Producing Evidence That Drives Change
Our research ultimately generates significant contributions to health policy and population health. Here are just a few examples.
Informing Guidelines that Improve Clinical Care and Health Policy
Policy to Protect Against Discrimination
Research led by Julia Marcus examining the life expectancy of people with and without HIV contributed to legislation that protects people living with HIV in California from discrimination by life and disability insurance companies.
This work helped shape the now-implemented THE EQUAL INSURANCE HIV ACT in CA, which updates the HIV statutes to reflect advancements in HIV testing and medical treatments and the overall increase of average life expectancies for individuals who have tested positive for HIV.
Supporting Guidance for STI Prevention
Research by Douglas Krakower, Julia Marcus, and research fellow Michael Traeger has shown that doxycycline as sexually transmitted infection prophylaxis (doxyPEP) can be strategically prescribed to maximize impact on sexually transmitted infections while minimizing harms linked to antibiotic overuse.
- This work was cited as evidence to support recommendations in the National Guidelines for the Use of DoxyPEP from the Centers for Disease Control and Prevention (CDC) and doxyPEP clinical guidelines from the New York State Department of Health’s AIDS Institute Clinical Guidelines Program.
- It also informed national guidance for doxyPEP prescribing from the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, a leading organization for STI guidelines in Australia and New Zealand.
Helping shape clinical guidelines to better target populations
Research by Julia Marcus and Douglas Krakower provides models that can be used to identify PrEP candidates in general clinic settings.
This work informed the USPTSF recommendation on PrEP, “that clinicians prescribe preexposure prophylaxis using effective antiretroviral therapy to persons who are at increased risk of HIV acquisition to decrease the risk of acquiring HIV”, thereby changing clinical practice surrounding HIV prevention and PrEP utilization.
Designing Widely Adopted Systems and Tools
Expanding Public Health Surveillance
TIDE researchers developed the Electronic medical record Support for Public Health (ESP) system, which was adopted by the Massachusetts Department of Public Health (MDPH).
As of 2023, its network covered 50% of the MA population.
Sound Evidence to Inform Clinical Practice
Defining Sepsis to Improve Surveillance
Work led by Chanu Rhee and Michael Klompas led to the development of an objective surveillance definition for sepsis that formed the basis of CDC’s “Adult Sepsis Event” surveillance strategy and has been used to generate CDC’s estimates of US sepsis burden.
- Use of Electronic Clinical Data to Track Incidence and Mortality for SARS-CoV-2-Associated Sepsis
- Epidemiology, Outcomes, and Trends of Patients With Sepsis and Opioid-Related Hospitalizations in U.S. Hospitals
- Improvements in Sepsis-associated Mortality in Hospitalized Patients with Cancer versus Those without Cancer
- Impact of Risk Adjustment Using Clinical vs Administrative Data on Hospital Sepsis Mortality Comparisons
- Epidemiology of Hospital-Onset Versus Community-Onset Sepsis in U.S. Hospitals and Association With Mortality
- Sepsis Surveillance Using Adult Sepsis Events Simplified eSOFA Criteria Versus Sepsis-3 Sequential Organ Failure Assessment Criteria
- Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons
- Using objective clinical data to track progress on preventing and treating sepsis: CDC’s new ‘Adult Sepsis Event’ surveillance strategy
- Incidence and Trends of Sepsis in Us Hospitals Using Clinical Vs Claims Data, 2009-2014
- Improving documentation and coding for acute organ dysfunction biases estimates of changing sepsis severity and burden: a retrospective study
- Comparison of trends in sepsis incidence and coding using administrative claims versus objective clinical data
These papers ultimately increased the consistency and reliability of sepsis surveillance compared to prior use of administrative data and generated important insights into sepsis epidemiology and quality of care.
Improved Guidelines for Preventing Ventilator-Associated Pneumonia
Research led by Michael Klompas analyzed pneumonia prevention strategies and distilled best practices to prevent hospital-acquired pneumonia and ventilator-associated events.
- Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 Update
- Association Between Daily Toothbrushing and Hospital-Acquired Pneumonia: A Systematic Review and Meta-Analysis
- Associations Between Ventilator Bundle Components and Outcomes
- The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative
- Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis
- Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update
This research has informed guidelines and training curricula, including:
- Infection prevention and control in-service education and training curriculum (World Health Organization)
- AARC Clinical Practice Guideline: Patient-Ventilator Assessment (American Association for Respiratory Care)
- Timing of Ventilator Circuit Tubing Replacement (Canada's Drug Agency)
- Diagnosis and management of aspiration pneumonia (British Thoracic Society)
Did you know?
As our portfolio of work continues to expand, so does its impact on policy and practice.