Strives in providing patient-centered care
The MedStar-Georgetown Surgical Outcomes Research Center (MG-SORC) is a coalition of surgeons, other clinicians, and scientists committed to contributing to the scientific mission of Georgetown University Medical Center (GUMC) and MedStar Health by advancing the efficient and effective delivery of surgical care in the United States. The MG-SORC's early contributions to science on disparities in surgical oncology care will help establish a foundation for which a nationally recognized surgical outcomes research center can be built.
Educational and clinical research programs
Educational opportunities
MHRI offers in-person and online educational opportunities to enhance the research knowledge and practices of our investigators and associates.
Who we are
Steering Committee (SC) Members
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Lynt Johnson, MD
Internal Advisory Board (IAB) Members
MG-SORC Team Members
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Waddah Al-Refaie, MD
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Megan Beck, MD PGY-2
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Andrew Crocker, Medical Student, GUMC
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David Xiao, Medical Student, GUMC
Former Research Residents/Fellows/Medical Students
- Young Hong, MD, PGY-4
- Sam Lawrence, Medical Student, GUMC
- Andrew Smith, Medical Student, GUMC
- Manila Jindal, Medical Student, VCU Medical School
- MG-SORC Research Fellow
In the news
Georgetown University Medical Center has issued a press release regarding the publishing of the MedStar-Georgetown Surgical Outcomes Research Center’s (MG-SORC) team study on Medicaid expansion in the Journal of the American College of Surgeons (JACS). The publication, entitled, “Medicaid Expansion and Disparity Reduction in Surgical Cancer Care at High Quality Hospitals?” appeared online Thursday, October 5, 2017, on the Journal of the American College of Surgeons' website. It addresses the question whether Medicaid expansion improves access to surgical cancer care at high-quality hospitals using the 2001 New York State Medicaid expansion, which is considered a precursor to the Affordable Care Act (ACA). The researchers were surprised to discover the racial disparity gap widened when it came to access to high-quality hospitals for cancer surgery. The study team had expected to see a shrinking racial gap, but instead found the proportion of minority Medicaid patients treated at hospitals that provide high-quality cancer surgery fell significantly compared to their white counterparts.
This study follows Dr. Al-Refaie’s finding in January 2017, that New York’s Medicaid expansion improved access to cancer surgery for the previously uninsured but did not preferentially benefit ethnic and racial minorities who are typically the most vulnerable of America’s poorest populations. That study was also published in JACS.
David Xiao, a health justice scholar at Georgetown University School of Medicine, is first author on the study. Xiao's work was sponsored by the MedStar Summer Research Program. Additional co-authors include Chaoyi Zheng, MS, Manila Jindal, Lynt B. Johnson, MD, MBA, FACS, Thomas DeLeire, PhD, and Nawar Shara, PhD.
Georgetown University Medical Center has issued a press release regarding the publishing of the MG-SORC’s team study on pre-ACA Medicaid expansion in JACS. The publication, entitled, “Did Pre-Affordable Care Act Medicaid Expansion Increase Access to Surgical Cancer Care?” appeared online Tuesday January 24, 2017, on the JACS' website. The study found that the Medicaid expansion significantly improves access to surgical cancer care overall, but the proportion of minorities having surgery, relative to whites, did not change – this was an unexpected finding. The researchers felt the findings may provide timely and meaningful insight into what could result from the expansion of Medicaid, a state and federal program that provides health insurance for those with very low incomes, that has occurred in 32 states including the District of Columbia, under the ACA.
The Study team, who represent one of the first collaborative projects between multiple schools at Georgetown University, MedStar Georgetown University Hospital (MGUH), and MedStar Health Research Institute (MHRI), include authors Waddah B. Al-Refaie, MD; Chaoyi Zheng, MS; Manila Jindal; Michele Lee Clements; Patryce Toye, MD; Lynt B Johnson, MD; David Xiao; Timothy Westmoreland, JD; Thomas DeLeire, PhD; and Nawar Shara, PhD.
