Bio

Bio


Stanford Shoor is a Clinical Professor of Medicine and Rheumatology at Stanford University. He has conducted clinical research in Rheumatology and Internal Medicine and has more than 60 publications in medical journals but his emphasis is teaching and patient care. He is a key clinical faculty member in the Rheumatology Fellowship program and heads the Division?s programs in resident and medical student education. His special interests are sarcoidosis, evidence based medicine, patient self-care and practice improvement. He received the Department of Medicine division teaching award in 2012 and 2013 and has been honored as a Visiting Professor at Hiroshima University and the Muribushi Residency Program in Okinawa. He is proud of having received the ?Moving Mountains? award from the Martin Luther King Jr. Foundation of Santa Clara County. He majored in History at Stanford University and has an interest in foreign languages, especially Italian, French and Spanish. He owes his skills to his mother, who was his high school French teacher and his father, who was a physician, but his sanity to his wife and three sons.

Clinical Focus


  • Rheumatology
  • Gout, Sarcoidosis, Vasculitis, SLE, RA

Academic Appointments


Administrative Appointments


  • Director Residency Rotation & Medical Clerkship, Division of Rheumatology (2011 - Present)

Honors & Awards


  • "Moving Mountains Award", Martin Luther King Jr. Foundation Santa Clara County (2014)
  • Rheumatology Teaching Award, Dept of Medicine, Stanford University (2012, 2013)
  • Mentoring and Teaching Award, Biodesign Program Stanford University (2012)
  • Visiting Professor, Okinawa Muribushi Residency Hospitals (2015)
  • Visiting Professor, Hiroshima University Hospital (2012)

Boards, Advisory Committees, Professional Organizations


  • Member, American College of Rheumatology (1985 - Present)
  • Member, Medical & Scientific Committee Northern California Arthritis Foundation (2011 - Present)
  • Reviewer, Permanente Medical Journal (2015 - Present)

Professional Education


  • Residency:University of Washington (1982) WA
  • Board Certification: Rheumatology, American Board of Internal Medicine (1984)
  • Fellowship:Stanford University - Immunology/Rheumatology (1984) CA
  • Board Certification: Internal Medicine, American Board of Internal Medicine (1982)
  • Internship:University of Washington (1980) WA
  • Medical Education:Stanford University School of Medicine (1979) CA

Community and International Work


  • Arthritis Foundation Medical and Scientific Committee

    Location

    Bay Area

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

Research & Scholarship

Current Research and Scholarly Interests


Patient Centered Care in Rheumatic Disease
Sarcoidosis

Teaching

2015-16 Courses


Graduate and Fellowship Programs


  • Immunology/Rheumatology (Fellowship Program)

Publications

All Publications


  • Incidence and Prevalence of Juvenile Idiopathic Arthritis Among Children in a Managed Care Population, 1996-2009 JOURNAL OF RHEUMATOLOGY Harrold, L. R., Salman, C., Shoor, S., Curtis, J. R., Asgari, M. M., Gelfand, J. M., Wu, J. J., Herrinton, L. J. 2013; 40 (7): 1218-1225

    Abstract

    Few studies based in well-defined North American populations have examined the occurrence of juvenile idiopathic arthritis (JIA), and none has been based in an ethnically diverse population. We used computerized healthcare information from the Kaiser Permanente Northern California membership to validate JIA diagnoses and estimate the incidence and prevalence of the disease in this well-characterized population.We identified children aged ? 15 years with ? 1 relevant International Classification of Diseases, 9th edition, diagnosis code of 696.0, 714, or 720 in computerized clinical encounter data during 1996-2009. In a random sample, we then reviewed the medical records to confirm the diagnosis and diagnosis date and to identify the best-performing case-finding algorithms. Finally, we used the case-finding algorithms to estimate the incidence rate and point prevalence of JIA.A diagnosis of JIA was confirmed in 69% of individuals with at least 1 relevant code. Forty-five percent were newly diagnosed during the study period. The age- and sex-standardized incidence rate of JIA per 100,000 person-years was 11.9 (95% CI 10.9-12.9). It was 16.4 (95% CI 14.6-18.1) in girls and 7.7 (95% CI 6.5-8.9) in boys. The peak incidence rate occurred in children aged 11-15 years. The prevalence of JIA per 100,000 persons was 44.7 (95% CI 39.1-50.2) on December 31, 2009.The incidence rate of JIA observed in the Kaiser Permanente population, 1996-2009, was similar to that reported in Rochester, Minnesota, USA, but 2 to 3 times higher than Canadian estimates.

