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Corey Siegel: Leading the way in IBD care

Photo: Corey A. Siegel, MD
This story was originally published in DHMC's employee newsletter, CenterView, on June 15, 2009.

Dr. Corey Siegel's vision is to "provide expert patient care, and be at the forefront of Inflammatory Bowel Disease (IBD) research and the education in our community."

And the director of the DHMC Inflammatory Bowel Disease Center thinks they are right on track. "I think we are doing a great job," he said. "We are really proud of the patient care we give." D-H will continue its commitment to patient care and education this weekend as it co-hosts the fourth annual D-H Patient and Family IBD Symposium, with the Crohn's and Colitis Foundation of America, from 9 a.m. to 3 p.m., on Saturday, June 20, in Auditoria E, F and G.

Siegel said the conference first was launched to perpetuate a symbiotic relationship between the hospital and patients and since it has consistently drawn more than 200 attendees. "We work to break down complex issues and put it in a format that patients understand. There are talks for "beginners" who are just starting to learn about these diseases, and for "experts" who know the basics, but want to hear more detail about their disease and current research. Hopefully, the education day appeals to all attendees, and everybody feels that they learned something " he said.

Siegel said the Inflammatory Bowel Disease Center serves not only as the premier referral center in Northern New England, but also as a leader in creating a unified approach to treating IBD - taking it from a place where doctors are the sole experts in a patient's care and turning it into 'the center' where everyone a patient deals with is an expert. "We try to make it one cohesive group of providers. We want patients to say, 'There is a group of people who take care of me,' not just 'that's my doctor.'"

Leading the way

Siegel is leading a number of clinical research initiatives, including creating a prediction tool for those diagnosed with Crohn's disease. The tool enables patients and their families to clearly view the chance of having a complication from their disease, and then see the predicted effectiveness of different treatment options. "Ten years ago there were a handful of medications to treat IBD," he said. "Now we have more of a variety that we can use - but these newer treatments have side effects, including life-threatening infections and lymphoma that although rare, need to be considered. The real focus of the research is to translate complex tradeoffs of risks and benefits into a clear and individualized message for patients. We want them to have the best possible information available so they are able to make more educated decisions about their care."

With the collaboration of his wife, Lori Siegel, PhD, who is an expert in modeling complex systems, the prediction tool has been internally validated in approximately 800 patients. Using this tool, when patients ask their doctor what their prognosis is, the doctor is able to show them a computer model that helps predict how the patient will do over the next three years - specifically how different treatment options will affect their disease.

Siegel said his work is connected to improving the quality of care of patients. As defined by the institute of medicine, quality is focused on six features - safe, timely, effective, efficient, equitable, and patient centered care (STEEEP). "My work is focused on the safety and patient-centered components," he said. "The idea is to determine the safety of these medications and find ways to make patients really understand the risks versus the benefits so that they can make choices that fit with their personal preferences. We need to pose it in a way that is honest, fair, and balanced, with our only agenda being that it is a clear communication of accurate information."

Earlier this month, Drs. Corey and Lori Siegel attended the Digestive Disease Week conference in Chicago, to present "A Prediction Tool to Help Children with Crohn's Disease and their Parents Understand Individualized Risks of Disease Complications and Response to Therapy." Siegel said his oral presentation included a pediatric model of the graphical communications tool, which he hopes to incorporate into a web-based tool to use as a patient decision aid for both children and adults with Crohn's disease. He also recently presented a similar program to gastroenterology leaders in Canada and Europe.

"I am really proud of the IBD group we have put together " Siegel said. He credits gastroenterologists Dr. Campbell Levy, Dr. Gary Levine, Dr. Peter Anderson, Dr. Steve Bensen, and Connie Dragnev, who is the only IBD specialty nurse practitioner in Northern New England. They work closely with surgeons Dr. John Murray and Dr. Horace Henriques. In addition, the IBD Center includes nurses Kristen Moskalenko-Locke and Theresa Lynch, administrative assistants Michelle Huntoon and Darlene Johnson, and dedicated research coordinators. "There also are a number of residents, medical students and undergraduates who have helped with the research and the patient database of the over 1,300 IBD patients treated at DHMC."

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