He has been actively involved in community-based studies of the natural history and primary and secondary prevention of coronary heart disease, heart failure, and deep venous thrombosis for more than 2 decades. He and several clinical researchers established the Worcester Heart Attack Study in the early 1980's. Through the current period of federal funding support, they are examining more than 3 decade long trends (1975-2007) in the incidence rates, in-hospital and long-term survival, and therapeutic approaches used in the management of more than 14,000 greater Worcester residents hospitalized with acute myocardial infarction at all medical centers in the Worcester metropolitan area. Presently he serve as the Co-PI on a population-based surveillance project that is examining changing trends in the incidence, hospital and long-term case-fatality rates, and management practices of in and outpatients with venous thromboembolism among residents of the Worcester metropolitan area. They are also receiving funding support from the National Heart, Lung, and Blood Institute to develop community-wide hospital and outpatient surveillance for heart failure in greater Worcester residents. He also serve as the senior epidemiologist for the Global Registry of Acute Coronary Events (GRACE) Project which is a large multinational coronary disease registry examining differences in the management practices, hospital, and post-discharge outcomes of more than 50,000 patients hospitalized in 14 countries with an acute coronary syndrome.
In collaboration with several investigators from the UMMS, they have recently received funding support from the NIH to initiate two observational epidemiologic studies, one in the area of acute heart failure and the other in the setting of venous thrombosis in the elderly. In the heart failure (HF) project, they are studying the symptoms patients with acute HF report experiencing, their extent of delay in seeking medical care after the onset of these acute symptoms, and factors facilitating, or serving as obstacles to, the seeking of medical care in a timely manner.