Scott Shofer

Positions:

Associate Professor of Medicine

Medicine, Pulmonary, Allergy, and Critical Care Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 1997

University of California - Santa Cruz

M.D. 2001

Boston University

Medical Resident, Medicine

Stanford University

Fellow in Pulmonary Medicine, Medicine

Duke University

Grants:

PSA for Mona Malik

Administered By
Medicine, Pulmonary, Allergy, and Critical Care Medicine
Awarded By
Institute for Medical Research, Inc.
Role
Principal Investigator
Start Date
End Date

IPA for Melissa Wagner

Administered By
Surgery, Cardiovascular and Thoracic Surgery
Awarded By
Durham Veterans Affairs Medical Center
Role
Principal Investigator
Start Date
End Date

PSA for Jessica Shier

Administered By
Medicine, Pulmonary, Allergy, and Critical Care Medicine
Awarded By
Institute for Medical Research, Inc.
Role
Principal Investigator
Start Date
End Date

IMR PSA: Wendy Curry

Administered By
Medicine, Pulmonary, Allergy, and Critical Care Medicine
Awarded By
Institute for Medical Research, Inc.
Role
Principal Investigator
Start Date
End Date

Publications:

Variable Learning Curve of Basic Rigid Bronchoscopy in Trainees.

BACKGROUND: Despite increased use of rigid bronchoscopy (RB) for therapeutic indications and recommendations from professional societies to use performance-based competency, an assessment tool has not been utilized to measure the competency of trainees to perform RB in clinical settings. OBJECTIVES: The aim of the study was to evaluate a previously developed assessment tool - Rigid Bronchoscopy Tool for Assessment of Skills and Competence (RIGID-TASC) - for determining the RB learning curve of interventional pulmonary (IP) trainees in the clinical setting and explore the variability of learning curve of trainees. METHODS: IP fellows at 4 institutions were enrolled. After preclinical simulation training, all RBs performed in patients were scored by faculty using RIGID-TASC until competency threshold was achieved. Competency threshold was defined as unassisted RB intubation and navigation through the central airways on 3 consecutive patients at the first attempt with a minimum score of 89. A regression-based model was devised to construct and compare the learning curves. RESULTS: Twelve IP fellows performed 178 RBs. Trainees reached the competency threshold between 5 and 24 RBs, with a median of 15 RBs (95% CI, 6-21). There were differences among trainees in learning curve parameters including starting point, slope, and inflection point, as demonstrated by the curve-fitting model. Subtasks that required the highest number of procedures (median = 10) to gain competency included ability to intubate at the first attempt and intubation time of <60 s. CONCLUSIONS: Trainees acquire RB skills at a variable pace, and RIGID-TASC can be used to assess learning curve of IP trainees in clinical settings.
Authors
Mahmood, K; Wahidi, MM; Shepherd, RW; Argento, AC; Yarmus, LB; Lee, H; Shojaee, S; Berkowitz, DM; Van Nostrand, K; Lamb, CR; Shofer, SL; Gao, J; Davoudi, M
MLA Citation
Mahmood, Kamran, et al. “Variable Learning Curve of Basic Rigid Bronchoscopy in Trainees.Respiration, vol. 100, no. 6, 2021, pp. 530–37. Pubmed, doi:10.1159/000514627.
URI
https://scholars.duke.edu/individual/pub1478182
PMID
33849039
Source
pubmed
Published In
Respiration
Volume
100
Published Date
Start Page
530
End Page
537
DOI
10.1159/000514627

Impulse Oscillometry Identifies Small Airways Pathology Among Obese Patients Otherwise Missed by Traditional Spirometry

Authors
Vose, A; Patel, BP; Bedoya, A; Tighe, RM; Shofer, SL
MLA Citation
Vose, A., et al. “Impulse Oscillometry Identifies Small Airways Pathology Among Obese Patients Otherwise Missed by Traditional Spirometry.” American Journal of Respiratory and Critical Care Medicine, vol. 203, no. 9, 2021.
URI
https://scholars.duke.edu/individual/pub1497466
Source
wos-lite
Published In
American Journal of Respiratory and Critical Care Medicine
Volume
203
Published Date

Hyperbaric oxygen therapy to prevent central airway stenosis after lung transplantation.

BACKGROUND: Central airway stenosis (CAS) is a severe airway complication after lung transplantation associated with bronchial ischemia and necrosis. We sought to determine whether hyperbaric oxygen therapy (HBOT), an established treatment for tissue ischemia, attenuates post-transplant bronchial injury. METHODS: We performed a randomized, controlled trial comparing usual care with HBOT (2 atm absolute for 2 hours × 20 sessions) in subjects with extensive airway necrosis 4 weeks after transplantation. Endobronchial biopsies were collected at 4, 7, and 10 weeks after transplantation for a quantitative polymerase chain reaction. Coprimary outcomes were incidence of airway stenting and acute cellular rejection (ACR) at 1 year. RESULTS: The trial was stopped after enrolling 20 subjects (n = 10 per group) after a pre-planned interim analysis showed no difference between usual care and HBOT groups in stenting (both 40%), ACR (70% and 40%, respectively), or CAS (40% and 60%, respectively). Time to first stent placement (median [interquartile range]) was significantly shorter in the HBOT group (150 [73-150] vs 186 [167-206] days, p < 0.05). HIF gene expression was significantly increased in donor tissues at 4, 7, and 10 weeks after transplantation but was not altered by HBOT. Subjects who developed CAS or required stenting had significantly higher HMOX1 and VEGFA expression at 4 weeks (both p < 0.05). Subjects who developed ACR had significant FLT1, TIE2, and KDR expression at 4 weeks (all p < 0.05). CONCLUSIONS: Incidence of CAS is high after severe, established airway necrosis after transplantation. HBOT does not reduce CAS severity or stenting. Elevated HMOX1 and VEGFA expressions appear to associate with airway complications.
Authors
MLA Citation
Kraft, Bryan D., et al. “Hyperbaric oxygen therapy to prevent central airway stenosis after lung transplantation.J Heart Lung Transplant, vol. 40, no. 4, Apr. 2021, pp. 269–78. Pubmed, doi:10.1016/j.healun.2021.01.008.
URI
https://scholars.duke.edu/individual/pub1473700
PMID
33518452
Source
pubmed
Published In
J Heart Lung Transplant
Volume
40
Published Date
Start Page
269
End Page
278
DOI
10.1016/j.healun.2021.01.008

