Infectious Diseases Outcome Research Fellowship

The purpose of the ARL's Infectious Diseases Outcomes Research (IDOR) Division is to conduct studies of anti-infective use which will determine what practices are associated with the best patient outcomes (including costs) in both controlled and uncontrolled, real world situations.  The resulting information can then be used to bridge the rift between outcomes research and clinical practice by ensuring that institutions have the data needed to obtain the highest standard of care for their patients and to best allocate scarce health care resources.

Infectious Diseases Outcomes Research Performed at the ARL is clearly distinct from pharmaceutical research performed to answer questions primarily of drug safety and efficacy.  Useful Infectious Diseases outcomes data can be derived from both randomized clinical trials studies, retrospective comparative studies and observational investigations of infectious diseases treatment.  Some of these studies are designed to assess or facilitate the appropriateness of antibiotic use and to assess the relationships between use and the development of resistance.  Other studies examine specific epidemiologic data as it relates to patient outcomes for a treatment of an assortment of infectious disease states or resistant organisms.  The ability to quantify costs associated with antimicrobial resistance in specific patient populations can also be achieved through outcomes research.

Various study designs and data resources are utilized to accomplish the above goals.  Clinical trial data is sometimes used; however, prospective or retrospective observational studies give a better assessment of effectiveness in a real world setting where treatment duration and patient specific characteristics is not fixed.  At times, large databases including insurance claims data may be the best resource to provide large sample size assessment of regional and national trends in antimicrobial usage and resistance.  Prospective pharmacoeconomic modeling is also a tool, which is used to project likely outcomes when clinical, or observational data may be incomplete or lacking.  Sophisticated statistical testing and pharmacoeconomic analysis incorporating sensitivity analysis are routinely employed to extract the most meaningful interpretation of the data.

The Infectious Diseases Outcome Research Fellowship Program at the ARL and Wayne State University is designed to provide comprehensive on-hands training in ID health outcomes analysis using epidemiologic health care assessment approaches including microbiologic, and molecular organism evaluations, and pharmacoeconomic analysis of patient outcomes. Experience is gained by prospective and retrospective clinical trial outcome assessment using a variety of outcome measurement analysis techniques including univariate and multivariate risk factor analysis, decision tree, propensity matching, DOOR and survival analysis as well as pharmacoeconomic assessment of patient care. The program includes on-hands statistical analysis training, laboratory and clinical training. The clinical training consists of rounding experience with our ID consult service and participation on the antimicrobial stewardship committee as other various committees for the Detroit Medical Center. The fellow will also participate in teaching Pharm.D. students on ID consult rounds and in the classroom setting for our ID therapeutics module. Part of the training will also consist of didactic coursework. There are no coursework fees while enrolled in the fellowship program. All coursework is taken for graduate credit and is transferable.

Previous ARL ID Outcomes Research Fellows projects have included investigations of epidemiology, clinical outcomes, pharmacokinetic and pharmacodynamic, toxicodynamic as well as pharmacoeconomic outcomes of a variety of infectious diseases.  Our fellows have gone on to secure tenure and non-tenure track faculty positions as well as high profile industry positions, and continue to actively engage in teaching, scholarship and clinical practice.  

Required coursework*

  • CM 6010 Biostatistics I (4 credits)
  • CM 7250 Biostatistics II (4 credits)
  • CM 7240 Epidemiology I (4 credits)
  • NIH Grant Writing Workshop I & II

Fellows will register for the Public Health Certificate Program in order to take the above coursework. Fellows may opt-out of the required coursework if they have completed similar training prior to joining the fellowship program.

Please note: There are no credit hour charges for any coursework at Wayne State University when enrolled in the fellowship-training program.

A Master of Public Health degree program is also available through Wayne State University's School of Medicine at no tuition charge for fellows who wish to extend their coursework.

*Applicants with prior equivalent graduate course work are excused from the required coursework listed above.

Additional coursework available

  • ECO 5000 Intermediate microeconomics
  • ECO 7020 Fundamentals of economic analysis
  • A variety of summer courses in Epidemiology are also available through University of Michigan Summer Epidemiology Coursework

Program director

Michael J Rybak, Pharm.D. MPH, Ph.D., FCCP, FIDSA

Additional faculty resources and collaborators

Sara Alosaimy, Pharm.D., MPH, Research Scientist, Department of Pharmacy Practice, Anti-Infective Research Laboratory.  Dr. Alosaimy's research expertise is in the area of epidemiologic and biostatistical evaluations of ID patient health outcomes including antimicrobial efficacy and safety.

Susan L. Davis, Pharm.D., FCCP., Associate Dean and Professor of Pharmacy Practice, Wayne State University, Infectious Diseases Pharmacy Specialist, Henry Ford Hospital. Susan's research interest is ID health outcomes assessment, epidemiology and antimicrobial stewardship.

Sorabh Dhar, M.D., Associate Professor of Medicine, Division of Infectious Diseases, Wayne State University, Director for Antimicrobial Stewardship, Detroit Medical Center.  Dr. Dhar's interests are in the epidemiologic assessment of infection and patient outcome especially as it relates to antimicrobial resistance.

Teena Chopra, M.D., M.P.H., Assistant Professor of Medicine, Division of Infectious Diseases, Director for Infection Control and Epidemiology, Detroit Medical Center. Dr. Chopra's interest and research focus is antimicrobial stewardship especially as it relates to long term nursing facilities.

Marcus Zervos, M.D. Professor of Medicine, Wayne State University and Division Head, Infectious Diseases, Henry Ford Hospital.  Dr. Zervos is interested in characterizing gram-positive resistance specifically in enterococci and staphylococci species.  He has also participated in several studies examining the epidemiology and health outcomes of patients with multi-drug resistant bacterial infections.

Paul Kilgore, M.D., M.P.H.  Associate Professor of Pharmacy & Medicine, Department of Pharmacy Practice.  Dr. Kilgore's focus is on public health issues and epidemiologic investigations exploring patient outcomes.  He is also interested in studying the impact of vaccination of patient outcomes and antimicrobial stewardship.

Fabrice Smieliauskas, Ph.D., Assistant Professor of Pharmacy Practice/Economics. Dr. Smieliauskas expertise is in economic and pharmacoeconomic assessments of health outcomes and the impact of medical technologies and procedures.

Benefits

Post-doctoral fellows receive a competitive salary stipend and full medical benefits as well as free tuition for graduate studies as stated above.

Application process

  1. Cover Letter
  2. Curriculum Vitae
  3. Transcripts
  4. Three letters of reference