DEPARTMENT OF MEDICINE 2016 Annual Report DIVISIONS AND INSTITUTES The Divisions » Allergy John Ohman, MD » Cardiology James Udelson, MD » Clinical Decision Making» John Wong, MD » Clinical Nutrition Edward Saltzman, MD »» »Endocrinology Ron Lechan, MD » Gastroenterology Joel Weinstock, MD » Geographic Medicine and Infectious Disease David Snydman, MD » Hematology/Oncology Andrew Evens, DO » Internal Medicine and Adult Primary Care Deborah Blazey-Martin, MD » Nephrology Andrew Levey, MD » Pulmonary, Critical Care and Sleep Medicine Nicholas Hill, MD » Rheumatology Timothy McAlindon, MD The Institutes » Institute for Clinical Research and Health Policy Studies Harry Selker, MD » Molecular Cardiology Research Institute Richard Karas, MD, PhD » Molecular Oncology Research Institute Philip Tsichlis, MD Photography by Martha Stewart Photography. Design and production by Mark Vincent Communications, Inc. — www.markvincent.net. TABLE OF CONTENTS The Department of Medicine Chairman’s Message 4 Departmental Leadership 6 Departmental Organization Chart 7 Clinical Activity 11 Research Activity 13 Internal Medicine Training Program 15 The Divisions Allergy 18 Cardiology 20 Clinical Care Research 36 Clinical Decision Making 38 Clinical Nutrition 42 Endocrinology, Diabetes and Metabolism 46 Gastroenterology 54 Geographic Medicine and Infectious Diseases 60 Hematology/Oncology 72 Internal Medicine and Adult Primary Care 88 Geriatrics 96 William B. Schwartz Division of Nephrology 98 Pulmonary, Critical Care and Sleep Medicine 106 Rheumatology 114 The Institutes Institute for Clinical Research and Health Policy Studies 124 Molecular Cardiology Research Institute (MCRI) 138 Molecular Oncology Research Institute (MORI) 148 Publications 152 3 CHAIRMAN’S MESSAGE It is with pleasure that I offer the Annual Report for the Department of Medicine for 2016, a year that ended with a major strategic accomplishment for Tufts Medical Center. In December, 2016, the board of Hallmark Health System, with 368 beds in Lawrence Memorial Hospital and Melrose- Wakefield Hospital, voted to joined Wellforce, the parent company of Tufts Medical Center and Lowell General Hospital. The goal is to offer an academic medicine presence in the two community hospitals and to increase the availability to their patients of specialty services at Tufts Medical Center. In the Department of Medicine leadership at Tufts Medical center, Dr. David Snydman replaced Dr. Richard Karas as Vice-Chair for Research and Mark Haas replaced Allison Ankeny as Department Administrator. Reflecting the nationwide trend in reducing hospital admissions, inpatient clinical activity in 2016 was similar to that in 2015 whereas outpatient activity increased by 8%. The increase was evident in most divisions. Research grant awards were largely unchanged from 2015. The Division of Internal Medicine and Adult Primary Care added 2 primary care physicians, 1 urgent care physician, and 1 social worker to the Academic Medical Deeb N. Salem, MD, FACP, FACC, FACCP— Center practice. To facilitate patient access, the division extended outpatient clinic The Sheldon M. Wolff Professor and Chairman, Department of Medicine working hours and added a weekend clinic. There was a 14% increase in the primary care patient panel and visit volume and a 53% increase in new patient volume. The division received a grant from NEQCA to improve population control of hypertension and a certified diabetes education collaboration with Lowell General Hospital was initiated. In the section of Geriatrics, a new geriatric- orthopedic service was added. The Cardiology Division, in conjunction with the CardioVascular Center and the Division of Cardiac Surgery, ranked among the top 10 centers in the US by volume of transplants and quality of outcomes. The Division was also among the top 3 US centers in the treatment of hypertrophic cardiomyopathy, with a growing volume of surgical myectomies. The transcutaneous aortic valve replacement (TAVR) program and the regional referral network for complex procedures all continued to grow. TUFTS MEDICAL CENTER DEPARTMENT OF MEDICINE — ANNUAL REPORT 2016 Dr. Wong, chief of the Division of Clinical Decision Making was named co-chair of the Workgroup on Preventive Care for the AMA’s Physician Consortium for Performance Improvement. The Division of Endocrinology received 9 new grant awards for clinical and basic science research. The national clinical trial of the NIH-supported vitamin D and type-2 diabetes (D2d) study completed enrollment of over 2400 participants. In a sad loss for the institution, Dr. Susan Hadley, a well-loved member of the Division of Geographic Medicine and Infectious Diseases, died in 2016. Debra Poutsiaka was chosen by division fellows as the first Susan Hadley Clinician