Active Projects
A selection of the research projects currently underway at WIRE, spanning clinical outcomes, quality improvement, observational research, and research infrastructure.
These are representative examples, not a complete list of our active work.
EUS-Guided FNB Without Rapid On-Site Cytologic Examination (ROSE)
PI: Matthew T. Peller, MD
An institutional quality study evaluating the performance and outcomes of EUS-guided fine needle biopsy (FNB) performed without rapid on-site cytologic examination (ROSE). This study examines whether high-quality tissue acquisition for cytopathologic diagnosis can be reliably achieved without ROSE, which has significant implications for resource utilization and procedural efficiency in endoscopic ultrasound.
- Institutional quality study
- EUS-guided tissue acquisition
- Resource utilization
- Cytopathology outcomes
PANC-GLP: Acute Pancreatitis Risk with GLP-1 Agonist Therapy
PI: Zachary L. Smith, DO, MSc
A target trial emulation examining the risk of acute pancreatitis in patients with obesity who initiate GLP-1 receptor agonist therapy compared with those who do not. This study leverages large-scale real-world data through WIRE's institutional data partnerships to address an emerging clinical question as GLP-1 agonist prescribing continues to expand rapidly.
- Target trial emulation
- GLP-1 receptor agonists
- Acute pancreatitis risk
- Real-world evidence
Target Trial Emulation of NSAIDs and Statins for Recurrent Acute Pancreatitis Prevention
PI: Zachary L. Smith, DO, MSc
A target trial emulation using TriNetX Linked Claims data from 143,742 acute pancreatitis patients across 29 healthcare organizations, comparing NSAID therapy, statin therapy, and no pharmacotherapy for the prevention of recurrent acute pancreatitis. This study applies cloning-censoring-weighting methodology to emulate a three-arm randomized trial.
- Target trial emulation
- TriNetX
- Pancreatitis prevention
- Claims-based research
Colorectal Cancer Screening Outcomes After Positive Multitarget Stool DNA Testing
PI: Zachary L. Smith, DO, MSc
A multi-paper TriNetX Linked Claims research program examining follow-up colonoscopy completion and downstream outcomes after positive multitarget stool DNA (mt-sDNA/Cologuard) testing, with particular attention to how the length of observable claims follow-up shapes estimates of completion. Additional studies will examine screening trajectory patterns, diagnostic cascade costs, interval colorectal cancer incidence, and comparative effectiveness across screening modalities.
- Colorectal cancer screening
- mt-sDNA testing
- Claims observation windows
- Follow-up colonoscopy
- Claims-based research
Reporting Patterns and P-Value Distributions in TriNetX and Nationwide Inpatient Sample Research
PI: Zachary L. Smith, DO, MSc
A preregistered scoping review analyzing p-value distributions and reporting bias indicators across 4,323 TriNetX publications and 2,537 Nationwide Inpatient Sample publications (2017–2026). The study applies p-curve, z-curve, caliper tests, and density discontinuity analyses to compare evidence of threshold-specific reporting bias between platform-based cohort analytics and traditional database research.
- Meta-research
- P-value distribution
- Reporting bias
- TriNetX
- Observational research methodology
ERCP Outcomes During the Nationwide Intravenous Fluid Shortage
PI: Hassaan Zia, MD (former WIRE faculty)
An observational study examining whether the nationwide intravenous fluid shortage impacted clinical outcomes following ERCP procedures. This timely investigation leverages a natural experiment created by the supply chain disruption to evaluate the effect of modified fluid resuscitation strategies on post-ERCP complications, including post-ERCP pancreatitis.
- Natural experiment design
- IV fluid shortage impact
- Post-ERCP pancreatitis
- Supply chain disruption