Deborah Watkins Bruner PhD, RN, FAAN

Robert W. Woodruff Chair in Nursing

Professor

Director of Faculty Mentoring, NHWSN

Associate Director of Outcomes Research, Winship Cancer Institute

Areas of Expertise

Adult Health

  • Clinical: Care of the Adult Cancer Patient
  • Research: Oncology and Chronic Disease Clinical Trial Design; Symptom Management Clinical Trials; Patient Reported Outcomes; Quality of Life; Biobehavioral Intervention Design and Testing; Radiation Therapy Outcomes; Preferences, Utilities, Comparative Effectiveness, Recruitment and Heath Disparities in Clinical Trials
  • Teaching:  Mentoring; Research Methods, Clinical Trial Design

Phone: 404.712.9695

Email: deborah.w.bruner@emory.edu

Additional Contact Information

Mailing Address:

Nell Hodgson Woodruff School of Nursing

Emory University

1520 Clifton Road, NE

Atlanta, GA 30322-4027

Room: 232

Biography

Deborah Watkins Bruner, RN, PhD, FAAN, is an internationally renowned researcher and according to the Blue Ridge Institute, is the number one NIH funded nurse researcher in the world for two years running from 2012 to 2013 and from 2013 to 2014.  Her work and leadership in developing and establishing Patient Reported Outcomes (PROs) as highly significant outcome metrics in national clinical trials has changed clinical practice guidelines for patients treated with bone metastasis and for cancer patient symptom management of several treatment-related symptoms including sexual dysfunction.   Dr. Bruner completed her doctoral degree in nursing research, with a focus on outcomes research, at the University of Pennsylvania and has been continuously and well-funded for the past 16 years. Dr. Bruner's teaching focuses on quantitative research methods, randomized clinical trials, health disparities and the acute and late effects of cancer along with symptom management and comparative effectiveness. She is the first and currently only nurse to serve as Principal Investigator of one of the National Cancer Institute (NCI) sponsored National Community Oncology Research Programs (NCORP) and is the Deputy Chair for Publications of one of the national clinical trials cooperative groups, the NRG Oncology Group. Dr. Bruner has worked for over two decades with the Radiation Oncology Therapy Group (RTOG) and the Gynecologic Oncology Group (GOG) as Chair of the RTOG Health Services Research and Outcomes (HSRO) Committee and a founding member of the RTOG and GOG quality of life committees. She conducted RTOG's first clinical trial incorporating quality of life. In the area of recruitment and health disparities, Dr. Bruner has successfully employed the scientific evaluation of social marketing, a method novel to cancer research, and leads multifaceted studies of the behavioral aspects of human subject recruitment to research trials. Dr. Bruner has published over 130 peer-reviewed journal articles, and 16 books/book chapters. She has served as editor-in-chief of one book and three editions of an ONS Guidelines Manual for radiation oncology nursing. Her articles have been published in a number of leading journals including the Journal of the America Medical Association, the New England Journal of Medicine, the Journal of Clinical Oncology, International Journal of Radiation Oncology, Biology, Physics, Cancer and the Oncology Nursing Forum.   Dr. Bruner’s research expertise has led to recognition and high impact scientific leadership through multiple national appointments including:  serving as co-chair of the NCI Symptom Management and Health Related Quality of Life Committee, tasked with review, approval and prioritization of the nation’s NCI-sponsored symptom management and quality of life clinical trials portfolio.  She was appointed by the Director of the NCI to the Clinical Trials Advisory Committee (CTAC) and served on subcommittees of CTAC, the Clinical Trials Working Group (CTWG) Evaluation Working Group, and the National Clinical Trials Network (NCTN) Working Group.  She was also co-chair of the 2011 NCI-sponsored Clinical Trials Planning meeting on Patient Reported Outcomes, which developed recommendations for core patient reported outcomes to be assessed across all cancer clinical trials (JNCI, In Press).   Finally, she has been honored with University Awards in research and mentorship;  National Awards such as the Excellence in Radiation Oncology, Oncology Nursing Society/Varian Nursing Award and the Linda Hunter Quality of Life Lecture, Society of Gynecologic Nurse Oncologists; and International Awards such as Best New Investigator, International Society for Pharmacoeconomics & Outcomes Research, Poster Presentation.  She has also been recognized by the global community through her invitational lectures in Canada, England, Israel, Ireland, Belgium, Australia, and Jordan.  She has recently been a guest lecturer at the University of Peking and the University of Nanjing, China.

Research

Dr. Bruner’s program of research focuses on patient reported outcomes (PROs) and symptom management across cancer sites with a focus on pelvic tumors, preferences and utilities and comparative effectiveness for cancer therapies, and health disparities in recruitment to clinical trials. Her methodological work in PRO development and value added of PROs in clinical research, and her work in sexuality after cancer, are internationally recognized as demonstrated by her national and international invitational lectures and panel participation. Dr. Bruner is the only nurse to be awarded a grant from the National Cancer Institute to lead a large interdisciplinary team as Principal Investigator, of a national cancer clinical trials cooperative group, the Radiation Therapy Oncology Group (RTOG) Community Clinical Oncology Program (CCOP). RTOG, a consortium of over 360 institutions in the U.S. and Canada involving over 1,000 physicians, nurses, physicists, and statisticians, is focused on the study of radiation therapy (RT)-related symptom amelioration, quality of life and comparative effectiveness.  The RTOG CCOP accrued over 2,000 patients to cancer clinical trials in the last five years. Dr. Bruner’s research in RTOG led to a paradigm shift from a historically medically dominated focus on survival and toxicity, to a patient-centered, nurse led, bio-behavioral focus that includes PROs as primary or secondary outcomes in clinical trials. Dr. Bruner conducted the first PRO study in RTOG and found a disturbing discordance of up to 45% between patient and clinician reports of prevalence and severity of subjective symptoms.   Building on these data, Dr. Bruner has been developing methods and leading national efforts to incorporate PROs as standard measures in clinical trials for the past 25 years.  Her work has provided the highest level I evidence for clinical practice guidelines.  For example, in a randomized trial of palliative RT for bone metastasis, she included a patient reported pain measure and found 1 8Gy treatment provided equivalent pain control to 10 treatments up to 30Gy.  There were no differences in objective narcotic relief or quality of life between arms with significant cost savings on the single treatment arm. Data from this trial was used in the Palliative Radiotherapy for Bone Metastases: An ASTRO Evidence-Based Guideline. Further, Dr. Bruner’s work correlated women’s report of sexual function after pelvic RT for gyn cancers with a novel measure of vaginal physiologic changes.  Changes in sexual function are one of the most prevalent, serious and understudied long term survivorship issues in these patients. The Vaginal Sound, developed by Dr. Bruner, is a reliable measure of vaginal length tested in a national study, and with it shereported on one of the few studies to quantify RT-related vaginal morbidity in women treated with vaginal brachytherapy (VBT) and correlate changes with PROs. She has documented that women treated with VBT have a shorter than normal vaginal length and that regular use of a dilator is significantly associated with a decreased risk for vaginal toxicity, but that adherence to dilator use is poor.  This led to her randomized trial assessing enhanced education/counseling for dilator adherence improvements by 20%. The body of this work has been used in evidence based guidelines for nurses in the Oncology Nursing Society, Manual for Radiation Oncology Nursing Practice and Education, and cited in the 2010 Cochran review of vaginal dilator use as well as in the recent International Guidelines on Vaginal Dilation after Pelvic Radiotherapy.

Publications

  • Pisansky, T., Pugh, S., Greenberg, R., Pervez, N., Reed, D., Rosenthal, S., Mowat, R., Raben, A., Buyyounouski, M., Kachnic, L. Bruner, D.W.  Tadalafil for prevention of erectile dysfunction after radiotherapy for prostate cancer – the Radiation Therapy Oncology Group [0831] randomized clinical trial. Journal of the American Medical Association (JAMA). 2014;311(13):1300-7.PMID:24691606.

  • Bruner DW, O'Mara A. Nurse scientists in cancer cooperative groups. Semin Oncol Nurs. 2014 Feb;30(1):4-10. Epub 2013 Dec 18. PMID:24559774.

  • Bruner, D.W., Hanisch, L., Trotti, A., Reeve, B., Schrag, D, Sit, L., Minasian, L,  O'Mara, A., Denicoff, A., Rowland, J.,  Montello, M., Geoghegan, C., Abernethy, A., Clauser, S., Castro, K., Mitchell, S., Burke, L., Trentacosti, A.M,. Mendoza, T.,  Basch, E. Stakeholder Perspectives on Implementing the National Cancer Institute's Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), (2011) Translational Behavioral Medicine: Practice, Policy and Research. 1(1):110-122.