Deborah Fisher

Overview:

1) Clinical interests and focus: I am a general gastroenterologist with a particular interest in colorectal cancer screening/surveillance and quality improvement.  I recently served on the ASGE Assessment of Quality in Endoscopy committee and currently serve on the AGA Clinical Practice Updates committee.

2) Research focus: Outcomes, big data, and health services research as applied to a variety of GI areas including weight-loss devices, NAFLD, colorectal cancer screening, choledocholithiasis.  I conduct clinical research (outcomes, clinical trials, diagnostic studies) in colorectal cancer screening and have collaborated with the School of Engineering on GI clinical applications of new technology.

3) Educational activities:  Clinical teaching in gastroenterology and endoscopy, directing the Department of Medicine MENTORS program for research fellows, mentoring trainees and junior faculty in research.  I am faculty of the GI T32 training grant and of the Duke Clinical Research Training Program. In my role as the GI Director of Social and Digital Media, I train and advise in using social media for medical education and professional development.

Positions:

Associate Professor of Medicine

Medicine, Gastroenterology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Member in the Duke Clinical Research Institute

Duke Clinical Research Institute
School of Medicine

Education:

M.D. 1996

Vanderbilt University

Medical Resident, Medicine

University of Virginia

Fellow in Gastroenterology, Medicine

Duke University

Grants:

H9X-MC-GBGL

Administered By
Duke Clinical Research Institute
Awarded By
Eli Lilly and Company
Role
Principal Investigator
Start Date
End Date

Core variable Assessment Towards a NatIonal evaluation Program (CATNIP) - Subcontract with Weill Cornell

Administered By
Duke Clinical Research Institute
Awarded By
Weill Cornell Medicine
Role
Principal Investigator
Start Date
End Date

Duke Training Grant in Advanced Gastrointestinal Endoscopy

Administered By
Medicine, Gastroenterology
Awarded By
Boston Scientific Corporation
Role
Mentor
Start Date
End Date

Publications:

Esophageal and Gastric Motility Changes Following Lung Transplantation.

MLA Citation
Leiman, David A., et al. “Esophageal and Gastric Motility Changes Following Lung Transplantation.J Clin Gastroenterol, vol. 55, no. 8, Sept. 2021, pp. 730–31. Pubmed, doi:10.1097/MCG.0000000000001499.
URI
https://scholars.duke.edu/individual/pub1472848
PMID
33492889
Source
pubmed
Published In
J Clin Gastroenterol
Volume
55
Published Date
Start Page
730
End Page
731
DOI
10.1097/MCG.0000000000001499

Impact of screening and follow-up colonoscopy adenoma sensitivity on colorectal cancer screening outcomes in the CRC-AIM microsimulation model.

BACKGROUND: Real-world data for patients with positive colorectal cancer (CRC) screening stool-tests demonstrate that adenoma detection rates are lower when endoscopists are blinded to the stool-test results. This suggests adenoma sensitivity may be lower for screening colonoscopy than for follow-up to a known positive stool-based test. Previous CRC microsimulation models assume identical sensitivities between screening and follow-up colonoscopies after positive stool-tests. The Colorectal Cancer and Adenoma Incidence and Mortality Microsimulation Model (CRC-AIM) was used to explore the impact on screening outcomes when assuming different adenoma sensitivity between screening and combined follow-up/surveillance colonoscopies. METHODS: Modeled screening strategies included colonoscopy every 10 years, triennial multitarget stool DNA (mt-sDNA), or annual fecal immunochemical test (FIT) from 50 to 75 years. Outcomes were reported per 1000 individuals without diagnosed CRC at age 40. Base-case adenoma sensitivity values were identical for screening and follow-up/surveillance colonoscopies. Ranges of adenoma sensitivity values for colonoscopy performance were developed using different slopes of odds ratio adjustments and were designated as small, medium, or large impact scenarios. RESULTS: As the differences in adenoma sensitivity for screening versus follow-up/surveillance colonoscopies became greater, life-years gained (LYG) and reductions in CRC-related incidence and mortality versus no screening increased for mt-sDNA and FIT and decreased for screening colonoscopy. The LYG relative to screening colonoscopy reached >90% with FIT in the base-case scenario and with mt-sDNA in a "medium impact" scenario. CONCLUSIONS: Assuming identical adenoma sensitivities for screening and follow-up/surveillance colonoscopies underestimate the potential benefits of stool-based screening strategies.
Authors
Fisher, DA; Saoud, L; Hassmiller Lich, K; Fendrick, AM; Ozbay, AB; Borah, BJ; Matney, M; Parton, M; Limburg, PJ
MLA Citation
URI
https://scholars.duke.edu/individual/pub1468689
PMID
33314646
Source
pubmed
Published In
Cancer Medicine
Published Date
DOI
10.1002/cam4.3662