    View details for DOI 10.3899/jrheum.120661

    View details for Web of Science ID 000321993800028

    View details for PubMedID 23588938

  • Osteoarthritis, Exercise, and Knee Replacement JOURNAL OF RHEUMATOLOGY Fries, J. F., Bruce, B., Shoor, S. 2012; 39 (4): 669-671

    View details for DOI 10.3899/jrheum.111087

    View details for Web of Science ID 000302840800001

    View details for PubMedID 22467944

  • Proceedings of the European American Rheumatology Association Immunotherapy in Rheumatic Diseases - Science and Clinical Practice, February 25-28, 2009-Sonoma, CA, USA JOINT BONE SPINE Shoor, S., Liote, F. 2009; 76 (4): 433-434

    Abstract

    Evidence is often insufficient to answer questions in clinical practice. In an effort to fill these "gaps" between clinical investigation and daily conundrums, practicing rheumatologists use experience, logic, pathophysiology, individual patients and collegial consultation. In order to capture this science of clinical practice, a group of European and American clinicians and clinician investigators worked in investigative teams or Study Sections, each devoted to utilizing the science of clinical practice to address and critical clinical questions in Rheumatoid Arthritis, Imaging, Vasculitis and Gout that are inadequately answered by published evidence. Conclusions were summarized by a method of debate and discussion. It is anticipated that by defining uncertainty and using such an analytical and experiential method, rheumatologists can assist themselves in solving problems in their daily practice.

    View details for DOI 10.1016/j.jbspin.2009.05.002

    View details for Web of Science ID 000268468100025

    View details for PubMedID 19541524

  • Myocardial Infarction and Its Association with the Use of Nonselective NSAIDs: A Nested Case-Control and Time-to-Event Analysis. The Permanente journal Cheetham, T. C., Graham, D. J., Campen, D., Hui, R., Spence, M., Levy, G., Shoor, S. 2008; 12 (1): 16-22

    Abstract

    Objective: In April 2005, the US Food and Drug Administration issued a public health advisory warning to health care clinicians about the cardiovascular (CV) safety of nonsteroidal anti-inflammatory drugs (NSAIDs). Although the warning about cyclooxygenase-2 selective NSAIDs was anticipated, little data exists about the CV safety of nonselective NSAIDs. We analyzed data from a group of NSAID users to determine if specific nonselective agents were associated with an increased risk of myocardial infarctions (MIs) and sudden cardiac death (SCD).Design: A nested case-control design was used to study NSAID users ages 18 to 84 years. Cases were defined by a hospital admission for MI or an out-of-hospital SCD. Study control subjects were matched for age, sex, current Kaiser Permanente membership, and geographic location (Northern or Southern California). Odds ratios (OR) were estimated using conditional logistic regression.Results: Our base population included 1,394,764 NSAID users. From this population we identified 8143 cases and 31,496 matched study control subjects. The median time to event was <100 days for all NSAIDs. Two nonselective NSAIDs were associated with increased odds of adverse CV outcomes: indomethacin (OR, 1.27; 95% confidence interval, 1.04-1.56) and naproxen (OR, 1.14; 95% confidence interval, 1.00-1.30).Conclusion: Our results suggest that some nonselective NSAIDs are associated with an increased risk of MI and SCD. We found the increased risk to be small compared with the risk associated with rofecoxib. Cardiovascular events occurred early in therapy. Caution is warranted with some nonselective NSAIDs, especially those for which other studies have found evidence of risk.