This study was originally presented by Dr. Al-Refaie at the Southern Surgical Association Annual Meeting in December 2016.
JACS has issued a press release on the MG-SORC team's study on patient readmissions to vulnerable hospitals after complex cancer operations, appearing online Tuesday May 31 on the JACS’ website. Findings such as these led to the creation of the Medicare Hospital Readmissions Reduction Program (HRRP) in the ACA, which penalizes hospitals that have higher than expected readmission rates. HRRP currently covers four common medical conditions: pneumonia, heart failure, acute myocardial infarction, and chronic obstructive pulmonary disease (COPD), along with two joint replacement operations (knee and hip). The program will expand in 2017 and begin including coronary artery bypass grafting (CABG) procedures.
The Study team included Waddah Al-Refaie, MD; Young Hong, MD; Mina Zheng, MS; Elizabeth Hechenbleikner, MD; Lynt B. Johnson, MD, FACS; and Nawar Shara, PhD. This study was originally presented at the Western Surgical Association 123rd Scientific Session, November 2015.
Presentations, publications, and awards
Presentations
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Evaluating Variability in the Implementation of Surgical Time-Outs. Presented at the 2016 Academic Surgical Congress, February 2-3, 2016, Jacksonville, FL.
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Does Music in the OR Impact Self-Perceived Performance? A Large Multi-Specialty Study. Presented at 11th Annual Academic Surgical Congress, February 2, 2016.
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Geospatial Travel Patterns of Major Cancer Surgery Patients within a Regionalized Health System. Presented at 10th Annual Academic Surgical Congress, February 3-4, 2015, Las Vegas, NV.
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Minority Serving Hospitals and Cancer Surgery Readmissions: A Reason for Concern
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Understanding Readmissions after Cancer Surgery in Vulnerable Hospitals
Publications
Quadri HS, Smaglo BG, Morales SJ, Phillips AC, Martin AD, Chalhoub WM, Haddad NG, Unger KR, Levy AD, Al-Refaie WB. Gastric Adenocarcinoma: A Multimodal Approach. Front Surg. 2017 Aug 3; 4:42. doi: 10.3389/fsurg.2017.00042. eCollection 2017. Review. PubMed PMID: 28824918; PubMed Central PMCID: PMC5540948.
Bayasi M, Al-Refaie W. Enhanced Surgical Recovery Through Enhanced Research From Integrated Health Systems. JAMA Surg. 2017 Jul 19;152(7): e171051. doi:10.1001/jamasurg.2017.1051. Epub 2017 Jul 19. PubMed PMID: 28492815.
Jindal M, Zheng C, Quadri HS, Ihemelandu CU, Hong YK, Smith AK, Dudeja V, Shara NM, Johnson LB, Al-Refaie WB. Why Do Long-Distance Travelers Have Improved Pancreatectomy Outcomes? J Am Coll Surg. 2017 Aug;225(2):216-225. doi: 10.1016/j.jamcollsurg.2017.04.003. Epub 2017 Apr 14. PubMed PMID: 28414114.
Al-Refaie WB, Zheng C, Jindal M, Clements ML, Toye P, Johnson LB, Xiao D, Westmoreland T, DeLeire T, Shara N. Did Pre-Affordable Care Act Medicaid Expansion Increase Access to Surgical Cancer Care? J Am Coll Surg. 2017 Apr;224(4):662-669. doi: 10.1016/j.jamcollsurg.2016.12.044. Epub 2017 Jan 24. PubMed PMID: 28130171.
Hechenbleikner EM, Zheng C, Lawrence S, Hong Y, Shara NM, Johnson LB, Al-Refaie WB. Do hospital factors impact readmissions and mortality after colorectal resections at minority-serving hospitals? Surgery. 2017 Mar;161(3):846-854. doi: 10.1016/j.surg.2016.08.041. Epub 2016 Oct 28. PubMed PMID: 28029380.
Hong Y, Zheng C, Hechenbleikner E, Johnson LB, Shara N, Al-Refaie WB. Vulnerable Hospitals and Cancer Surgery Readmissions: Insights into the Unintended Consequences of the Patient Protection and Affordable Care Act. J Am Coll Surg. 2016 Jul;223(1):142-51. doi: 10.1016/j.jamcollsurg.2016.04.042. Epub 2016 May 31. PubMed PMID: 27261414; PubMed Central PMCID: PMC5266542.
Quadri HS, Hong YK, Al-Refaie WB. Approach to the surgical management of resectable gastric cancer. Clin Adv Hematol Oncol. 2016 Apr;14(4):249-57. Review. PubMed PMID: 27166607.
Quadri HS, Hong YK, Al-Refaie WB. Approach to the surgical management of resectable gastric cancer. Clin Adv Hematol Oncol. 2016 Mar;14(3):249-57. Review. PubMed PMID: 27058031.
Zheng C, Habermann EB, Shara NM, Langan RC, Hong Y, Johnson LB, Al-Refaie WB. Fragmentation of Care after Surgical Discharge: Non-Index Readmission after Major Cancer Surgery. J Am Coll Surg. 2016 May;222(5):780-789.e2. doi: 10.1016/j.jamcollsurg.2016.01.052. Epub 2016 Feb 5. PubMed PMID: 27016905; PubMed Central PMCID: PMC5244824.
Ihemelandu C, Zheng C, Hall E, Langan RC, Shara N, Johnson L, Al-Refaie W. Multimorbidity and access to major cancer surgery at high-volume hospitals in a regionalized era. Am J Surg. 2016 Apr;211(4):697-702. doi: 10.1016/j.amjsurg.2015.09.017. Epub 2016 Feb 28. PubMed PMID: 26926527; PubMed Central PMCID: PMC5260797.
Hall EC, Zheng C, Langan RC, Johnson LB, Shara N, Al-Refaie WB. Medicaid beneficiaries undergoing complex surgery at quality care centers: insights into the Affordable Care Act. Am J Surg. 2016 Apr;211(4):750-4. doi: 10.1016/j.amjsurg.2015.11.026. Epub 2016 Jan 6. PubMed PMID: 26874897; PubMed Central PMCID: PMC5266546.
Mavros MN, Xu L, Maqsood H, Gani F, Ejaz A, Spolverato G, Al-Refaie WB, Frank SM, Pawlik TM. Perioperative Blood Transfusion and the Prognosis of Pancreatic Cancer Surgery: Systematic Review and Meta-analysis. Ann Surg Oncol. 2015 Dec;22(13):4382-91. doi: 10.1245/s10434-015-4823-6. Epub 2015 Aug 21. Review. PubMed PMID: 26293837.
Langan RC, Huang CC, Mao WR, Harris K, Chapman W, Fehring C, Oza K, Jackson PG, Jha R, Haddad N, Carroll J, Hanna J, Parker A, Al-Refaie WB, Johnson LB. Pancreaticoduodenectomy hospital resource utilization in octogenarians. Am J Surg. 2016 Jan;211(1):70-5. doi: 10.1016/j.amjsurg.2015.04.014. Epub 2015 Jun 4. PubMed PMID: 26122361; PubMed Central PMCID: PMC5224709.
Smith AK, Shara NM, Zeymo A, Harris K, Estes R, Johnson LB, Al-Refaie WB. Travel patterns of cancer surgery patients in a regionalized system. J Surg Res. 2015 Nov;199(1):97-105. doi: 10.1016/j.jss.2015.04.016. Epub 2015 Apr 9. PubMed PMID: 26076685.
Langan RC, Zheng C, Harris K, Verstraete R, Al-Refaie WB, Johnson LB. Hospital-level resource use by the oldest-old for pancreaticoduodenectomy at high-volume hospitals. Surgery. 2015 Aug;158(2):366-72. doi: 10.1016/j.surg.2015.02.022. Epub 2015 May 23. PubMed PMID: 26013984; PubMed Central PMCID: PMC5221761.
Langan RC, Huang CC, Colton S, Potosky AL, Johnson LB, Shara NM, Al-Refaie WB. Readmissions after major cancer surgery among older adults. Surgery. 2015 Aug;158(2):428-37. doi: 10.1016/j.surg.2015.01.028. Epub 2015 May 21. PubMed PMID: 26003911.
Langan RC, Graham JA, Chin AB, Rubinstein AJ, Oza K, Nusbaum JA, Smirniotopoulos J, Kayser R, Jha R, Haddad N, Al-Kawas F, Carroll J, Hanna J, Parker A, Al-Refaie WB, Johnson LB. Laparoscopic-assisted versus open pancreaticoduodenectomy: early favorable physical quality-of-life measures. Surgery. 2014 Aug;156(2):379-84. doi: 10.1016/j.surg.2014.03.018. Epub 2014 Mar 14. PubMed PMID: 24680859.
Expert Panel on Gastrointestinal Imaging: Kaur H, Hindman NM, Al-Refaie WB, Arif-Tiwari H, Cash BD, Chernyak V, Farrell J, Grajo JR, Horowitz JM, McNamara MM, Noto RB, Qayyum A, Lalani T, Kamel IR. ACR Appropriateness Criteria(®)Suspected Liver Metastases. J Am Coll Radiol. 2017 May;14(5S): S314-S325. doi: 10.1016/j.jacr.2017.01.037. PubMed PMID: 28473088.
Levy AD, Manning MA, Al-Refaie WB, Miettinen MM. Soft-Tissue Sarcomas of the Abdomen and Pelvis: Radiologic-Pathologic Features, Part 1-Common Sarcomas: From the Radiologic Pathology Archives. Radiographics. 2017 Mar-Apr;37(2):462-483. doi: 10.1148/rg.2017160157. PubMed PMID: 28287938; PubMed Central PMCID: PMC5416744.
Eskander MF, de Geus SW, Kasumova GG, Ng SC, Al-Refaie W, Ayata G, Tseng JF. Evolution and impact of lymph node dissection during pancreaticoduodenectomy for pancreatic cancer. Surgery. 2017 Apr;161(4):968-976. doi: 10.1016/j.surg.2016.09.032. Epub 2016 Nov 17. PubMed PMID: 27865602.
Kouri BE, Abrams RA, Al-Refaie WB, Azad N, Farrell J, Gaba RC, Gervais DA, Gipson MG, Kolbeck KJ, Marshalleck FE, Pinchot JW, Small W Jr, Ray CE Jr, Hohenwalter EJ. ACR Appropriateness Criteria Radiologic Management of Hepatic Malignancy. J Am Coll Radiol. 2016 Mar;13(3):265-73. doi: 10.1016/j.jacr.2015.12.001. Review. PubMed PMID: 26944037.
Al-Refaie WB, Weinberg A, Nelson H. Are older adults adequately represented in surgical oncology trials? Bull Am Coll Surg. 2013 May;98(5):52-3.
Parisi A, Nguyen NT, Reim D, Zhang S, Jiang ZW, Brower ST, Azagra JS, Facy O, Alimoglu O, Jackson PG, Tsujimoto H, Kurokawa Y, Zang L, Coburn NG, Yu PW, Zhang B, Qi F, Coratti A, Annecchiarico M, Novotny A, Goergen M, Lequeu JB, Eren T, Leblebici M, Al-Refaie W, Takiguchi S, Ma J, Zhao YL, Liu T, Desiderio J. Current status of minimally invasive surgery for gastric cancer: A literature review to highlight studies limits. Int J Surg. 2015 May, 17:34-40.
Langan RC, Zheng C, Harris K, Verstraete R, Al-Refaie WB, Johnson LB. Hospital-Level Resource Use by the Oldest-Old for Pancreaticoduodenectomy at High Volume Hospitals. 2015. Surgery. Accepted for publication.
Langan RC, Graham JA, Chin AB, Rubinstein AJ, Oza K, Nusbaum JA, Smirniotopoulos J, Kayser R, Jha R, Haddad N, Al-Kawas F, Carroll J, Hanna J, Parker A, Al-Refaie WB, Johnson LB. Laparoscopic-assisted versus open pancreaticoduodenectomy: early favorable physical quality-of-life measures. Surgery. 2014 March, 6060 (14) 00111-1.
