Bio

Bio


Kavitha Ramchandran MD, graduated with an undergraduate degree in Human Biology from Stanford University, did medical school and residency training in medicine at University of California, San Francisco and completed her fellowship in Medical Oncology and Palliative Medicine at Northwestern University, Chicago. She joined faculty at Stanford University in 2007. Currently she is a Clinical Assistant Professor of Medicine in the Division of Oncology and Division of General Medical Disciplines.

Dr. Ramchandran is recognized for her contributions as a leader in the integration of palliative and oncology care. Dr. Ramchandran is one of a small number of dual trained faculty who are working to build synergies between the fields of oncology and palliative medicine in the areas of supportive care research, and novel models of care. She now serves as Stanford Cancer Institute’s Transformation Design lead for improving the palliative care experience for patients with a cancer diagnosis. She is also the Medical Director of Palliative Medicine at Stanford Cancer Institute.

In her care of patients Dr. Ramchandran values a deep relationship with the families she cares for. She provides care that is aligned with the patient and family's personal values with the goal of the best quality of life possible.

Dr. Ramchandran’s research focuses on developing care delivery models that incorporate values (patients, family members, and clinicians), as well as novel means of palliative care education. She also is part of an active thoracic oncology trials group recruiting patients for clinical trials using novel therapeutics.

Dr. Ramchandran currently serves on the Patient and Survivor Care Committee for the American Society of Clinical Oncology and the National Comprehensive Cancer Network Palliative Care task force. She serves as a clinician in thoracic oncology and in palliative medicine at Stanford Cancer Institute.

Clinical Focus


  • Cancer > Thoracic Oncology
  • Medical Oncology
  • Palliative Medicine

Academic Appointments


Administrative Appointments


  • Medical Director, Palliative Medicine, Stanford Cancer Institute (2012 - Present)

Honors & Awards


  • Honoree, AACR/ASCO: Methods in Clinical Cancer Research (2009)
  • Nominee, Medical Residency Teaching Award (2012)
  • Honoree, Clinical Effectiveness Leadership Training- CELT (2014)

Boards, Advisory Committees, Professional Organizations


  • Faculy, Global Oncology- GO (2015 - Present)
  • Team member, ASCO Quality Training (2015 - Present)
  • Palliative Care Best Practices Committee, National Comprehensive Cancer Network (2014 - Present)
  • Patient and Survivor Care Committee, American Society of Clinical Oncology (2014 - Present)
  • Team leader, Virtual Learning Collaborative- American Society of Clinical Oncology and American Association of Hospice and Palliative Medicine (2014 - Present)
  • Faculty, University of Colorado, Academy of Medical Educators (2012 - Present)
  • Faculty, Global Resource to Advance Cancer Education (2012 - Present)
  • Board member, Cancer Awareness, Research and Education, San Francisco General Hospital (2002 - Present)

Professional Education


  • Fellowship:Northwestern University - Department of Medicine Feinberg School of Medicine (2009) IL
  • Residency:UCSF-Internal Medicine (2007) CA
  • Medical Education:UCSF School of Medicine (2004) CA
  • Board Certification: Hospice and Palliative Medicine, American Board of Internal Medicine (2012)
  • Board Certification: Medical Oncology, American Board of Internal Medicine (2010)
  • Board Certification: Internal Medicine, American Board of Internal Medicine (2007)
  • Board Certification, Oncology, Oncology (2009)

Community and International Work


  • Global Oncology, TBD

    Topic

    Palliative Medicine in a Global Setting

    Partnering Organization(s)

    Global oncology

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    Yes

Research & Scholarship

Current Research and Scholarly Interests


My research focuses on innovative models of care delivey to understand how to integrate primary and specialist palliative care. We also do work in palliative care education and how to scale our education to be impactful and sustainable. We are evaluating online models.

In cancer care I do research on novel therapeutics in thoracic malignancies including immunotherapy, new targeted agents, and new sequencing of approved drugs.

Projects


  • Model of Care: Integration of palliative care into cancer care using a human centered design approach

    We will be codeveloping a new model of primary and specialist palliative care delivery at Stanford Cancer Institute incorporating the values of patients, family members and clinicians. New outcome metrics will be developed that incorporate the values of key end users and stakeholders.

    Location

    Stanford, CA, USA

Teaching

2014-15 Courses


Graduate and Fellowship Programs


Publications

Journal Articles


  • A predictive model to identify hospitalized cancer patients at risk for 30-day mortality based on admission criteria via the electronic medical record CANCER Ramchandran, K. J., Shega, J. W., von Roenn, J., Schumacher, M., Szmuilowicz, E., Rademaker, A., Weitner, B. B., Loftus, P. D., Chu, I. M., Weitzman, S. 2013; 119 (11): 2074-2080

