James Torner, PhD, MS

Associate Director for Recruitment and Patient Engagement

Personal Statement

James C. Torner, PhD, MS is Professor of Epidemiology and Chair of the Department of Epidemiology and Associate Director of the Institute for Clinical and Translational Science. He has conducted research in clinical trials, women’s health and disability related to injuries. He has been teaching, designing and conducting clinical trials for four decades. He designed and conducted in acute care medicine in trauma and trauma.

He has directed the Iowa Trauma Registry and has evaluated effective triage and critical care. He was the founding Director of the Preventive Intervention Center, which has conducted population-based clinical trials and cohort studies. He is a member of the design team for NIH-NINDS support NeuroNEXT.

He serves on DSMBs for several clinical trials. He will co-lead activities and be one of the liaisons to the Trial Innovation Network and the Recruitment Innovation Center and will collaborate on activities in BERD and the Workforce Development Core.

Education

General Science BS - The University of Iowa, 1971
Biostatistics MS - The University of Iowa, 1974
Epidemiology PgD - The University of Iowa, 1984

Positions

Assistant Professor, Department of Neurosurgery, University of Virginia (1984 - 1988)
Director, Brain Injury Research Program, Department of Neurosurgery, University of Virginia (1984 - 1991)
Associate Director, Epidemiologic Studies Program, Center for the Prevention of Disease and Injury, University of Virginia (1984 - 1991)
Assistant Professor, Center for the Prevention of Disease and Injury, University of Virginia (1987 - 1990)
Associate Professor, Department of Neurosurgery, University of Virginia (1988 - 1991)
Associate Professor of Neurosurgery and Internal Medicine, University of Virginia (1990 - 1991)
Director, Preventive Intervention Center, Dept. of Preventive Medicine, The University of Iowa (1991 - 2003)
Associate Professor, Dept. of Preventive Medicine and Environmental Health, The University of Iowa (1991 - 1993)
Division Head, Division of Epidemiology, Dept. of Preventive Medicine, The University of Iowa (1991 - 1999)
Professor, Dept. of Preventive Medicine and Environmental Health, The University of Iowa (1993 - 1999)
Associate Director, Injury Prevention Research Center, Training and Acute Care Cores, The University of Iowa (1993 - Present)
Professor and Head, Dept. of Epidemiology, College of Public Health, The University of Iowa (1999 - Present)
Professor (Secondary Appointment), Department of Surgery, College of Medicine, The University of Iowa (2000 - Present)
Professor (Secondary Appointment), Department of Neurosurgery, College of Medicine, The University of Iowa (2005 - Present)
Co-Director, Preventive Intervention Center, Dept. of Epidemiology, The University of Iowa (2006 - Present)
Associate Director, Institute for Clinical and Translational Science, The University of Iowa (2007 - 2010)
Senior Associate Director, Institute for Clinical and Translational Science, The University of Iowa (2010 - Present)

Honors

American Heart Association, Stroke, Fellow (1985)
American College of Epidemiology, Fellow (1986)
Faculty Research Award, University of Iowa College of Public Health (2008)
CPH Distinguished Faculty Lecturer (2011)
CPH Outstanding Alumni Award (2014)

Contribution to Science

Epidemiology of Unrutured Intracranial Aneurysms

Since 1989 I have be a Co-Principal Investigator of the International Study of Unruptured Intracranial Aneurysms. This international study included nearly 5500 patients from 61 clinical centers. The design was both a retrospective study of patients from 1976-1991 and prospective from 1991-1998. The Study has contributed to the understanding of the risk factors for aneurysm presentation and discovery, the risk for rupture, the long-term morbidity and mortality, and the treatment outcome. The Study has demonstrated the role of size and location to aneurysmal rupture and the impact of site ratio, morphology and shape parameters on aneurysm risk. The Study has also demonstrated the comparative effectiveness of aneurysm surgical and endovascular interventions.

