. Mackey's team has put together a multidisciplinary team of researchers and clinicians to achieve this goal. They have been developing and using techniques such as: (1) pharmacologic fMRI to elucidate central neural correlates of drug response and side effects, (2) sophisticated pharmacokinetic/pharmacodynamic drug models to characterize individual drug concentrations and effects, (4) novel neurobehavioral and psychophysical measurements to precisely characterize the perceptual aspects of the pain experience, (5) genomics to characterize candidate gene polymorphisms responsible for individual differences in pain perception and analgesic efficacy and (6) novel epidemiologic and statistical methods to develop multivariate models which ultimately predict individual drug responsiveness.
The obstetric anesthesia research group addresses a wide variety of questions related to the field. Two areas are currently our major focus:
- The use of spinal opioids for epidural and spinal anesthesia and analgesia.
- Spinal anesthesia for cesarean delivery.
In addition, we have done research on the economics of obstetric anesthesia, patient perception of risk, experimental pain, and the use of nitroglycerin for preterm labor and external cephalic version.
We have a large number of faculty involved in research and generally have 1 or 2 post-doctoral fellows conducting clinical studies. We have successfully helped undergraduate students, medical students, and residents complete research projects. Our fellows come from our own residency program as well as other academic institutions, and we have provided research opportunities for several foreign scholars. Our past fellows have gone on to academic careers or been very successful in private practice.
One of the strengths of our group is our ability to collaborate with a variety of people in the institution. We have conducted projects in the past with Drs. Alex Macario (economics), Yasser El Sayed (Fetal-Maternal Medicine), David Drover (pharmacokinetics and statistics), and Martin Angst (experiment pain). In the future we hope to collaborate with Dr. David Yeoman's experimental pain laboratory. Regular interaction among the members of the group is the key to the success of our active group. This is facilitated by monthly research meetings and journal clubs. We have also developed a formalized mentoring program. Dr. Riley, the Section Chief, directs the research program and, along with Dr. Sheila Cohen, (previous section chief and an experienced clinical researcher) meets regularly with the junior members of the team to discuss research and other issues.
The obstetric anesthesia research group addresses a wide variety of questions related to the field. Two areas are currently our major focus:
- The use of spinal opioids for epidural and spinal anesthesia and analgesia.
- Spinal anesthesia for cesarean delivery.
In addition, we have done research on the economics of obstetric anesthesia, patient perception of risk, experimental pain, and the use of nitroglycerin for preterm labor and external cephalic version.
We have a large number of faculty involved in research and generally have 1 or 2 post-doctoral fellows conducting clinical studies. We have successfully helped undergraduate students, medical students, and residents complete research projects. Our fellows come from our own residency program as well as other academic institutions, and we have provided research opportunities for several foreign scholars. Our past fellows have gone on to academic careers or been very successful in private practice.
One of the strengths of our group is our ability to collaborate with a variety of people in the institution. We have conducted projects in the past with Drs. Alex Macario (economics), Yasser El Sayed (Fetal-Maternal Medicine), David Drover (pharmacokinetics and statistics), and Martin Angst (experiment pain). In the future we hope to collaborate with Dr. David Yeoman's experimental pain laboratory. Regular interaction among the members of the group is the key to the success of our active group. This is facilitated by monthly research meetings and journal clubs. We have also developed a formalized mentoring program. Dr. Riley, the Section Chief, directs the research program and, along with Dr. Sheila Cohen, (previous section chief and an experienced clinical researcher) meets regularly with the junior members of the team to discuss research and other issues.
The focus of my clinical trials unit includes Phase II-III pharmaceutical and device trials in therapeutic areas such as high-risk cardiac surgery, septic shock, ARDS, anticoagulation, complicated infections, and a variety of infectious diseases. Currently, we have 5 clinical trials recruiting:
- Toramycin hemoperfusion in adults treated for endotoxemia & severe septic shock.
- Efficacy, immunogenicity and safety of a Clostridium Difficile vaccine for high-risk C.Diff naive adults.
- Levosimendan versus placebo in patients with left ventricular dysfunction at risk for low cardiac output following CABG, mitral valve repair/replacement or a combination of CABG and valve surgeries.
- Safety, efficacy and tolerability of Human Recombinant Alkaline Phosphatase in the treatment of patients with sepsis-associated Acute Kidney Injury.
- The pharmacokinetics, safety and antiviral activity of JNJ-63623872 in combination with Oseltamivir in adults hospitalized with Influenza A Infection.
I have just completed recruitment for a Multicenter Morphine Pharmacogenetic study. Prior to that, I completed a project on anesthesia machine preparation using activated charcoal filters for patients susceptible for malignant hyperthermia.
Current Projects
- An Innovation Testing Strategy for Early Lung disease Surveillance in Cystic Fibrosis (CF) Infants – co-investigator
- A Phase 3, Randomized, Double-blind, Sham-Procedure Controlled Study to Assess the Clinical Efficacy and Safety of ISIS 396443 Administered Intrathecally in Patients with Later-onset Spinal Muscular Atrophy – unblinded study coordinator
- Simulation study evaluating team performance on technical and nontechnical aspects - coordinating with Vanderbilt University
Faculty in the Division of Regional Anesthesia at Stanford have research interests encompassing a variety of topics related to regional anesthesiology and acute pain medicine, including:
- Point-of-Care Ultrasound (POCUS)
- Development of new techniques
- Advances in catheter technology
- Applications of regional anesthesia beyond the perioperative period
- Personalization of acute pain medicine
- Development and implementation of patient care pathways
- Multimodal, opioid-sparing pain relief
- Enhanced Recovery After Surgery (ERAS)
- Outcomes and comparative-effectiveness research
- Simulation and education in regional anesthesia
We have a number of ongoing projects involving faculty, fellows, residents, and medical students. Our group has a full-time research assistant dedicated to the execution of high-quality studies. We collaborate with other institutional departments, including the surgical subspecialties, as well as with other anesthesiology departments across the country. The diversity of interests in our core research team ensures that every trainee has the opportunity to pursue a project that aligns with his or her individual goals.
Our Team
Jean-Louis Horn, MD, Edward R. Mariano, MD, MAS, Ban Tsui, MD, Sarah J. Madison, MD, Jan Boublik, MD, PhD, T. Edward Kim, MD, Ryan Derby, MD, Toni Ganaway, BA, Steven K. Howard, MD, T. Kyle Harrison, MD, Cynthia Shum, DNP, MEd, RN, CHSE-A
Laura Simons leads the Biobehavioral Pediatric Pain Lab. The primary goal of this laboratory is to promote the health and well-being of children and adolescents with chronic pain and their families. In line with this goal, research projects focus on biological, neurological, cognitive, affective, and social risk and resiliency factors of the pain experience. Projects include brain imaging, longitudinal clinical cohort, and treatment interventions studies.
The Stanford Chariot Program is a blended clinical and research program that leverages immersive technology to supplement healthcare, with an attention towards pediatric care. Using a mix of customized, novel software and commercially available software, we seek to improve patient care delivery in systems within Lucile Packard children's hospital and dozens of other hospitals around the country and abroad.
At Stanford, I have been involved with Resident Education not only in terms of direct supervision, but by initiating and working on several educational projects (spinal anesthesia teaching module, keyword of the day, using iPads as a teaching tool in the orthopedic rotation, clinical base year rotation, libero lecture program and a feedback tool). My areas of interest in Medical Education are: Developing, leading and evaluating programs; Designing curricula and assessing learners; and Designing, implementing and studying innovations.