Pepper Center: Pilot and Exploratory Studies Core

Pepper Center

The overarching goal of the Pilot and Exploratory Studies Core is to facilitate the development and progress of innovative research relating to the Pepper Center focus on the predictors, characteristics, and outcomes of late-life disability, especially in vulnerable older populations.

A unique aspect of our work is a dual focus on prevention and palliation of disability. Preventing disability is a crucial focus of Geriatric research, but our research also needs to focus on the millions of older persons dealing with physical and cognitive impairments of old age who need our help right now. We believe that successful aging encompasses having a good quality of life regardless of one’s medical conditions and functional impairments.

Core Leaders:

Christine Ritchie, MD, MSPH

Brie Williams, MD, MS

Pepper Center Pilot Studies

Andy Auerbach, MD
Professor, Division of Hospital Medicine

Pilot: Characterizing Post-Acute Care Costs for Older Patients Discharged from an Academic Medical Center

The goal of this study is to generate estimates of post-discharge utilization patterns among adult Medicare beneficiaries discharged from UCSF Medical Center between 1/1/2012 and 12/31/2012. Dr. Auerbach will link CMS data to rich administrative data already available at UCSF. These estimates will in turn be used to develop clinical research grants to support inpatient transitions of care programs (e.g. use of discharge coordinators), consultative services such as palliative care services, and to potentially support novel demonstration projects where post-acute care costs are bundled or shared among key stakeholders.

Emily Finlayson, MD, MS
Associate Professor, UCSF Department of Surgery

Pilot: Functional Outcomes after Breast Cancer Surgery in Older Nursing Home Residents

The goals of this pilot project are to determine the functional trajectories of older women who undergo breast cancer surgery while living in a nursing home, and to provide preliminary data for an R01 application for a broader study of the downstream consequences of mammography and surgical treatment of breast cancer among nursing home residents.

Salomeh Keyhani, MD
Associate Professor, UCSF Division of General Internal Medicine and the San Francisco VA Medical Center

Pilot: Improving 30-day Readmission Risk Prediction for Hospitalized Older Adults Using Measures of Social Risk and Functional Status from Electronic Medical Records

The goal of this pilot is to develop natural language processing algorithms to extract data on social risk and function from electronic health records in order to improve 30-day readmission risk prediction for hospitalized older adults. This pilot will also provide preliminary data for an R01 application that will compare the performance of current readmission models, which include demographics and health status, to a model that also includes social risk and function extracted using automated natural language processing algorithms for two conditions: congestive heart failure and stroke.

Jennifer Lai, MD, MBA
Assistant Professor, Division of Gastroenterology

Pilot: Applying Measures of Frailty and Functional Status to Older Cirrhotics Receiving Liver Transplants

Dr. Lai has been overseeing an observational study of functional status in liver transplant candidates. Support from the Pepper Center has enabled her to engage in analyses evaluating the role of frailty in mortality prediction.

Rebecca Sudore, MD
Assistant Professor, Division of Geriatrics
UCSF Pepper Center Co-Director of Diversity

Pilot: Piloting a Guide to Prepare Older Adults to Make Informed Decisions for Disability and Serious Illness

The goal of this pilot study is to obtain preliminary data about the efficacy of an interactive, multimedia web-based intervention, called PREPARE, designed to improve decision making for diverse, older adults over the course of disability and serious illness ( This pilot will generate data to support an R01 application to test the efficacy of PREPARE among diverse older adults with disability (≥ 1 dependence in an instrumental activity of daily living(IADL)) and < 2 years life expectancy (determined by physicians) in a county healthcare system.

To learn more about the UCSF Pepper Center, please contact Pepper Center Coordinator, Sarah Garrigues