Langan RC, Huang CC, Mao W, Harris K, Chapman W, Fehring C, Oza K, Jackson PG, Fishbein TM, Jha R, Haddad N, Carroll J, Hanna J, Parker A, Al-Refaie WB, Johnson LB. Pancreaticoduodenectomy Hospital Resource Utilization in the Oldest of Old. 2015. The American Journal of Surgery. Accepted for publication.
Mavros MN, Xu L, Maqsood H, Gani F, Ejaz A, Spolverato G, Al-Refaie WB, Frank SM, Pawlik TM. Perioperative Blood Transfusion and the Prognosis of Pancreatic Cancer Surgery: Systematic Review and Meta-analysis. Ann Surg Oncol. 2015 Dec;22(13):4382-91
Haider AH, Scott VK, Rehman KA, Velopulos C, Bentley JM, Cornwell EE 3rd, Al-Refaie W. Racial disparities in surgical care and outcomes in the United States: a comprehensive review of patient, provider, and systemic factors. J Am Coll Surg. 2013 Mar;216(3):482-92.
Russell Langan, Jim Huang, Nawar M. Shara, Arnold Potosky, Lynt B. Johnson, Waddah B. Al-Refaie. Readmission after Major Cancer Surgery in Older Adults. Surgery. Accepted for publication.
Desiderio J, Jiang ZW, Nguyen NT, Zhang S, Reim D, Alimoglu O, Azagra JS, Yu PW, Coburn NG, Qi F, Jackson PG, Zang L, Brower ST, Kurokawa Y, Facy O, Tsujimoto H, Coratti A, Annecchiarico M, Bazzocchi F, Avanzolini A, Gagniere J, Pezet D, Cianchi F, Badii B, Novotny A, Eren T, Leblebici M, Goergen M, Zhang B, Zhao YL, Liu T, Al-Refaie W, Ma J, Takiguchi S, Lequeu JB, Trastulli S, Parisi A. Robotic, laparoscopic and open surgery for gastric cancer compared on surgical, clinical and oncological outcomes: a multi-institutional chart review. A study protocol of the International study group on Minimally Invasive surgery for GASTRIc Cancer-IMIGASTRIC. BMJ Open. 2015 Oct 19;5(10).
Andrew K. Smith, Nawar M. Shara, Alexander Zeymo, Katherine Harris, Randy Estes, Lynt B. Johnson, Waddah B. Al-Refaie. Travel Pattern to Receive Major Cancer Surgery in a Regionalized System. Journal of Surgical Research. Accepted for publication.
Awards
The scientific paper entitled “Did Pre-Affordable Care Act Medicaid Expansion Increase Access to Surgical Cancer Care” by authors Waddah B. Al-Refaie, MD; Chaoyi Zheng, MS; Manila Jindal; Michele Lee Clements, Patryce Toye, MD; Lynt B Johnson, MD; David Xiao; Timothy Westmoreland, JD; Thomas DeLeire, PhD; and Nawar Shara, PhD, has been selected as the recipient of the 2016 Shipley award from the Southern Surgical Association (SSA). This award is presented to an individual who, within the first two years of membership, is deemed to have presented the best scientific paper at the SSA Annual Meeting. Dr. Al-Refaie presented the project, which is one of the first collaborative projects between multiple schools at Georgetown University, MGUH and MHRI.
Surgical Resident Research Program
The MedStar-Georgetown Surgical Outcomes Research Center (MG-SORC), MedStar Health Research Institute (MHRI), and MedStar Health Academic Affairs are pleased to offer this combined research development and bio-statistical support program.
This is a 1-year program that will focus primarily on the design, conduct, and publication of a research project which may include, but is not limited to, a secondary analysis of existing clinical research data available to MedStar investigators, and a clinical research project using MedStar EHR data.
Application deadline: Monday, April 11
Criteria for applicants:
- Surgery resident in good standing within a MedStar Surgical GME program.
