Award for Clinical Science Investigator

Almario Faculty Headshot

Dr. Almario's research is focused on developing and validating innovative, scalable, evidence-based technologies that support patients and clinicians in making shared decisions that improve health and reduce costs. He has also conducted a number of studies that deepen our understanding of the epidemiology and impact of functional gastrointestinal disorders (e.g., irritable bowel syndrome, chronic idiopathic constipation, functional heartburn) on patients’ quality of life. Dr. Almario’s work has been published in Gastroenterology, American Journal of Gastroenterology, Lancet Gastroenterology & Hepatology, Clinical Gastroenterology and Hepatology, and the International Journal of Medical Informatics, among many others. He has also received funding from the National Institutes of Health, American College of Gastroenterology, American Gastroenterological Association, Crohn’s & Colitis Foundation, and multiple industry partners.

He is focused on developing and evaluating innovative, scalable technologies that support patients and clinicians by enhancing communication and facilitating behavior changes that improve health. For example, he helped build a patient-provider portal called AEGIS (Automated Evaluation of Gastrointestinal Symptoms) that ‘interviews’ patients and then converts their responses into a narrative history of present illness (HPI). Clinicians can then review the HPI in the electronic health record prior to the visit so that they can efficiently learn why the patient is seeking care. While AEGIS is ‘disease-agnostic’ in that it primarily focuses on patients’ gastrointestinal (GI) symptoms, its use is especially valuable among those with functional GI disorders (FGIDs) as it is critical for clinicians to accurately and fully assess the symptoms that caused them to seek care in the first place. After building AEGIS, his team conducted validation studies and found that it created HPIs that were more complete and comprehensive when compared to those written by physicians. Most recently, we just completed a study seeing whether use of AEGIS improves provider-centric outcomes (e.g., quality of documentation, charting time). 

In addition, he is interested in furthering our understanding of the epidemiology and impact of GI symptoms and FGIDs in the U.S. To help accomplish this, his team completed a study called the “National GI Survey” that recruited over 71,000 individuals across the U.S. to complete the AEGIS algorithm. This robust dataset led to numerous conference abstracts and peer-reviewed publications. For example, it allowed us to examine the prevalence and predictors of GI symptoms, in general, as well as specific symptoms such as fecal incontinence and gastroesophageal reflux disease. Moreover, his team conducted a study that found that the prevalence of lower and upper GI symptoms differ between those with irritable bowel syndrome (IBS) with constipation (IBS-C) and chronic idiopathic constipation (CIC). They also found that abdominal pain is experienced differently among the IBS subtypes; those with IBS-C have more bothersome, frequent, and diffuse pain versus those with IBS with diarrhea (IBS-D) and mixed IBS (IBS-M).

Currently, they are preparing for the “National GI Survey 2” and now aim to recruit 100,000 individuals to complete the study. This time around, in addition to using the AEGIS algorithm, we will also incorporate Rome IV questionnaires. Doing so will allow us to examine the epidemiology of Rome IV FGIDs as well as assess their impact on quality of life and healthcare utilization. Below is a partial list of questions that we will be addressing using this new dataset:
• What is the prevalence and predictors of Rome IV positivity in the general U.S. population for IBS-C, IBS-D, IBS-M, CIC, and opioid-induced constipation (OIC)?
• What other GI symptoms do those with Rome IV IBS-C, IBS-D, IBS-M, CIC, and OIC experience concomitantly?
• What proportion of those in the general population with Rome IV positive IBS-C, IBS-D, IBS-M, CIC, and OIC have sought medical care for their GI symptoms?
• Among those with Rome IV positive IBS-C, IBS-D, IBS-M, CIC, and OIC, are there differences in symptom severity (i.e., diarrhea, constipation, abdominal pain) between those who have and have not sought medical care?
• For those with IBS-C and CIC, what proportion are currently taking prescription medicines? Of those taking a prescription medicine, how satisfied are they with the medicine?

Clinical Science is the research approach aimed at understanding the diagnosis and treatment of diseases and disorders through studies involving people, usually carried out in clinical settings.