Educator awardee. Drs. Brian Chow, Tine Vindenes and Lindsay Margoles, joined the division as faculty. Dr. Cindy Varga joined the Division of Hematology/Oncology, bringing additional expertise in the management of plasma cell neoplasms including multiple myeloma and amyloidosis. In the Division of nephrology, Dr. Andrew Levey, was inducted into the Association of American Physicians. A new Qualification Marker developed by Dr. Perrone for use in studies of the treatment of polycystic kidney disease was adopted by the FDA. Dr. Weiner was appointed Chair of the Quality, Patient Safety and Clinical Practice Committee of the American Society for Nephrology and Dr. Scott Gilbert was appointment Chair of the Society’s Workforce and Training Committee. Dr. Klemens Meyer received the Nancy Johnson Heart Award from Dialysis Clinics, Inc. Dr. Hill, Chief of the Division of Pulmonary, Critical Care and Sleep medicine, was appointed chair of the Steering Committee of the NIH-sponsored Pulmonary Vascular Diseasomics project and received the Distinguished Faculty Award from the medical school. Dr. Preston was appointed chair of the Educational Committee of the Pulmonary Hypertension Association. Dr. Garpestad was appointed Associate Chief Medical Officer at Tufts Medical Center. The division added several junior faculty PhDs conducting basic research. In the Division of Rheumatology, Dr. William Harvey became Director of Informatics Integration in the Tufts CTSI program. He also joined the Board of Directors of the American College of Rheumatology. Dr. Chenchen Wang received an Excellence in Integrative Medicine Award from the European Society of Integrative Medicine. The division added one faculty member. The three institutes at the medical center are separate from but closely allied with the divisions in the Department of Medicine. All three institutes maintained their prominent roles in the publication of research papers, teaching, and participation in expert panels. Many other awards and honors were received by members of the Department of Medicine in 2016. In the pages that follow, we invite you to read more about our efforts in furthering the missions of clinical care, teaching and research. Sincerely yours, Deeb Salem 5 DEPARTMENTAL LEADERSHIP Deeb N. Salem, MD, of the New England Journal of Medicine in 2003 and FACC, FACCP became Vice Chair of that Committee in the spring of 2009. In 2010, Dr. Salem was elected Chairman of the Dr. Deeb Salem has had a distinguished Mass Medical Society’s Committee on Sponsored career as an academic cardiologist. In Programs and Chairman of the Tufts University School of 1987, he was appointed Professor of Medicine's Graduate Medical Education Committee. He Medicine at Tufts University School of currently is on the Executive Advisory Board of the New Medicine. He served as Chief of Cardiology at the Tufts England Journal of Medicine, Chairman of the New England Medical Center from 1987 to 1995 and was NEQCAFinance Committee and is a member of the Tufts appointed the Sheldon M Wolff Professor and Chairman Medical Center's Quality of Care Committee, Finance of the Department of Medicine at Tufts University School Committee and Strategic Planning Committee. In 2014, of Medicine and Physician-in- Chief of Tufts Medical Dr. Salem was elected to the Board of Trustees of the Center in 1999. He is a Fellow of the American College of Massachusetts Hospital Association and in 2015 became Cardiology, the American College of Physicians, and the a member of the Wellforce Finance Committee. American College of Chest Physicians. Dr. Salem was the founding President of the New England Michael Barza, MD Affiliate of the American Heart Association. His Dr. Michael Barza is Vice Chair for academic accomplishments include over one hundred Clinical Affairs at Tufts Medical Center and eighty scientific publications. He is recognized as a and Professor of Medicine at Tufts national expert in coronary artery disease, valvular heart University School of Medicine. In disease and congestive heart failure. Dr. Salem received a 2012, he was named the Sara Murray Distinguished Alumni Award from Boston University Jordan Professor of Medicine at Tufts University School School of Medicine in 1998, a Distinguished Faculty of Medicine. Award from Tufts University School of Medicine in 1998, Dr. Barza joined the faculty of Tufts-New England an American Heart Association Great Communicator Medical Center in 1972. He served as Associate Chief of Award in 1999 and an American Heart Association. the Division of Geographic Medicine and Infectious Distinguished Leadership Award in 2000. He received the Disease as well as hospital epidemiologist. He is a Fellow Massachusetts Physician Health Service Distinguished of the American