Operator Perception of a Single-Use Flexible Bronchoscope: Comparison With Current Standard Bronchoscopes.

BACKGROUND: Single-use flexible bronchoscopes have gained popularity in recent years for various advantages over the traditional reusable bronchoscope. There are several commercially available disposable bronchoscopes; however, all have limitations compared to reusable bronchoscopes. The Vathin H-SteriScope is a single-use flexible bronchoscope that may have overcome some of these limitations. METHODS: We designed a survey to evaluate the performance of this new single-use bronchoscope on a bronchoscopy model with operators who are familiar with current single-use and reusable bronchoscopes. The operators were asked to rank overall assessment, scope quality, handling, maneuverability, tool interaction, and image quality of the H-SteriScope on a scale of 0-100. These operators were then asked to rank their current single-use and reusable bronchoscopes with the same scale. The results were evaluated to determine the operator perception of the H-SteriScope. RESULTS: The H-SteriScope and current reusable bronchoscopes were perceived to have significant differences compared with currently available single-use bronchoscopes in overall assessment of the scope, scope quality, handling, maneuverability, tool interaction, and image quality (P < .001). The H-SteriScope was perceived to have similar maneuverability as the reusable bronchoscope (P = .86). There were no differences among the H-SteriScope (P = .88), the current single-use bronchoscope (P = .84), and the current reusable bronchoscope (P = .89) between the training and nontraining interventional pulmonology subgroups. CONCLUSIONS: In terms of operator perception, the H-SteriScope appears to have similar maneuverability as the reusable bronchoscope. Both the H-SteriScope and the reusable bronchoscopes performed better in all measured sectors than the current single-use bronchoscope. Additional studies are required to evaluate the practicality, safety, and cost efficiency of the H-SteriScope in clinical practice.
Authors
Liu, L; Wahidi, M; Mahmood, K; Giovacchini, C; Shofer, S; Cheng, G
MLA Citation
Liu, LiHua, et al. “Operator Perception of a Single-Use Flexible Bronchoscope: Comparison With Current Standard Bronchoscopes.Respir Care, vol. 65, no. 11, Nov. 2020, pp. 1655–62. Pubmed, doi:10.4187/respcare.07574.
URI
https://scholars.duke.edu/individual/pub1446823
PMID
32487752
Source
pubmed
Published In
Respir Care
Volume
65
Published Date
Start Page
1655
End Page
1662
DOI
10.4187/respcare.07574

Endobronchial coils for emphysema: Dual mechanism of action on lobar residual volume reduction.

BACKGROUND AND OBJECTIVE: The RENEW trial demonstrated that bronchoscopic lung volume reduction using endobronchial coils improves quality of life, pulmonary function and exercise performance. In this post hoc analysis of RENEW, we examine the mechanism of action of endobronchial coils that drives improvement in clinical outcomes. METHODS: A total of 78 patients from the RENEW coil-treated group who were treated in one or both lobes that were deemed as the most destroyed were included in this retrospective analysis. Expiratory and inspiratory HRCT scans were used to assess lobar volume change from baseline to 12 months post coil treatment in treated and untreated lobes. RESULTS: Reduction in lobar RV in treated lobes was significantly associated with favourable clinical improvement. Independent predictor of the change in RV and FEV1 was the change in lobar RV reduction in the treated lobes and for change in 6MWD the absence of cardiac disease and the change in SGRQ, while the independent predictor of change in SGRQ was the change in 6MWD. CONCLUSION: Our results suggest that residual lobar volume reduction in treated lobes measured by QCT is the driving mechanism of action of endobronchial coils leading to positive clinical outcomes. However, the improvement in exercise capacity and quality of life seems to be affected by the presence of cardiac disease.
Authors
Hartman, JE; Shah, PL; Sciurba, F; Herth, FJF; Slebos, D-J; RENEW Study Group,
MLA Citation
Hartman, Jorine E., et al. “Endobronchial coils for emphysema: Dual mechanism of action on lobar residual volume reduction.Respirology, vol. 25, no. 11, Nov. 2020, pp. 1160–66. Pubmed, doi:10.1111/resp.13816.
URI
https://scholars.duke.edu/individual/pub1469205
PMID
32267059
Source
pubmed
Published In
Respirology
Volume
25
Published Date
Start Page
1160
End Page
1166
DOI
10.1111/resp.13816