About

Christopher W Sims is an Associate Professor of the Practice in the Sanford School of Public Policy and in the Department of Art, Art History & Visual Studies at Duke University. He is also the Director of the Duke Center for Documentary Studies. His academic and professional background includes an undergraduate degree in history from Duke University, a master’s degree in visual communication from the University of North Carolina at Chapel Hill, and an M.F.A. in studio art from the Maryland Institute College of Art. Sims has worked as a photo archivist at the U.S. Holocaust Memorial Museum and in communications for non-profit organizations. His research and artistic work focus on documentary arts, with a particular emphasis on photography and visual storytelling. He has published a monograph titled “The Pretend Villages” and his work has been exhibited in over 50 venues worldwide. Sims’s projects have been featured in prominent media outlets such as The Washington Post, BBC World Service, and others. In 2024, he was a Research-in-Residence Fellow at the University of Passau and a Visiting Professor at the University of Regensburg in Germany. His artistic and scholarly contributions explore themes related to social justice, military training grounds, and contemporary documentary practices.

Research topics

• Intensive care medicine
• Medicine
• Bioinformatics
• Biochemistry
• Pathology
• Pediatrics
• Obstetrics
• Internal medicine
• Gynecology
• Environmental health

Selected publications

• Clinical Images: Anti‐ <scp>MDA5</scp> dermatomyositis with rapidly progressive interstitial lung disease presenting with rapidly progressive glomerulonephritis due to <scp>C3</scp> glomerulopathy

  ACR Open Rheumatology · 2026-04-01

  articleOpen access

  The patient, a 64-year-old woman with hypertension and type II diabetes, was admitted to the hospital for acute kidney injury with nephrotic range proteinuria. Before admission, she had three months of duskiness of the distal fingertips with mottling, or livedo reticularis. Computed tomography of the chest demonstrated increasing upper-lobe peribronchovascular consolidations and ground glass opacities with an organizing pneumonia pattern. Renal biopsy demonstrated glomerulonephritis with focal immune deposits that stained exclusively for C3 (A and B), consistent with rapidly progressive glomerulonephritis (RPGN) due to C3 glomerulopathy. Given her skin changes and worsening hypoxemia concerning for rapidly progressive interstitial lung disease (RP-ILD), myositis-specific antibody testing was obtained and demonstrated anti-MDA5 antibody positivity (74 units; reference interval <20 units), confirming anti-MDA5 dermatomyositis (DM). She had normal muscle strength and a normal creatine kinase level, consistent with an amyopathic presentation. Her ferritin level, a prognostic marker of anti-MDA5 DM RP-ILD,1 increased from 1,232 to 5,260 ng/mL, corresponding with acutely worsening hypoxemia requiring intubation. She was initially treated with mycophenolate mofetil, high-dose steroids, and rituximab and required escalation to cyclophosphamide, tacrolimus, and intravenous Ig due to worsening oxygen requirements. She ultimately died of pulmonary and renal failure. Renal involvement in idiopathic inflammatory myopathies is extremely rare, although it has been described2; however, anti-MDA5 DM is not known to present with renal disease. Although a single case report has described anti-MDA5 DM presenting with thrombotic microangiopathy,3 this is the first case describing anti-MDA5 DM and RPGN secondary to C3 glomerulopathy, highlighting the importance of recognizing renal involvement as a rare but possible overlap with anti-MDA5 DM. Verbal consent was obtained from the patient and the patient's family before case write up. Disclosure form. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