    View details for PubMedID 21369507

  • Athletes, nonsteroidal anti-inflammatory drugs, coxibs, and the gastrointestinal tract. Current sports medicine reports Shoor, S. 2002; 1 (2): 107-115

    Abstract

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common self-administered and prescribed drugs taken in the United States. From 30% to 50% of those using these medications experience some degree of gastrointestinal (GI) side effect. Independent of NSAID use, a majority of athletes suffer GI symptoms, most of which has been documented in endurance athletes. Studies of NSAID use in patients with chronic osteo- and rheumatoid arthritis have defined a set of factors that can identify those who are at higher risk of serious GI events. Using such a model, clinicians can choose either to discontinue NSAID use, or prescribe a lower-risk NSAID or coxib (rofecoxib, celecoxib), prophylaxis with misoprostol, or proton pump inhibitor. Coxibs have been designed to decrease GI ulceration and bleeding by selective inhibition of cyclooxygenase-2, and offer an option for patients at high risk of GI hemorrhage. There are data suggesting that rofecoxib may be associated with an increased risk of myocardial infarction, and until further data are available, caution should be used when considering its prescription to patients at high risk of cardiovascular events.

    View details for PubMedID 12831719

  • Self-care and the doctor-patient relationship MEDICAL CARE Shoor, S., Lorig, K. R. 2002; 40 (4): 40-44
  • DEVELOPMENT AND EVALUATION OF A SCALE TO MEASURE PERCEIVED SELF-EFFICACY IN PEOPLE WITH ARTHRITIS ARTHRITIS AND RHEUMATISM Lorig, K., CHASTAIN, R. L., Ung, E., Shoor, S., Holman, H. R. 1989; 32 (1): 37-44

    Abstract

    There is evidence that the psychological attribute of perceived self-efficacy plays a role in mediating health outcomes for persons with chronic arthritis who take the Arthritis Self-Management Course. An instrument to measure perceived self-efficacy was developed through consultation with patients and physicians and through study of 4 groups of patients. Tests of construct and concurrent validity and of reliability showed that the instrument met appropriate standards. Health outcomes and self-efficacy scores improved during the Arthritis Self-Management Course, and the improvements were correlated.

    View details for Web of Science ID A1989R917000006

    View details for PubMedID 2912463

  • A COGNITIVE-BEHAVIORAL TREATMENT FOR RHEUMATOID-ARTHRITIS HEALTH PSYCHOLOGY OLEARY, A., Shoor, S., Lorig, K., Holman, H. R. 1988; 7 (6): 527-544

    Abstract

    This experiment tested a cognitive-behavioral rheumatoid arthritis treatment designed to confer skills in managing stress, pain, and other symptoms of the disease. We hypothesized that a mediator of the magnitude of treatment effects might be enhancement of perceived self-efficacy to manage the disease. It was predicted that the treatment would reduce arthritis symptoms and possibly would improve both immunologic competence and psychological functioning. The treatment provided instruction in self-relaxation, cognitive pain management, and goal setting. A control group received a widely available arthritis helpbook containing useful information about arthritis self-management. We obtained suggestive evidence of an enhancement of perceived self-efficacy, reduced pain and joint inflammation, and improved psychosocial functioning in the treated group. No change was demonstrated in numbers or function of T-cell subsets. The magnitude of the improvements was correlated with degree of self-efficacy enhancement.

    View details for Web of Science ID A1988R935000004

    View details for PubMedID 3063517

  • DEVELOPMENT OF AN INSTRUMENT TO EXPLORE PSYCHOLOGICAL MEDIATORS OF OUTCOME IN CHRONIC ARTHRITIS TRANSACTIONS OF THE ASSOCIATION OF AMERICAN PHYSICIANS Shoor, S. M., Holman, H. R. 1984; 97: 325-331

    View details for Web of Science ID A1984AHS6200061

    View details for PubMedID 6535348

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