    Abstract

    This study sought to develop a predictive model for 30-day mortality in hospitalized cancer patients, by using admission information available through the electronic medical record.Observational cohort study of 3062 patients admitted to the oncology service from August 1, 2008, to July 31, 2009. Matched numbers of patients were in the derivation and validation cohorts (1531 patients). Data were obtained on day 1 of admission and included demographic information, vital signs, and laboratory data. Survival data were obtained from the Social Security Death Index.The 30-day mortality rate of the derivation and validation samples were 9.5% and 9.7% respectively. Significant predictive variables in the multivariate analysis included age (P < .0001), assistance with activities of daily living (ADLs; P = .022), admission type (elective/emergency) (P = .059), oxygen use (P < .0001), and vital signs abnormalities including pulse oximetry (P = .0004), temperature (P = .017), and heart rate (P = .0002). A logistic regression model was developed to predict death within 30 days: Score = 18.2897 + 0.6013*(admit type) + 0.4518*(ADL) + 0.0325*(admit age) - 0.1458*(temperature) + 0.019*(heart rate) - 0.0983*(pulse oximetry) - 0.0123 (systolic blood pressure) + 0.8615*(O2 use). The largest sum of sensitivity (63%) and specificity (78%) was at -2.09 (area under the curve = -0.789). A total of 25.32% (100 of 395) of patients with a score above -2.09 died, whereas 4.31% (49 of 1136) of patients below -2.09 died. Sensitivity and positive predictive value in the derivation and validation samples compared favorably.Clinical factors available via the electronic medical record within 24 hours of hospital admission can be used to identify cancer patients at risk for 30-day mortality. These patients would benefit from discussion of preferences for care at the end of life. Cancer 2013;119:2074-2080. © 2013 American Cancer Society.

    View details for DOI 10.1002/cncr.27974

    View details for Web of Science ID 000319277000022

    View details for PubMedID 23504709

  • Palliative Care Always ONCOLOGY-NEW YORK Ramchandran, K., Von Roenn, J. H. 2013; 27 (1): 13-?

    Abstract

    Palliative cancer care is the integration into oncologic care of therapies that address the issues that cause physical and psychosocial suffering for the patient and family. Effective provision of palliative cancer care requires an interdisciplinary team that can provide care in all settings (home, inpatient, and outpatient). There is clear evidence for improved outcomes in multiple domains-symptoms, quality of end-of-life care, provider satisfaction, cost of care-with the integration of palliative care into cancer care. As a result, there are now guideline-based recommendations for incorporating palliative care into cancer care. Unfortunately there continue to be barriers to effective integration; these include gaps in education and research, and a cultural stigma that equates palliative care with end-of-life care. These barriers will need to be addressed in order to achieve seamless palliative care integration across the continuum of cancer care for all patients and their families.

    View details for Web of Science ID 000314141000002

    View details for PubMedID 23461040

  • Emerging Concepts in the Pathology and Molecular Biology of Advanced Non-Small Cell Lung Cancer AMERICAN JOURNAL OF CLINICAL PATHOLOGY Kulesza, P., Ramchandran, K., Patel, J. D. 2011; 136 (2): 228-238

    Abstract

    Non-small cell lung cancer (NSCLC) is traditionally classified histologically, but until recently, the histologic subtype has had little impact on the selection of therapy. Drugs such as pemetrexed and bevacizumab are indicated for specific NSCLC subtypes, and this type of stratification represents the first step toward individualizing therapy in NSCLC. Beyond histologic features, the status of molecular targets, such as the epidermal growth factor receptor (EGFR) gene, has been shown to correlate with response to treatment with EGFR tyrosine kinase inhibitors in patients with relapsed or refractory disease and in the first-line therapy setting. New therapies targeting the EGFR and other molecular aberrations are under way to help define specific subsets of patients responsive to certain molecularly targeted treatments. The role of pathologists in guiding treatment decisions will increase because molecular profiling, together with pathologic and histologic analysis, represents the future of personalizing medicine for patients with NSCLC.

    View details for DOI 10.1309/AJCPO66OIRULFNLZ

    View details for Web of Science ID 000292905000006

    View details for PubMedID 21757595

  • Phantom Limb Pain #212 JOURNAL OF PALLIATIVE MEDICINE Ramchandran, K., Hauser, J. 2010; 13 (10): 1285-1286

    View details for DOI 10.1089/jpm.2010.9775

    View details for Web of Science ID 000282953900020

    View details for PubMedID 20942763

  • Sex Differences in Susceptibility to Carcinogens SEMINARS IN ONCOLOGY Ramchandran, K., Patel, J. D. 2009; 36 (6): 516-523

    Abstract

    Lung cancer has reached epidemic proportions in women, and is now the most common cause of cancer death among both men and women in the United States. While smoking rates have declined marginally in women, the rising impact of lung cancer in women may imply that women are at higher risk from carcinogens secondary to underlying factors related to sex. These factors include differences in female physiology such as bronchial responsiveness and airway size, sex-based differences in nicotine metabolism via the cytochrome p450 system driven by hormones, and differences in DNA repair capacity, as well as the evolution of cigarettes. These hypotheses will be explored in depth in this article.

    View details for DOI 10.1053/j.seminoncol.2009.09.005

    View details for Web of Science ID 000278079100006

    View details for PubMedID 19995643

  • My Friend, My Patient JOURNAL OF PALLIATIVE MEDICINE Ramchandran, K. 2009; 12 (1): 95-96

    View details for DOI 10.1089/jpm.2009.9688

    View details for Web of Science ID 000262827900026

    View details for PubMedID 19284274

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