  PublisherDOI

• Serum BAFF levels in pregnant patients with systemic lupus erythematosus

  Lupus · 2026-01-22

  article1st authorCorresponding

  Background/Purpose The B cell Activating Factor (BAFF) signaling pathway influences rheumatic disease through its role in the selection, maturation, and survival of B cells. Increased BAFF also correlates with hypertension and preeclampsia in pregnant women without rheumatic disease. We sought to correlate BAFF levels in pregnancy with pregnancy outcomes among women with rheumatic disease. Methods Blood samples, disease activity assessments, labs, and pregnancy outcomes were prospectively collected from pregnant women with systemic lupus erythematosus (SLE). Inclusion criteria were enrollment prior to 30 weeks gestation and known pregnancy outcome. Preeclampsia diagnosis was determined through chart review and consensus among 6 providers (maternal-fetal medicine, nephrology, and rheumatology); pregnancies were excluded if a preeclampsia diagnosis could not be agreed upon. We assessed for changes in BAFF levels throughout pregnancy, and we investigated its association with disease activity and adverse pregnancy outcomes. Results This study included 408 samples in 230 women with SLE ( n = 110) and other rheumatic diseases ( n = 120). The average maternal age was 31.3 years and self-reported race was 5% Asian, 30% Black, and 61% White. The median level of BAFF was significantly higher in the 1st trimester compared to the 2nd and 3rd trimester measures ( p = .002). Among women with SLE, compared to pregnancies without preeclampsia, those with preeclampsia had significantly higher BAFF levels in the first trimester (2061 vs 1217 pg/mL, p = .007). In models adjusted for age, obesity, and maternal race, patients with SLE experienced a 19% higher odds of developing preeclampsia with every 100-unit increase BAFF in the first trimester (AOR 1.19; 95% CI: 1.05, 1.36). Women with SLE and elevated BAFF levels were more likely to have elevated dsDNA, but not more likely to experience lupus nephritis during pregnancy. Conclusion This study found elevated BAFF levels in the first trimester of pregnancy were associated with subsequent development of preeclampsia. While elevated BAFF was associated with elevated dsDNA, it was not associated with lupus nephritis, the strongest predictor of preeclampsia among women with SLE. This finding suggests that elevated BAFF early in pregnancy may be a novel risk factor for poor pregnancy outcomes in women with SLE.

  PublisherDOI

• Family Planning and Rheumatoid Arthritis

  Current Rheumatology Reports · 2025-05-29 · 2 citations

  review1st authorCorresponding
  PublisherDOI

• An Evidence Map of the Women Veterans’ Health Literature, 2016 to 2023

  JAMA Network Open · 2025-04-22 · 14 citations

  reviewOpen access

  Importance: Women veterans are the fastest-growing veteran subpopulation in the US. Women veterans often experience military service-related health issues in addition to conditions common to all women. Because women veterans are more likely to receive care in the civilian setting than through the Department of Veterans Affairs (VA), all women's health clinicians should be equipped to provide patient-centered care for women veterans. The health care of women veterans requires evidence-based care informed by population-specific scientific literature. An updated evidence map evaluating women veteran-focused health literature is needed. Objective: To map the scope and breadth of women veterans' health literature published from 2016 to 2023. Evidence Review: In this systematic review, MEDLINE, Embase, and CINAHL Complete were searched for eligible articles published from 2016 to 2023. Articles reporting about US women veterans' health outcomes or on the experience of providing care to women veterans were included. Included articles were required to report patient-level outcomes that included either data for only women veterans or reported results separately for women veterans. Articles were grouped by primary focus area based on categories previously established by the VA Women's Health research agendas and prior evidence maps. Findings: The volume of women veterans' health literature published between 2016 and 2023 of 932 articles was double that of the prior 8 years. The largest portion of this literature was focused on chronic medical conditions (137 articles [15%]), general mental health (203 articles [22%]), and interpersonal violence (121 articles 3[13%]). Areas of greatest growth included reproductive health (physical and mental), pain, suicide, and nonsuicidal self-injury. Additionally, emerging areas of inquiry were found, including military-related toxic exposures and harassment within the health care setting. Conclusions and Relevance: In this systematic review of literature focused on the health of women veterans, the volume of literature was found to have doubled and expanded in important areas that aligned with VA research priorities. However, despite the growth in research related to women veterans, several important research gaps remain within this field of study. Research addressing health issues pertinent to a growing and aging women veterans' population will require rigorous research and program evaluations.

  PublisherDOI

• Experiences Receiving and Delivering Virtual Health Care For Women: Qualitative Evidence Synthesis

  Journal of Medical Internet Research · 2025-05-15 · 5 citations

  articleOpen access

  BACKGROUND: Persisting sex- and gender-based disparities in access to high-quality, personalized health care in the United States can lead to devastating outcomes with long-lasting consequences. Strategic use of virtual resources could expand equitable health care access for women. However, optimal approaches and timing for individualized, virtually delivered health care for women are unclear. OBJECTIVE: This study aims to conduct a detailed analysis of the current literature to answer the following question: "According to women and their health care teams, what are the reported successes and challenges in accessing, delivering, and participating in synchronous virtual health care for women?" METHODS: We conducted a qualitative evidence synthesis using a best-fit framework approach based on the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework and concepts from the Public Health Critical Race Praxis. We searched MEDLINE, Embase, and CINAHL from January 1, 2010, to October 10, 2022, using a combination of database-specific, relevant, controlled vocabulary terms and keywords; this search was updated in MEDLINE through January 2024. Additional citations were identified through handsearching. Our eligibility criteria were developed using the Sample, Phenomenon of Interest, Design, Evaluation, Research type tool to identify qualitative studies addressing synchronous virtual care for women. Citations were screened in duplicate, and eligible articles were abstracted. An iterative thematic synthesis approach was used to identify descriptive themes related to the successes and challenges related to delivering high-quality virtual care. Data reduction was performed using inductive and deductive reasoning. Quality assessment was conducted using the Critical Appraisal Skills Program and certainty of evidence using Confidence in the Evidence from Reviews of Qualitative Research approaches. RESULTS: Of 85 eligible articles, we sampled 51 (60%) for data extraction based on representation of patient and clinician perspectives, marginalized voices, and relevance to a variety of clinical contexts. We identified themes across NASSS domains, including difficulty building rapport and emotional connections in the virtual setting, the amplification of barriers for women with preexisting challenges (eg, language barriers, limited transportation, and family and social commitments), and differing perceptions of privacy and safety related to virtual care depending on patient home context. Themes found to have high confidence included the value of convenience and cost savings offered by virtual care, the importance of patient choice in visit modality, the potential for negative impact on user well-being, considering the clinical context of modality choice, the importance of technology usability, and the value of virtual care for women located in regions without adequate supply of clinical offerings. CONCLUSIONS: The benefits of virtual care for health care access may be more acutely felt by women, especially those with preexisting challenges. Strategic incorporation of virtual modalities into health care delivery for women could improve equitable access to high quality, patient-centered care. TRIAL REGISTRATION: PROSPERO CRD42021283791; https://www.crd.york.ac.uk/PROSPERO/view/CRD42021283791. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1089/heq.2023.0089.

  PublisherDOI

• Smoking Cessation Screening and Treatment Among Veterans With Multiple Sclerosis