- Training level: PGY2 or above (during their clinical or research years)
- Approval letter from Department Chair and Program Director
- Submit a letter of Interest articulating their idea, research mentor and plan (described below)
- Results from this research endeavor are expected to be submitted to an academic conference and published in a peer-reviewed manuscript
Criteria for faculty mentors:
Please note that we are not asking for faculty to apply to the program directly. Rather, we are asking that residents choose a mentor – either someone new or someone with whom they already have a relationship. Faculty will then submit their information as part of the resident’s application. Interested faculty are strongly encouraged to discuss their research lines with potential candidates to enhance this process.
- Surgical faculty with a minimum appointment of Georgetown University Assistant Professor
- Research experience with prior-peer reviewed publications or presentations
- Surgical faculty experienced in resident mentorship–defined as a formal (assigned by the program) or informal mentorship of surgical residents. ** Mentors spend time above and beyond standard educational/clinical teaching/operative coaching sessions, focusing on individualized guidance and suggestions, typically related to an aspect of the professional development of the mentee.
Faculty mentor expectations:
- Faculty agrees to provide individualized and consistent mentorship to the resident throughout the year-long project.
- Faculty agrees to support the resident in their goal of completing the MedStar SRRP project within the described one-year timeline.
- Results from this research endeavor are expected to be submitted to an academic conference and published in a peer-reviewed manuscript.
- Faculty and resident agree to provide progress reports every 6 months of their research activities.
Resident application requirements:
- Letter of support for the resident from their Department Chair and/or Program Director stating their support of the resident, his/her mentor, and their project idea.
- Letter of interest articulating the following: project’s research aims, significance, proposed methodology, timeline, sponsoring surgical faculty mentor (4,000 characters with space), and stated commitment to presenting their completed work to date at the 2017 MHRI Research Symposium.
- Letter of support from the faculty mentor stating: 1) their expertise as a mentor, 2) his/her commitment to the resident and their project, and 3) examples of past mentees and their publications.
- Surgical faculty supported in program participation by their Division Chief or Department Chair–as demonstrated in a Letter of Support.
- Resident CV
- Faculty mentor CV
We will enroll up to three participants annually. Applications will be reviewed by the MedStar Surgical Resident Research Program (SRRP) Advisory Committee (from MedStar Health – Washington region) and MedStar-Georgetown Surgical Outcomes Research Center.
We hope you will consider applying for this program. For more information, please contact Michele Lee Clements, Program Manager, MG-SORC, at Michele.LeeClements@medstar.net.
Ways to support us
There are several ways you can support the MedStar-Georgetown Surgical Outcomes Research Center (MG-SORC), to advance the efficient and effective delivery of surgical care for patients with cancer. Your tax-deductible contribution to MedStar Georgetown University Hospital in support of MG-SORC helps accelerate innovation to surgical oncology and advance care to better serve patients and families at MedStar Health and beyond.
A Gift to MG-SORC will benefit:
- MG-SORC Travel Fund: supports the field of surgical outcomes and health disparities.
- Surgical Oncology Travel Fund: supports the field of surgical oncology.
- MG-SORC Annual Lectureship: Funds will support a yearly visiting lectureship to discuss the latest research in Surgical Outcomes and the delivery of surgical care.
- Surgical Oncology Annual Lectureship: Funds will support a yearly visiting lectureship to discuss the latest, cutting-edge research endeavors in the field of Surgical Oncology.
- MG-SORC Surgical Fellow Fund: provides career development opportunities for residents/medical students who are interested in understanding and expanding the field of surgical outcomes at Georgetown and MedStar Health.
- MG-SORC Named Surgical Outcomes Scientist Endowment: enables us to recruit talented and highly sought-after research scientists to aggressively pursue these lines of research at Georgetown University and MedStar Health.
For more ways you can support the MG-SORC, please contact Pam Maroulis, CFRE, vice president of philanthropy at MedStar Georgetown University Hospital, at 202-444-2239 or via email at pamela.r.maroulis@medstar.net.