Outcomes

John Woods, PhD

Senior Investigator
Methodist Research Institute
Indiana University Health
1800 N. Capitol Avenue
Indianapolis, IN 46202
P: 317.962.8896
F: 317.962.9369
Email: jwoods1@iuhealth.org

Laboratory
Current Projects
Recent Publications
Abbreviated Biography
Curriculum Vitae
 

Laboratory

The mission of the outcomes research laboratory is to study the effects of medical practices and policies on the quality and cost of patient outcomes. While basic biomedical research is producing new discoveries at an unprecedented rate, at the same time the healthcare delivery system is falling behind in its capacity to translate this knowledge into effective clinical practice. This research starts with knowledge gained from basic science and controlled clinical trials and studies how to apply this knowledge to a broad spectrum of patients under usual conditions of clinical practice to optimize patient outcomes. The ultimate goal is to improve practice effectiveness, efficiency and appropriateness.

Current Projects

Heart Transplantation Research

Early Biomarkers as Risk Predictors of Long-Term Heart-Transplant Outcomes
In human studies we are analyzing early biological markers derived from biopsied heart tissue within the first three months after heart transplantation to determine their potential as risk predictors of long-term adverse outcomes. We are particularly interested in using these markers as early indicators of cardiac allograft vasculopathy (the transplant version of atherosclerosis), which is now the principle, long-term cause of mortality in heart transplant patients.

Trauma Outcomes Research

Antibiotic concentrations and clinical outcomes in volume-expanded patients
We are undertaking a series of projects focused on improving the effectiveness of antibiotic therapy in critically ill and injured patients. Our central hypothesis is that trauma patients with infections often fail to achieve adequate drug levels in infected tissues despite being treated with effective antibiotics at recommended doses. Current antibiotic dosing practices, which are typically based on average pharmacokinetic parameters derived from normal volunteers, do not achieve adequate drug concentrations in the infected tissues of critically injured trauma patients.

Evaluation of Novel Scoring Methods for Assessing Student Performance in Simulated Advanced Trauma Life Support (ATLS) Scenarios
We have collected pilot data as a first step in developing a more objective and precise method for scoring physician performance using simulated patient scenarios. Physicians in training are vulnerable to errors in judgment when forced to think and act in a crisis. These vulnerabilities may not be fully recognized in clinical practice until multiple questionable judgments have occurred in live patient settings. Such high-stakes but difficult-to-evaluate deficits are often related, not to a lack of basic medical knowledge, but to an inability to manage the overall crisis. The Advanced Trauma Life Support (ATLS) certification process includes an explicit assessment of trainee performance in simulated emergency scenarios. However, an observer using a checklist that results in a pass-fail grade currently scores these assessments. Our long-term goal is to accrue a sufficient sample over multiple training sessions to develop a more precise and objective scoring system based on the Rasch measurement model, a model that has been widely used in education and psychological testing and is now beginning to receive attention in medicine.

Goal-directed renal function monitoring
This study has been designed to test the hypothesis that the creatinine clearance rate (Ccr) assessed every  two hours is a more effective early-warning marker for triggering resuscitative interventions. To test this hypothesis, we will determine whether the inclusion of Ccr as an additional resuscitation trigger will reduce the incidence of acute renal dysfunction, shorten ICU length of stay and improve hospital outcomes in critically ill and injured patients. The study has been designed as a randomized outcome effectiveness trial. Current standard-of-care triggers will be used in both of two groups to activate an existing resuscitation protocol. In the Study Group, 2-hour creatinine clearance rates will provide an additional trigger for activating the resuscitation protocol.

Outcomes and costs of wound dressings
We are conducting a retrospective review of the use of wound dressing products at IU Health to study the costs and benefits of altering wound dressing protocols. Wound dressings represent a sizable cost for hospitals.

