Bio

Clinical Focus


  • Pediatrics
  • Hospital Medicine
  • Children with Special Health Care Needs
  • Shared Decision Making

Academic Appointments


Honors & Awards


  • KL2 Mentored Career Development Award (NIH KL2 TR 001083), Stanford Center for Clinical and Translational Research and Education (Spectrum) (2016)

Boards, Advisory Committees, Professional Organizations


  • Member, American Academy of Pediatrics (2011 - Present)
  • Member, Academic Pediatrics Association (2014 - Present)
  • Member, Society for Pediatric Research (2016 - Present)
  • Member, Society of Medical Decision Making (2017 - Present)

Professional Education


  • Medical Education:University of California at Irvine School of Medicine Registrar (2011) CA
  • MS, Stanford University, Health Policy (2018)
  • Residency:Baylor College of Medicine (2014) TX
  • Board Certification: Pediatrics, American Board of Pediatrics (2014)
  • Fellowship:Stanford Pediatric Hospital Medicine Fellowship (2016) CA
  • Fellowship, Stanford University - Clinical Excellence Research Center, Health Systems Design (2016)

Research & Scholarship

Current Research and Scholarly Interests


Jody Lin, MD received her BS in Chemical Biology with a minor in Public Policy at UC Berkeley followed by her MD at UC Irvine. She then completed her general pediatrics residency at Baylor College of Medicine before coming to Stanford to complete concurrent fellowships in Pediatric Hospital Medicine at the Department of Pediatrics and Health Systems Design at the Clinical Excellence Research Center (CERC).

Dr. Lin is currently a Spectrum KL2 Career Development Award scholar through which she will complete a Masters in Health Services Research and pursue further research in shared decision making and health systems design for children with medical complexity. Current projects include exploring narratives of parents of children with medical complexity, developing technological aids for chronic illness management, and piloting new models of care in early childhood.

Dr. Lin has volunteered for and led multiple initiatives providing medical services to resource-limited populations, most notably partnering with county public health programs and nonprofits to provide wraparound services to combat generational homelessness. Subsequently she became interested in program evaluation using health services research methodologies and has focused on improving care for vulnerable populations in pediatrics, such as children with medical complexity. She was also part of a multidisciplinary team that created new models of care to improve health care value in early childhood at CERC.

Clinical Trials


  • GoalKeeper: Intelligent Information Sharing for Children With Medical Complexity Not Recruiting

    This proposal addresses the major challenge of improving health outcomes for children with cancer and other complex conditions, for whom the effectiveness of outpatient care depends on care coordination across a diverse group of caregivers that includes parents, community support organizations and pediatric care providers. The investigators have developed GoalKeeper, a prototype system for supporting care coordination across multiple care providers. The primary aim of the clinical trial is to assess the potential for this new system, GoalKeeper, to improve meaningful use of goal-centered care plans in the care of children with cancer and other complex chronic conditions.

    Stanford is currently not accepting patients for this trial.

    View full details

Publications

All Publications


  • Patients Prescribed Direct-acting Oral Anticoagulants Have Low Risk of Post-Polypectomy Complications. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Yu, J. X., Oliver, M., Lin, J., Chang, M., Limketkai, B. N., Soetikno, R., Bhattacharya, J., Kaltenbach, T. 2018

    Abstract

    BACKGROUND & AIMS: Use of direct-acting oral anticoagulants (DOACs) is increasing, but little is known about the associated risks in patients undergoing colonoscopy with polypectomy. We aimed to determine the risk of post-polypectomy complications in patients prescribed DOACs.METHODS: We performed a retrospective analysis using the Clinformatics Data Mart Database (a de-identified administrative database from a large national insurance provider) to identify adults who underwent colonoscopy with polypectomy or endoscopic mucosal resection (EMR) from January 1, 2011, through December 31, 2015. We collected data from 11,504 patients prescribed antithrombotic agents (1590 DOAC, 3471 warfarin, and 6443 clopidogrel) and 599,983 patients not prescribed antithrombotics of interest (controls). We compared 30-day post-polypectomy complications, including gastrointestinal bleeding (GIB), cerebrovascular accident (CVA), myocardial infarction (MI), and hospital admissions, of patients prescribed DOACs, warfarin, or clopidogrel vs controls.RESULTS: Post-polypectomy complications were uncommon but occurred in a significantly higher proportion of patients receiving any antithrombotic vs controls (P<0.001). The percentage of patients in the DOAC group with GIB was 0.63% (95% CI, 0.3%-1.2%) vs 0.2% (95% CI, 0.2%-0.3%) in controls. The percentage of patients with CVA in the DOAC group was 0.06% (95% CI, 0.01%-0.35%) vs 0.04% (95% CI, 0.04%-0.05%) in controls. After we adjusted for bridge anticoagulation, EMR, Charlson comorbidity index (CCI), and CHADS2 (congestive heart failure, hypertension, age over 75, diabetes, stroke [double weight]) score, patients prescribed DOACs no longer had a statistically significant increase in the odds of GIB (odds ratio [OR], 0.90; 95% CI, 0.44-1.85), CVA (OR, 0.45; 95% CI, 0.06-3.28), MI (OR, 1.07; 95% CI, 0.14-7.72), or hospital admission (OR, 0.86; 95% CI, 0.64-1.16). Clopidogrel, warfarin, bridge anticoagulation, higher CHADS2, CCI, and EMR were associated with increased odds of complications.CONCLUSION: In our retrospective analysis of a large national dataset, we found that patients prescribed DOACs did not have significantly increased adjusted odds of post-polypectomy GIB, MI, CVA, or hospital admission. Bridge anticoagulation, higher CHADS2 score, CCI, and EMR were risk factors for GIB, MI, CVA, and hospital admissions. Studies are needed to determine the optimal peri-procedural dose for high-risk patients.

    View details for PubMedID 30503964

  • Potential Impact of Initial Clinical Data on Adjustment of Pediatric Readmission Rates. Academic pediatrics Nakamura, M. M., Toomey, S. L., Zaslavsky, A. M., Petty, C. R., Lin, C., Savova, G. K., Rose, S., Brittan, M. S., Lin, J. L., Bryant, M. C., Ashrafzadeh, S., Schuster, M. A. 2018

    Abstract

    OBJECTIVE: Comparison of readmission rates requires adjustment for case-mix (ie, differences in patient populations), but previously only claims data were available for this purpose. We examined whether incorporation of relatively readily available clinical data improves prediction of pediatric readmissions and thus might enhance case-mix adjustment.METHODS: We examined 30-day readmissions using claims and electronic health record data for patients ≤18 years and 29 days of age who were admitted to 3 children's hospitals from February 2011 to February 2014. Using the Pediatric All-Condition Readmission Measure and starting with a model including age, gender, chronic conditions, and primary diagnosis, we examined whether the addition of initial vital sign and laboratory data improved model performance. We employed machine learning to evaluate the same variables, using the L2-regularized logistic regression with cost-sensitive learning and convolutional neural network.RESULTS: Controlling for the core model variables, low red blood cell count and mean corpuscular hemoglobin concentration and high red cell distribution width were associated with greater readmission risk, as were certain interactions between laboratory and chronic condition variables. However, the C-statistic (0.722 vs 0.713) and McFadden's pseudo R2 (0.085 vs 0.076) for this and the core model were similar, suggesting minimal improvement in performance. In machine learning analyses, the F-measure (harmonic mean of sensitivity and positive predictive value) was similar for the best-performing model (containing all variables) and core model (0.250 vs 0.243).CONCLUSIONS: Readily available clinical variables do not meaningfully improve the prediction of pediatric readmissions and would be unlikely to enhance case-mix adjustment unless their distributions varied widely across hospitals.

    View details for DOI 10.1016/j.acap.2018.09.006

    View details for PubMedID 30470563

  • STABLE POLYPECTOMY COMPLICATION RATES IN AN ERA OF INCREASING USE OF ENDOSCOPIC MUCOSAL RESECTION (EMR) Yu, J. X., Lin, J., Oliver, M., Chang, M. S., Kwong, A. J., Limketkai, B., Soetikno, R. M., Bhattacharya, J., Kaltenbach, T. R. MOSBY-ELSEVIER. 2018: AB487
  • DIRECT-ACTING ORAL ANTICOAGULANT (DOAC) USE IS NOT ASSOCIATED WITH INCREASED RISK OF COMPLICATIONS AFTER POLYPECTOMY Yu, J. X., Oliver, M., Lin, J., Chang, M. S., Kwong, A. J., Limketkai, B., Soetikno, R. M., Bhattacharya, J., Kaltenbach, T. R. MOSBY-ELSEVIER. 2018: AB392
  • Well-Appearing Newborn With a Vesiculobullous Rash at Birth. Pediatrics Stewart, S. E., Lin, J. L., Everhart, J. L., Pham, T. H., Marqueling, A. L., Rieger, K. E., Hilgenberg, S. L. 2018

    Abstract

    A term, appropriate-for-gestational-age, male infant born via normal spontaneous vaginal delivery presented at birth with a full-body erythematous, vesiculobullous rash. He was well-appearing with normal vital signs and hypoglycemia that quickly resolved. His father had a history of herpes labialis. His mother had an episode of herpes zoster during pregnancy and a prolonged rupture of membranes that was adequately treated. The patient underwent a sepsis workup, including 2 attempted but unsuccessful lumbar punctures, and was started on broad-spectrum antibiotics and acyclovir, given concerns about bacterial or viral infection. The rash evolved over the course of several days. Subsequent workup, with particular attention to his history and presentation, led to his diagnosis.

    View details for PubMedID 29437933

  • Shared Decision Making among Children with Medical Complexity: Results from a Population-Based Survey. The Journal of pediatrics Lin, J. L., Cohen, E., Sanders, L. M. 2018; 192: 216–22

    Abstract

    To compare the rates of shared decision making (SDM) reported by parents of children with medical complexity (CMC) with the rates of SDM reported by parents of noncomplex children with special health care needs (CSHCN).We examined the 2009-2010 National Survey of Children with Special Health Care Needs, a representative survey of 40 242 parents of CSHCN. CMC was defined as needing or using more medical care than usual, seeing 2 or more subspecialists, and positive response on at least 3 other items on the CSHCN screener. We identified 3 subgroups each of CMC and noncomplex CSHCN by sentinel diagnoses: asthma, seizures, and other diagnoses. SDM was defined as a binary composite variable, derived from 4 discrete items. We constructed 4 stepwise multivariable models to assess the relative odds of SDM, adjusted for sociodemographic characteristics (age, income, language, race, ethnicity, and marital status), behavioral comorbidity, family-centered care, and patient-centered medical home.The study population included 39 876 respondents. Compared with noncomplex CSHCN, CMC had a lower likelihood of SDM (aOR, 0.76; 95% CI, 0.64-0.91), which persisted in diagnostic subgroups: CMC with asthma (aOR, 0.67; 95% CI, 0.49-0.92) and CMC with other diagnoses (aOR, 0.74; 95% CI, 0.58-0.94), but not CMC with seizures (aOR, 0.95; 95% CI, 0.59-1.51).SDM is less common for CSHCN with complex needs than those without complex needs. Health system interventions targeting future-oriented care planning may improve SDM for CMC.

    View details for PubMedID 29102046

  • Does Routine Imaging of Patients for Progression or Relapse Improve Survival in Rhabdomyosarcoma? PEDIATRIC BLOOD & CANCER Lin, J. L., Guillerman, R. P., Russell, H. V., Lupo, P. J., Nicholls, L., Okcu, M. F. 2016; 63 (2): 202-205

    Abstract

    Patients with rhabdomyosarcoma (RMS) who complete therapy typically undergo 4 years of surveillance imaging despite lack of evidence that this improves outcomes. We compared overall survival (OS) between patients in whom progression or relapse was detected by routine clinical evaluation or by imaging.Children with progressive or relapsed RMS treated at Texas Children's Hospital between 1992 and 2012 were identified and their records were reviewed. Survival time after progression or relapse was compared between two groups: (1) patients in whom progression or relapse was suspected on the basis of clinical history, symptoms, laboratory evaluation, or physical exam; and (2) patients whose progression or relapse was initially detected by imaging.Of the 43 children with progressive or relapsed RMS, 26 (60%) had metastatic disease at diagnosis and 19 (44%) had alveolar histology. With a median follow up time of 5 years in six survivors, there was no difference in OS between patients in whom progression or relapse was diagnosed based on imaging (n = 15) or by clinical evaluation (n = 28) (3-year OS 20% vs. 11%, respectively, P = 0.38). Disease extent, primary site, and risk group at diagnosis were associated with survival after progression or relapse.Routine surveillance imaging practice should be critically reviewed for children with RMS. Although our findings must be validated by larger studies, they do have substantive implications. Reduced imaging tailored to the risk and pattern of recurrence, associated risks and cost could improve patient quality of life and decrease health-care expenditure without compromising outcome.

    View details for DOI 10.1002/pbc.25750

    View details for PubMedID 26376023