Wiebers D, Whisnant JP, Huston J, Meissner I, Brown RD, Piepgras DG, Forbes GS, Thielen K, Nichols D, O’Fallon WM, Peacock J, Jaeger L, Kassell NF, Kongable-Beckman GL, Torner JC, Naleway A, Yoo B, Sorensen B, Wiebers DO, Drake CG, Ferguson GG, Kurtzke J, Andreoli A, Edner G, Sengupta R, et al. Unruptured intracranial aneurysms: Natural history, clinical outcome, and risks of surgical and endovascular treatment. [Journal Article] Lancet 362(9378):103-110, 2003 July 12.
Hasan DM, Mahaney KB, Brown RD Jr, Meissner I, Piepgras DG, J, Capuano AW, Torner JC; for the International Study of Unruptured Intracranial Aneurysms Investigators. Aspirin as a Promising Agent for Decreasing Incidence of Cerebral Aneurysm Rupture. Stroke 42(11):3156-3162, 2011. PMID: 21980208; PMCID PMC3432499
Mackey J, Brown RD Jr, Moomaw CJ, Sauerbeck L, Hornung R, Gandhi D, Woo D, Kleindorfer D, Flaherty ML, Meissner I, Anderson C, Connolly ES, Rouleau G, Kallmes DF, Torner J, Huston J 3rd, Broderick JP; for the FIA and ISUIA Investigators. Unruptured Intracranial Aneurysms in the Familiar Intracranial Aneurysm and International Study of Unruptured Intracranial Aneurysms Cohorts: Differences in Multiplicity and Location. J Neurosurg 117(1):60-4, 2012. PMID: 22540404; PMCID PMC3914137
Raghavan ML, Sharda GV, Huston J3rd, Mocco J, Capuano AW, Torner JC, Saha PK, Meissner I, Brown RD Jr; for the International Study of Unruptured Intracranial Aneurysms Investigators. Aneurysm shape reconstruction from biplane angiograms in the ISUIA collection. Transl Stroke Res 5(2):252-9, 2014. PMID: 24477497; PMCID PMC4258537

Epidemiology and Treatment of Subrachnoid Hemorrhage

The Cooperative Aneurysm Study began in the late 1950’s. I joined the Cooperative group in 1973. International, multi-center clinical trials have been conducted in antifibrinolytic therapy for re-hemorrhage, fluid restriction, timing of surgery, nimodipine and nicardipine for vasospasm, hypothermia for aneurysm surgery, and tirilazad mesylate and clasostatin neuroprotection. Prognostic factors for hemorrhage, vasospasm and overall outcome including cognitive endpoints have been byproducts of the research studies. These have led to improvements in study design and determinants for intervention in clinical trials.

Haley EC, Kassell NF and Torner JC. A randomized controlled trial of high-dose intravenous nicardipine in aneurysmal subarachnoid hemorrhage: A report of the Cooperative Aneurysm Study. J Neurosurg 78:537-547, 1993.
Lanzino G, Kassell NF, Germanson TP, Kongable GL, Truskowski LL, Torner, JC, Jane JA. Age and outcome after aneurysmal subarachnoid hemorrhage: why do older patients fare worse? J Neurosurg 85:410-418, 1996.
Ilodigwe D, Murray GD, Kassell NF, Torner J, Kerr RS, Molyneux AJ, Macdonald RL. Sliding Dichotomy Compared with Fixed Dichotomization of Ordinal Outcome Scales in Subarachnoid Hemorrhage Trials. J Neurosurg 118(1):3-12, 2013. PMID: 23039145 PMCID N/A
Macdonald RL, Jaja B, Cusimano MD, Etminan N, Hanggi D, Hasan D, Ilodigwe D, Lantigua H, LeRoux P, Lo B, Louffat-Olivares A, Mayer S, Molyneux A, Quinn A, Schweizer TA, Schenk T, Spears J, Todd M, Torner J, Vergouwen MD, Wong GK, Singh J; SAHIT Collaboration. SAHIT Investigators—on the outcome of some subarachnoid hemorrhage clinical trials. Transl Stroke Res 4(3):286-96, 2013. PMID 24323299 PMCID N/A

Injury Prevention and Control

I have contributed to injury prevention and control in 1) studies of traumatic brain injury including prognostic studies, clinical trials and trauma system performance, 2) studies of risk factors and surveillance of injuries and 3) studies of injuries is special populations. Studies of traumatic brain injury involved the Traumatic Coma Databank, clinical trials of ICP monitoring and tiriliazad in patients in coma, prognostic factors for TBI outcome, evaluation of TBI patients in a comprehensive trauma system and residual symptoms and outcome in women with TBIs. Risk factors have been investigated in various populations and at risk groups such as construction workers, Persian Gulf War veterans, women veterans, agricultural workers and the elderly. I have conducted evaluation of the performance of the State of Iowa Trauma System assessing the continuity of care and system indicators.

