Racial/Ethnic Disparities Research

• Comparison of Rates of Firearm and Nonfirearm Homicide and Suicide in Black and White Non-Hispanic Men, by U.S. State (paper; CNN; GitHub repo)

  • In this study we estimated the magnitude of inequalities in homicide and suicide between Black and white men by US states and firearms use. We found that the Black-white inequality in firearm homicide is highest in Missouri and the rustbelt states (Michigan, Illinois, Indiana, and Pennsylvania), while the white-Black inequality in firearm suicide is highest in South and Western states (Mississippi, Nevada, Arkansas, New Mexico, Arizona, Alabama).

• Trends in Differences in US Mortality Rates Between Black and White Infants (letter; STAT news; LA times; Washington Times; The Economist)

  • In this study we investigated recent trends in the infant mortality rate for Blacks and whites in the US and show that progress towards reducing the racial gap in infant mortality has stalled.

• Long-term trends in the contribution of major causes of death to the black-white life expectancy gap by US state (pre-print; publication; web app)

  • Racial differences have been a fixture of American life for centuries, but their continued evolution is a topic of great relevance for public policy and social justice. States have fared differently in eliminating the Black-white life expectancy gap. Using vital statistics and census data, we describe how six major causes of death contributed to the life expectancy gap between Blacks and whites from 1969 to 2013. We find that states diverged in their cause-of-death specific contributions to the life expectancy gap in ways that either resulted in the near or total elimination of the gap, or alternatively its exacerbation. This analysis provides a foundation for future work to investigate state characteristics that may result in inequalities in mortality by race.

• Differences in obstetric care among nulliparous First Nations and non-First Nations women in British Columbia, Canada (paper; Global news)

  • We compared indicators of obstetric care quality and the use of obstetric interventions between First Nations and non-First Nations mothers in British Columbia, Canada. We found that First Nations mothers were less likely to receive care, such as an early ultrasound, or receive obstetrical interventions, including epidural, and cesarean delivery.

Obstetrical Care

• Inter-institutional variation in use of cesarean delivery for labour dystocia: a population-based cohort study (paper)

  • Using birth registry data from three Canadian provinces, we examined the variation in cesarean delivery rates for labour dystocia – the most common indication for cesarean delivery during labour among low-risk women. Because hospitals vary in the types of patients they see and the services they can offer, we performed adjustments for maternal- and hospital- factors to enable fairer comparisons. Substantial variation remained and may suggest that reasonable decreases to cesarean delivery rates can be made.

• Cervical dilation at time of cesarean delivery in nulliparous women: a population-based cohort study (paper)

  • Here, we describe contemporary practice patterns – at what cervical dilations are cesarean deliveries performed? How much does this vary across hospitals? Do these practices align with clinical guidelines?

• Safety of labour and delivery following closure of obstetrical services in small community hospitals in British Columbia, Canada (second author; paper)

  • Here, we used a quasi-experimental design known as fixed-effects analysis to demonstrate that the closure of planned obstetrical services in low-volume hospitals was not associated with an increase or decrease in the frequency of adverse events during labour and delivery.

• Classifying Gestational Weight Gain Trajectories Using the SITAR Growth Model. (paper)

  • We investigated how well the “SITAR” model fit weight gain patterns of pregnant women. These models fit the data well, suggesting that they can be used to describe weight gain trajectories.

• Effect of uterine rupture on a hospital’s future rate of vaginal birth after cesarean delivery (paper)

  • Using the US Nationwide Inpatient Sample, I study how the occurrence of a severe uterine rupture affects clinical practice. Specifically, I explore whether this event leads to more cesarean deliveries and estimate how long the effect lasts.

• Contributing author. Society of Obstetricians and Gynaecologists of Canada Clinical Practice Guideline on Management of Labour. [Invited author contribution]

Design and Analysis of Randomized Controlled Trials

• Informing randomized clinical trials of respiratory syncytial virus vaccination during pregnancy to prevent recurrent childhood wheezing: a sample size analysis (first author; accepted at Vaccine)

  • This paper was the result of a Bill & Melinda Gates Foundation-funded project on study designs to detect long-term childhood respiratory outcomes associated with maternal vaccination for respiratory syncytial virus.

• Beyond Intention-to-Treat: what is the right question? (fifth author; paper)

• An adaptive clinical trial design for a sensitive subgroup examined in the multiple sclerosis context (paper; MSc. thesis)

• Bayesian adaptive randomization for clinical trials (unpublished report)

Misc.

• Drug overdose mortality by US State, 1979-2015 (unpublished graphics)

• Evaluation of safety monitoring guidelines based on MRI lesion activity in multiple sclerosis (paper)

• Accuracy of p53 Codon 72 Polymorphism Status Determined by Multiple Laboratory Methods: A Latent Class Model Analysis (second author; paper)