Variations and Racial Disparities in Helicobacter pylori Guideline Adherence for Eradication Testing

Authors
Reichstein, J; Parish, A; Garbarino, S; Wilder, J; Epplein, M; Fisher, DA; Niedzwiecki, D; Muir, AJ; Leiman, DA
MLA Citation
Reichstein, Jonathan, et al. “Variations and Racial Disparities in Helicobacter pylori Guideline Adherence for Eradication Testing.” American Journal of Gastroenterology, vol. 115, 2020, pp. S670–71.
URI
https://scholars.duke.edu/individual/pub1473502
Source
wos-lite
Published In
American Journal of Gastroenterology
Volume
115
Published Date
Start Page
S670
End Page
S671

Antibiotic Resistance Rates in Helicobacter pylori Infection Derived from Retrospective Cure Rates

Authors
Reichstein, J; Parish, A; Garbarino, S; Wilder, J; Epplein, M; Fisher, DA; Niedzwiecki, D; Muir, AJ; Leiman, DA
MLA Citation
Reichstein, Jonathan, et al. “Antibiotic Resistance Rates in Helicobacter pylori Infection Derived from Retrospective Cure Rates.” American Journal of Gastroenterology, vol. 115, 2020, pp. S670–S670.
URI
https://scholars.duke.edu/individual/pub1473503
Source
wos-lite
Published In
American Journal of Gastroenterology
Volume
115
Published Date
Start Page
S670
End Page
S670

Colorectal Cancer Screening by Test Type Prior to and Following Mt-sDNA Market Entry Among Average Risk Patients: A Real World Analysis

Authors
Fisher, DA; Princic, N; Miller-Wilson, L-A; Wilson, K; Fendrick, M; Limburg, PJ
MLA Citation
Fisher, Deborah A., et al. “Colorectal Cancer Screening by Test Type Prior to and Following Mt-sDNA Market Entry Among Average Risk Patients: A Real World Analysis.” American Journal of Gastroenterology, vol. 115, 2020, pp. S146–S146.
URI
https://scholars.duke.edu/individual/pub1474101
Source
wos-lite
Published In
American Journal of Gastroenterology
Volume
115
Published Date
Start Page
S146
End Page
S146

Research Areas:

Adult
Algorithms
Ambulatory Care Facilities
Attitude of Health Personnel
Barrett Esophagus
Chi-Square Distribution
Colonoscopy
Community Health Services
Continental Population Groups
Data Mining
Databases as Topic
Decision Support Techniques
Dilatation
Early Detection of Cancer
Early Diagnosis
Endoscopy, Digestive System
Epidemiologic Methods
Feces
Gastrointestinal Diseases
Gastrointestinal Hemorrhage
Guideline Adherence
Health Behavior
Health Care Costs
Health Resources
Health Services Accessibility
Health Services Misuse
Health Services Research
Health Status
Healthcare Disparities
Hemostasis, Endoscopic
Humans
Intubation, Gastrointestinal
Liver
Lower Gastrointestinal Tract
Mass Screening
Melena
Needs Assessment
Neoplasm Recurrence, Local
Neoplasm Staging
Occult Blood
Odds Ratio
Outcome and Process Assessment (Health Care)
Patient Selection
Physical Examination
Preventive Health Services
Prognosis
Quality Assurance, Health Care
Quality Indicators, Health Care
Quality of Health Care
Quality of Life
Questionnaires
Reproducibility of Results
Research Design
Risk Reduction Behavior
Sensitivity and Specificity
Social Class
Socioeconomic Factors
Standard of Care
Stents
Surveys and Questionnaires
Survivors
Time Factors
Treatment Outcome
Upper Gastrointestinal Tract
Veterans