Zwerling C, Miller ER, Lynch CF, Torner, JC. Injuries among construction workers in rural Iowa: Emergency department surveillance. JOEM 38:698-704, 1996.
Zwerling C, Torner JC, Clarke WR, Voelker MD, Doebbeling BN, Merchant JA, Woolson RF, Schwartz DA. Self-reported postwar injuries among Gulf War veterans. Public Health Reports 115(4):346-349, 2000 July-Aug. PMCID: PMC1308575
Tiesman H, Young T, Torner JC, McMahon M, Peek-Asa C, Fiedler J. Effects of a Rural Trauma System on Traumatic Brain Injuries. J Neurotrauma 24(7):1189-1197, 2007.
Swanton AR, Young TL, Leinenkugel K, Torner JC, Peek-Asa C. Nonfatal tractor-related injuries presenting to a state trauma system J Safety Res. 53:97-102, 2015. PMID: 25934002 PMCID N/A

Epidemiology of Knee Osteoarthritis

Based upon studies of osteoporosis and musculoskeletal injuries, research in the risk factors for knee osteoarthritis and outcome of disability was conducted through the Multicenter Knee Osteoarthritis Study (MOST). Analyses have shown a higher prevalence that expected was evident in a community-based population. Risk factors such as age, obesity, physical activity and mechanistic factors have been shown to related to progression. The role of chronic pain on performance and outcome has also been demonstrated. The study continues t evaluate 1) early factors to development and 2) factors associated with aging.

Segal NA, Torner JC, Yang M, Curtis JR, Felson DT, Nevitt MC; for the Multicenter Osteoarthritis (MOST) Study Group. Muscle Mass is More Strongly Related to Hip Bone Mineral Density than is Quadriceps Strength or Lower Activity Level in Adults Over Age 50 Year. J Clin Densitom 11(4):503-10, 2008. PMID: 18456530; PMCID: PMC2654209
Felson DT, Nevitt MC, Yang M, Clancy M, Niu J, Torner JC, Lewis CE, Aliabadi P, Sack B, McCulloch C, Zhang Y. A New Approach Yields High Rates of Radiographic Progression in Knee Osteoarthritis. J Rheumatol 35(10):2047-54, Oct. 2008. PMID: 18793000; PMCID PMC2758234
Segal NA, Torner JC, Felson D, Niu J, Sharma L, Lewis CE, Nevitt M. Effect of Thigh Strength on Incident Radiographic and Symptomatic Knee Osteoarthritis in a Longitudinal Cohort. Arthritis Rheum 61(9):1210-1217, 2009. PMID: 19714608; PMCID: PMC2830551
Glass NA, Torner JC, Frey Law LA, Wang K, Yang T, Nevitt MC, Felson DT, Lewis CE, Segal NA. The relationship between quadriceps muscle weakness and worsening of knee pain in the MOST cohort: a 5-year longitudinal study. Osteoarthritis Cartilage 21(9):1154-9, 2013. PMID: 23973125; PMCID PMC3774035

Women’s Health

Increased focus on women’s health has led to research in the clinical trials of osteoporosis and the Women’s Health Initiative and studies of women’s health in veterans. Studies have shown risk factors for bone development and bone loss. Prevention through exercise in bone development has been demonstrated. For bone loss use of bisphonates have been demonstrated through the Fracture Intervention Trial. WHI demonstrated the role of hormone replacement therapy in increasing the risk of vascular events and not improving overall outcome in women. Studies of women veterans have demonstrated the need for gynecological services through the prevalence of urinary incontinence, fertility and PTSD for example. Studies are ongoing to examine processes for improving women’s access to care.

Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348(9041):1535-1541, 1996.
Hendrix SL, Wassertheil-Smoller S, Johnson KC, Howard BV, Kooperberg C, Rossouw JE, Trevisan M, Aragaki A, Baird AE, Bray PF, Buring JE, Criqui MH, Herrington D, Lynch JK, Rapp SR, Torner J, for the WHI Investigators. Effects of conjugated equine estrogen on stroke in the Women’s Health Initiative. Circulation 113:2425-2434, 2006.
Mengeling MA, Sadler AG, Torner J, Booth BM. Evolving Comprehensive VA Women’s Health Care: Patient Characteristics, Needs, and Preferences. Womens Health Issues 21(4 Suppl):S120-9, 2011. PMID: 21724131 PMCID N/A
Sadler AG, Mengeling MA, Syrop CH, Torner JC, Booth BM. Lifetime sexual assault and cervical cytologic abnormalities among military women. J Womens Health 20(11):1693-701, 2011. PMID: 21834691 PMCID N/A

Ongoing Research Support

2 U01 AG018832-15 (Torner, James C)

09/30/01-05/31/20

NIH

Multicenter Osteoarthritis Study (MOST) Second Renewal: Iowa Clinical Center

Symptomatic knee osteoarthritis affects 12% of elders and despite medical advances, remains, for many affected, a major source of pain and function limitation. The MOST study is the first large scale observational study to focus on persons with or at high risk of knee osteoarthritis.

Role: Principal Investigator

5 R49 CE002108 (Peek-Asa, Corinne)

08/01/12-07/31/17

Centers for Disease Control (Training & Education Core)

University of Iowa Injury Prevention Research Center

The goal is to coordinate and facilitate continuing education, developing curricula, and fostering student research.

Role: Team Leader of the Acute Care Research Team and primary liaison with the Iowa Statewide Trauma System

1 U54 TR001356-01 (Winokur, Patricia)

08/14/15-07/31/17

DHHS/NIH

University of Iowa Clinical and Translational Science Program

University of Iowa application for CTSA award

5 U01 NS077352-04 (Coffey, Christopher)

09/30/11-08/31/18

NIH

Network of Excellence in Neuroscience Clinical Trials (NEXT-DCC

The specific aims of the DCC application are to: 1) Provide study design and statistical leadership; 2) Develop and maintain a web-based distributed data entry system with the capability to quickly, efficiently, and accurately randomize subjects and collect data generated by the studies conducted within the network; 3) Provide project management support for the studies conducted within the network; and 4) Provide access to study-wide and network information.

R01 AR062505 (Torner, James)

09/14/12-8/31/17

PI on Main grant: Neogi, Tuhina (R01)

NIH/Subcontract with Boston University

Central Sensitization in Post-Knee Replacement Pain and Relation to OA Pathology

This is a multi-project center grant supporting three clinical research projects including population-based

and patient-based observational cohort studies related to musculoskeletal diseases.

(Ryan, Ginny)

07/15/15-09/30/17

VAMC

Impact of Sexual Assault and Combat-Related Trauma on Fertility in Veterans

2 R56 DE012101-16A1 (Levy, Steven M.)

04/01/98-08/31/18

NIH

Fluoride, Dietary, and Other Factors Related to Young Adult Bone Measures and Dental Caries

The objective of this proposal is to enhance understanding of normal bone development and its determinants by extending our assessments of the unique IBDS cohort into early adulthood (age 23 years) to address major questions about the period from late adolescence to early adulthood.

Role: Investigator

(Torner, James C.)

12/01/15-11/30/18

Washington University of St. Louis/PCORI

Posterior fossa decompression with or without duraplasty for Chiari type I malformation with syringomyelia

Role: PI for subcontract

Children with Chiari type I malformation (CM) and syringomyelia (SM), a ‘rare disease’, may suffer debilitating pain, spinal deformity, neurological deficits (myelopathy, weakness, sensory loss, and impaired gait), and diminished quality of life (QOL) (2, 7, 8, 27). CM+SM is treated with neurosurgical decompression of the craniovertebral junction with either of two technical variations: 1) posterior fossa decompression with duraplasty (PFDD), the gold standard operation, which involves intradural microsurgical dissection and duraplasty; or 2) extradural posterior fossa decompression (PFD), in which the dura is not opened. The Central Hypothesis of this proposal is that, compared with PFDD, PFD will result in fewer surgical complications and thus less harm to patients within 12 months of surgery. With a more favorable risk profile and non-inferior effect on clinical outcome and syrinx size compared with PFDD, PFD will be associated with superior QOL

Completed Research Support

(Torner, James)

09/24/12-12/31/16

Washington University

Park-Reeves Syringomyelia Consortium

Contact Information: