Simon Laboratory

Research Topics

Improving the evidence base for inpatient care provided to children with medical complexity, including but not limited to:

  • Describing the microbial environment of cerebrospinal fluid (CSF) shunt infections

  • Determining risk factors and optimizing treatment for CSF shunt infections and re-infections

  • Improving surgical decision-making to prevent CSF shunt infection

  • Identification and characterization of healthcare utilization by children with medical complexity

Research Overview

Our study team is driven by a talented group of research staff and collaborating sites who address translational, clinical and health services research projects. We are committed to improving the quality of evidence in the inpatient health care provided to children with medical complexity.

The laboratory of Tamara D. Simon, MD, MSPH, focuses on cerebrospinal fluid (CSF) shunt infections and re-infections in children with hydrocephalus.

In 2009, Dr. Simon obtained a K23 career development award from the National Institute of Neurological Disorders and Stroke. The grant allowed her to conduct multicenter studies to determine risk factors for CSF shunt infections through the Hydrocephalus Clinical Research Network, expanding upon similar work conducted using single center data and multicenter administrative databases.

While finding relatively few patient factors are associated with risk for first CSF shunt infection, we have learned that implementing a standardized surgical protocol reduced CSF shunt infection rates. The team is now pursuing the effectiveness of intrathecal antibiotics and antibiotic impregnated shunt catheters in preventing post-surgical CSF shunt infection. A grant to investigate this question using the PHIS+ database (PHIS+ Shunt Infection Prevention) is being supported through a R01 grant from the National Institute of Neurological Disorders and Stroke.

Our team’s subsequent translational line of inquiry has focused on the microbial environment of CSF shunt infections. With new collaborators, we have described wide bacterial and fungal diversity in the CSF of children with CSF shunt infections, and are actively investigating the presence of biofilms on shunt apparatus. A grant to characterize the CSF microbiota across the time course of shunted hydrocephalus (Cerebrospinal FLuId MicroBiota in Shunts Study or CLIMB) is being supported through an R01 grant from the National Institutes of Neurological Disorders and Stroke.

Additionally, the team’s health service research focus is on improving the quality of care provided to children with medical complexity in the inpatient setting. It is critical to accurately identify this vulnerable population of children to study and better understand where evidence gaps exist in their care and to inform the development of interventions to improve their care.

Dr. Simon was the scientific lead of the AHRQ-funded Working Group on Identification of Medically Complex Children in Administrative data, and a driving force for the development of the Center’s strategy to identify children with medical complexity in Medicaid administrative data. The resulting Pediatric Medical Complexity Algorithm (PMCA) identifies children with medical complexity with high sensitivity and specificity using hospital discharge or health plan administrative data. PMCA is now in use by multiple institutions both nationally and internationally. A grant investigating utilization by children with medical complexity in rural and urban settings was recently awarded to Dr. JoAnna Leyenaar at Dartmouth.

Meet Our Team

  • Lab Members

Tamara D. Simon, MD, MSPH
Principal Investigator

CHLA-Tamara-Simon-150x150-01.jpg

Katie Whitlock, MS
Biostatistician

CHLA-Katie-Whitlock-150x150-01.jpgKatie Whitlock (New Harmony Statistical Consulting LLC) supports Simon Lab research initiatives as its Biostatistician, Data Manager and general analytic Jack-of-all-Trades. Driven by a passion for improving patient care and medical and psychosocial outcomes through research, Whitlock has worked in academic- and hospital-based biomedical research for over a decade. Her expertise covers frequentist modeling techniques, including generalized linear mixed models, parametric and non-parametric survival techniques, and quality improvement techniques.

Sabrina Sedano, BS
Research Assistant

CHLA-Sabrina-Sedano-150x150-01.jpgSabrina Sedano completed her undergraduate studies at the University of California, Riverside. She works collaboratively with the research teams on the PHIS+ Shunt Infection Prevention and CLIMB clinical studies of children with hydrocephalus. She is interested in helping improve the quality of care for children with medical complexities and promoting research among minority groups. She works closely with families participating in the research projects, as well as overseeing data workflow and archiving.


Paul Hodor, PhD
Principal Systems Engineer, Enterprise Analytics, Seattle Children’s Hospital

CHLA-Paul-Hodor-150x150-01.jpgDr. Hodor is responsible for the bioinformatics analysis of data from the microbiota project, as well as for progress reporting for team projects. He has a longstanding interest in deriving knowledge from data in the life sciences. His current interests are in developing computational tools based on big data technologies and the reconstruction of microbial genomes from clinical samples. Past focus areas include building scalable solutions for the storage of human genomic data and machine learning models and biomarker discovery for pharmaceutical research.


Participating Sites

  • PHIS+ Shunt Infection Prevention
  • CLIMB
  • Alumni

Boston Children’s Hospital

Site Investigator: Benjamin Warf, MD
Study Staff: Madeline Karsten

Children’s Hospital Association

Site Investigator: Matt Hall, PhD

Children’s Hospital of Philadelphia 

Site Investigator: Susan Coffin, MD
Study Staff: Kellie Liston

Children’s Hospital of Pittsburgh

Site Investigator: Ian Pollack, MD
Study Staff: Kimberly Diamond

Cincinnati Children’s Hospital Medical Center

Site Investigator: Francesco Mangano, MD
Study Staff: Fanmuyi Yang and Sarah Mierke

Primary Children’s Hospital

Site Investigator: Emily Thorell, MD
Co-Investigator: Ram Gouripeddi, PhD
Study Staff: Evan Heller

Seattle Children’s Hospital

Site Investigator: Jason Hauptman, MD
Co-Investigators: Boots Kronman, MD, and Chuan Zhou, PhD
Study Staff: Alex Rangel-Humphrey

University of Washington

Co-Investigator: Paul Fishman, PhD

Washington University in St. Louis 

Site Investigator(s): David Limbrick, MD, PhD
Study Staff: Diego Morales

British Columbia Children’s Hospital 

Site Investigator(s): Patrick McDonald, MD
Study Staff: Alex Cheong

Seattle Children’s Hospital

Site Investigator: Jason Hauptman, MD
Study Staff: Alex Rangel-Humphrey

University of Washington

Site Investigator: Luke Hoffman, MD, PhD
Study Staff: Chris Pope, PhD

Wayne State University

Site Investigator: Carolyn Harris, PhD

PHIS+ Shunt Infection Prevention

Stephen Chun – Seattle Children’s Hospital
Leslie Davis – Children's Hospital of Philadelphia
Emily Day – Boston Children’s Hospital
Richard Drake – Primary Children’s Hospital
Emily Insalaco – Children's Hospital of Pittsburgh
Julie McGalliard - Seattle Children’s Hospital
Tina Mounlavongsy – Boston Children's Hospital
Alex Platt-Koch – Primary Children’s Hospital
Roshni Prabhu – Seattle Children’s Hospital
Coleman Riordan – Boston Children’s Hospital
Ashton Roach – Cincinnati Children’s Hospital Medical Center
Michael Russo – Children’s Hospital of Philadelphia
Linda Shih – Seattle Children’s Hospital

CLIMB

Haley Botteron – Washington University in St. Louis
Julie McGalliard - Seattle Children’s Hospital
Amanda Morgan – Washington University in St. Louis
Roshni Prabhu – Seattle Children’s Hospital
Linda Shih – Seattle Children’s Hospital

Publications

Publications are up to date at https://profiles.sc-ctsi.org/tamara.simon.

Current Funding

  • The National Institutes of Neurological Disorders and Stroke
  • National Institute on Minority Health and Health Disparities
  • Southern California Clinical and Translational Science Institute

Completed Funding

  • The National Institutes of Neurological Disorders and Stroke
  • National Heart, Lung, and Blood Institute
  • Patient-Centered Outcomes Research Institute
  • Agency for Healthcare Research and Quality Centers for Medicare and Medicaid Services
  • Center for Clinical and Translational Research at Seattle Children’s Research Institute
  • Seeking Techniques in Advancing Research in Shunts
  • Primary Children’s Medical Center Foundation
  • Clinical Center for Translational Science Pilot Project at University of Utah

Data and Specimen Request

If you and your research team are interested in using the PHIS+ data please email your request to tsimon@chla.usc.edu. Please include the institution you are affiliated with as well as your contact information.

If you and your research team are interested in using our biospecimens repository please email your request to CSFMicrobiota@chla.usc.edu. Please include the institution you are affiliated with as well as your contact information

In the News 

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