This week's Faculty Spotlight shines on Christoph Hornik, MD, PhD, MPH, associate professor of pediatrics in the Division of Critical Care Medicine, and chief of the Division of Quantitative Sciences. Hornik talks to us about his research focused on applying clinical pharmacology, biostatistics, and innovative trial methods to drug development for critically ill children. He also discusses his clinical work as part of the multidisciplinary team caring for infants and children with cardiac disease in the pediatric cardiac intensive care unit. Notably, Hornik believes that a strong integration of pediatric critical care with other specialty care services will become increasingly important as pediatric care continues to evolve in the treatment of more complex diseases requiring more advanced, and potentially higher risk, interventions.
How long have you been at Duke? How did you decide to come here?
I joined Duke as an intern in 2005. My decision to come here was primarily driven by my experience as a visiting medical student from Germany a few years prior. While some of the faculty who strongly influenced my decision to leave Germany after medical school graduation are no longer at Duke, several still remain and all have left very strong impressions on me and help shape my career.
What are your responsibilities within the Division of Critical Care Medicine? What does a typical day for you look like?
I spend the majority of my time as a clinical researcher with a secondary appointment at the Duke Clinical Research Institute. There, my work focuses on applying clinical pharmacology, biostatistics, and innovative trial methods to drug development for critically ill children. I also serve as the associate director of our Pharmacometrics and Small Trials Program. In this role, I guide a team of pharmacometricians who provide clinical pharmacology and pharmacometrics services to sponsors and investigators, and a team of cross-trained project leaders, who operationalize smaller single and multicenter trials using innovative and efficient operational principles.
Clinically, I attend as part of the multidisciplinary team caring for infants and children with cardiac disease in the pediatric cardiac intensive care unit. I trained in both pediatric cardiology and critical care medicine, and work closely with colleagues from pediatric cardiology, anesthesia, and pediatric cardiac surgery. Our team includes critical care and cardiology fellows, and an outstanding group of critical care nurse practitioners. Together, we provide a lot of peri-operative care, and manage children with critical medical cardiac disease including acute heart failure.
You are the Chief of the Division of Quantitative Sciences, can you tell us about your responsibilities within that division?
The Division of Quantitative Sciences is a small but very dedicated group of faculty, fellows, and staff statisticians that provide quantitative services to researchers within the Department of Pediatrics. With support from the department, we help researchers with primarily data management and statistical analysis of their projects. This includes analytic consultation and support with manuscript of grant preparation.
How did you first get interested in medicine? What made you decide to pursue pediatric critical care medicine in particular?
I became interested in medicine during my high school years, primarily out of a passion for science and biology, and a strong interest in applying whatever knowledge I might gain to help people somehow.
What’s one thing you wished more of your patients knew about pediatric critical care or medicine in general?
Critical care should be viewed as a possible, maybe necessary, often unwanted extension of essentially any pediatric care. This is particularly true for my field of cardiac critical care, where our work is so closely tied to the efforts of our colleagues taking care of children in the operating room, the inpatient, and outpatient services. A strong integration of pediatric critical care with other specialty care services will be important to continue the progress pediatrics has made in improving child health, especially as we collectively tackle more and more complex diseases with more advanced, and potentially higher risk, interventions.
What are your specific interests in the field of pediatric critical care medicine?
Cardiac critical care, in particular the post-operative management of neonates and infants.
Can you tell us about some of your current research?
Broadly speaking, my research is in the field of pediatric drug development. I lead multicenter trials, real-world data applications, and pharmacokinetic and pharmacodynamic analyses to help identify safe and effective doses for medications in children.
Who was your most significant mentor and what knowledge did you gain through this collaboration?
I have had multiple significant mentors throughout my career. I attribute whatever success I may have had to date not just to my mentors, but specifically to the multiple mentorship models I have followed all along.
Since your completed your pediatric internship and residency as well as a pediatric critical care fellowship here at Duke, do you have any advice for trainees?
For trainees interested in cardiac critical care, I think pursuing training in both pediatric cardiology and critical care medicine, as I did, is a real strength. While the proposition of an additional year or two of training may be difficult to swallow, I am certainly glad I had the opportunity to be exposed to both fields. For trainees interested in non-cardiac critical care, I would encourage seeking out a passion that ties critical care to another therapeutic area and patient population, whether peri-operative or medical to help you establish specific expertise.
What passions or hobbies do you have outside of work?
My time outside of work is spent with my family: my wife Chi and our two boys.