High-frequency jet ventilation as a strategy for reducing the incidence of hospital-associated pneumonia
We are designing a study to test the hypothesis that the incidence of hospital-associated pneumonia (HAP) can be reduced significantly by substituting high-frequency jet ventilation for the standard mechanical ventilation currently used in ICU patients. HAP is the second leading cause of all hospital-acquired infections, accounting for up to 25% of all infections seen in the ICU. HAP prolongs the average hospital stay by 7-9 days, accounts for over 50% of prescribed antibiotics in hospitalized patients, generates excess hospital costs of $40,000 per patient, and is associated with $2 billion in extra medical care expenditures annually in the U.S. In the ICU, nearly 90% of all HAP occurs during mechanical ventilation, accounting for 30%-70% of all ventilator-associated deaths.

Recent Publications

  1. Labarrere CA, Woods JR, Hardin JW, Campana GL, Ortiz MA, Jaeger BR, Reichart B, Bonnin JM, Currin A, Cosgrove S, Pitts DE, Kirlin PC, O'Donnell JA, Hormuth DA, Wozniak TC. Early prediction of cardiac allograft vasculopathy and heart transplant failure. Am J Transplant. Mar 2011;11(3):528-535. Link
  2. Tarassenko L, Clifton DA, Pinsky MR, Hravnak MT, Woods JR, Watkinson PJ. Centile-based early warning scores derived from statistical distributions of vital signs. Resuscitation. Aug 2011;82(8):1013-1018. Link
  3. Labarrere CA, Woods JR, Hardin JW, et al. Early prediction of cardiac allograft vasculopathy and heart transplant failure. Am J Transplant. Mar 2011;11(3):528-535. Link
  4. Ortiz MA, Campana GL, Woods JR, et al. Continuously-infused human C-reactive protein is neither proatherosclerotic nor proinflammatory in apolipoprotein E-deficient mice. Exp Biol Med (Maywood). Jun 2009;234(6):624-631. Link
  5. Labarrere CA, Woods JR, Ortiz MA, Campana GL. C-reactive protein and severity of coronary allograft vasculopathy. Nat Clin Pract Cardiovasc Med. Mar 2009;6(3):E1; discussion E2. Link

Abbreviated Biography

Dr. Woods first joined Indiana University Health Methodist Hospital's Department of Medical Research in 1977. During his tenure he founded the IU Health Methodist Center for Health Services Research, helped design and analyze the FDA-supervised lithotripsy trial for the treatment of kidney stone disease, and directed the Medicare Heart Bypass Demonstration Program, one of six Medicare-sponsored heart surgery payment demonstrations in the country.

In 1998 Dr. Woods was recruited to the University of South Carolina where he was Associate Professor of Family and Preventive Medicine and Director of the University's Center for Health Services and Policy Research. At Carolina he founded the Pay-for-Performance Forum, a statewide coalition of health care providers, state agencies, and business leaders seeking to build a business case for healthcare quality. He also served as a consultant to the hospital system affiliated with the School of Medicine, where he worked with the hospital's executive leadership and board to help structure their quality initiative and served on the Quality Improvement Coordinating Council.

In 2006, Dr. Woods returned home to Indianapolis to initiate the Outcomes Research Program at the Methodist Research Institute. Dr. Woods has served on numerous national committees, including the Provider Payment Panel for the Health Care Financing Administration (now CMS) Office of Research and Demonstrations, the National Health Sciences and practice Patterns Survey of Georgetown University's Institute for Health Policy Analysis in Washington, D.C., and the Foundation for Accountability (FACCT) National Performance Measurement Panel for Coronary Artery Disease. He has taught university courses in health services research, program evaluation, and statistics, and post-graduate research methods courses for the American College of Physicians.

His research focuses on the evaluation of hospital outcomes and costs and the application of quality improvement methods to clinical practice. He has published more then 60 research articles and abstracts and has co-authored a medical textbook on the treatment of kidney stone disease. Dr. Woods holds masters and doctoral degrees in experimental psychology.

Dr. Wood's Curriculum Vitae