Research Awards
2020 Award Recipients
Kyle Staller, MD
Christopher V. Almario, MD
Maria Raffaella Barbaro, PhD
2019 Award Recipients
Arpana Gupta, PhD
David Levinthal, MD, PhD
Ilan Koppen, MD, PhD
2018 Award Recipients
Amaranath Karunanayake, PhD
Katja Kovacic, MD
Cristina Martinez, PhD
Ans Pauwels, PhD
2013 Award Recipients
Enrico Corazziari, MD
Jan Tack, MD, PhD
Report from Gary Mawe, PhD: The Roles of Intestinal Nerves and Serotonin in Gut Function and Dysfunction
Ashley Blackshaw, PhD
Carlo Di Lorenzo, MD
Niranga Manjuri Devanarayana, MD
Report from Lukas Van Oudenhove, PhD: Solving the Biopsychosocial Puzzle in Functional Dyspepsia
Muriel Larauche, PhD
2011 Award Recipients
Report from Ronnie Fass, MD: Sleep and Gastroesophageal Reflux Disease (GERD)
Million Mulugeta, PhD
Adrian Miranda, MD
Samuel Nurko, MD
Sudarshan Jadcherla, MD
Shaman Rajindrajith, MD
2009 Award Recipients
Satish Rao, MD
Emeran Mayer, MD
Javier Santos, MD
Report from Martin Storr, MD, PhD: Functional Gastrointestinal Disorders: New Insights in Enteric Regulation
Report From Miguel Saps, MD: Functional Abdominal Pain in Children and Adolescents
2007 Award Recipients
Report from Bruce D. Naliboff, PhD: Symptom Based Psychology for Functional Gastrointestinal Disorders
Report from Magnus Simrén, MD, PhD: Irritable Bowel Syndrome: Searching for Underlying Causes
Report from Brennan M. R. Spiegel, MD, MSHS: Diagnostic Testing in Irritable Bowel Syndrome: Theory vs. Reality
Report from Sylvie Bradesi, PhD: Role of the Central Immune System in Functional Disorders
Paul E. Hyman, MD
Report from Miranda A. L. van Tilburg, PhD: Home Based Guided Imagery to Treat Pediatric Functional Abdominal Pain
Report from Fernando Azpiroz, MD, PhD: Understanding Intestinal Gas
2005 Award Recipients
Report from Yvette Tache, PhD: Stress and Irritable Bowel Syndrome: Unraveling the Code
Report from Shaheen Hamdy, MRCP, PhD: Adult Neurogenic Dysphagia -- Disorders and Conditions that Disrupt Swallowing
Report from Michael A. Pezzone, MD, PhD: Chronic Pelvic Pain and the Overlap of Pelvic Pain Disorders
Report from Bridget R. Southwell, PhD: Research into Treatment-Resistant Constipation in Children
Report from Rachel Rosen, MD, MPH: Symptoms Arising from Non-Acid Reflux in Children
2003 Award Recipients
Report from William E. Whitehead, PhD: Summary of Clinical Research Activities
Jyoti N. Sengupta, PhD
Report from Caroline Elder Danda, PhD: Biopsychosocial Perspectives on Assessment and Treatment
Report from Terry Buchmiller-Crair, MD: Using the Fetal Gastrointestinal Tract to Overcome Neonatal Disease
Report from Dan L. Dumitrascu, MD, PhD: The Psychosocial Adjustment to Illness in Irritable Bowel Syndrome
Report from Klaus Bielefeldt, MD, PhD: Understanding Pain and Discomfort in Functional GI Disorders
Research Grants
IFFGD Competitive Grants
2014 IFFGD Idiopathic Gastroparesis Research Grants
Leo Cheng, PhD
Braden Kuo, MD, MSc
Richard McCallum, MD
2008 IFFGD Competitive Research Grants
IFFGD Noncompetitive Grants
Other Research Grant Opportunities
Funding Research
Need for Funding Research
How to Make a Difference
The State of Research at NIH & NIDDK
Clinical Trials & Studies
Guide to Randomized Clinical Trials
Clinical Trials and Studies

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