  Military Medicine · 2025-03-23

  article

  INTRODUCTION: Cigarette smoking is a leading cause of preventable death in the United States and disproportionately affects veterans. While smoking cessation is the goal for all veterans, it is especially critical for veterans with multiple sclerosis (MS; VwMS), for whom smoking is more detrimental to health and function. Smoking is associated with more MS relapses/flares, greater disability, faster disease progression, and earlier MS-related death. This quality improvement project aims to describe current practice pathways for screening and treating smoking cessation in VwMS and explore whether these differ by sociodemographic factors. MATERIALS AND METHODS: A validated algorithm was used to identify VwMS who were current or former smokers at one VA hospital in North Carolina from fiscal year 2020 to 2022 who had been screened for smoking and could be followed for 1 year. A chart review was conducted by 2 reviewers and 25% of charts were audited for reliability. Data extraction was guided by the Consolidated Framework for Implementation Research. Within-group proportions were used to help compare receipt of care across different groups in the context of sociodemographic factors. This work was deemed quality improvement and not subject to IRB review. RESULTS: Of all VwMS (n = 309), 39.5% (n = 122) were identified as current or former smokers. Of those, only 58% (n = 71) were eligible largely because many VwMS lacked a current screen, which was an identified gap in care. Among those screened, most screenings had taken place through primary care services (73%), and most were offered behavioral interventions at screening (n = 66), yet few were interested (n = 4) or received a referral to the cessation clinic (n = 2). One additional referral was given during the follow-up year. Most VwMS were also offered pharmacological interventions (n = 68), with more interest (n = 11) and cessation medication prescriptions (n = 8). Eleven additional VwMS received prescriptions throughout the follow-up year, but a third of those (36%) were required due to inpatient hospitalizations. While subgroup sample sizes were limited, potential disparities were noted. For example, women veterans and veterans from minoritized populations were less likely to be assessed for smoking status and offered cessation strategies. CONCLUSIONS: This study identified relatively low rates of smoking cessation screening, interest in treatment, and treatment delivery for VwMS. Important racial and sex disparities were noted. There are several potential barriers and facilitators including Electronic Health Record referral logistics, veteran and provider awareness of the relationship between smoking and MS, stigma of behavioral interventions, fragmented care, and competing demands on clinicians. This work was done at one local VA hospital within North Carolina, the leading state in tobacco production, and is not necessarily representative of other hospital screening and treatment practices. The role of specialty providers (e.g., mental health and neurology) in smoking cessation for VwMS should be further explored and may be an important opportunity for improving screenings and tailored discussion. Future work, incorporating VHA clinician and VwMS perspectives, is needed to further characterize and address barriers/facilitators to improve smoking cessation care and health of VwMS.

  PublisherDOI

• Moving the ACR's Reproductive Health Guidelines Into Practice

  JCR Journal of Clinical Rheumatology · 2025-04-23 · 1 citations

  article

  BACKGROUND: Project ECHO (Extension for Community Healthcare Outcomes) links experts with community providers through video teleconferences that include both didactics and case discussions. We piloted the first ECHO with a specific focus on reproductive rheumatology intended to increase rheumatologists' knowledge and self-efficacy in providing reproductive health care. METHODS: The Project ECHO guides informed ReproRheum ECHO curriculum development, provider recruitment, logistics, and assessment. Assessments included interviews and pre/post surveys to assess knowledge, self-efficacy, and identify program strengths and weaknesses. RESULTS: Eight rheumatology providers (5 physicians, 2 nurse practitioners, 1 rheumatology fellow) and 4 experts (2 reproductive rheumatologists, 2 maternal-fetal medicine physicians) participated in six 1-hour ReproRheum ECHO sessions from January to March 2023. All but one provider attended all sessions, demonstrating feasibility. Knowledge of the rate of birth defects after exposure to both azathioprine and mycophenolate significantly increased in participating physicians. Provider self-efficacy also increased significantly (6.8 ± 1.2 pre-ECHO to 8.1 ± 0.5 post-ECHO, p = 0.03). All participants "agreed" or "strongly agreed" that they had increased confidence in their ability to answer colleagues' questions and guide patients' choices in contraception and medication in pregnancy. In interviews, providers reported satisfaction with and appreciation of both didactic and case discussions, the multidisciplinary approach, and connecting with other providers. They reported improved comfort and increased frequency of discussing reproductive health in practice. CONCLUSIONS: The pilot ReproRheum ECHO was feasible and improved knowledge and self-efficacy among rheumatologists in reproductive health. This model is a promising approach to improving reproductive health care for women with rheumatic disease.

  PublisherDOI

• Characterizing Intervention Components and Complexity of Nonpharmacologic Healthcare Interventions to Manage Distress Behaviors in Older Adults

  Journal of Applied Gerontology · 2025-04-28 · 1 citations

  articleOpen access

  Distress behaviors are common in residential care settings and contribute to staff burnout and poor quality of life for older adults. While nonpharmacologic interventions reduce distress behaviors, implementation in routine care remains challenging. Our study applies a narrative reanalysis of interventions to 34 studies identified in a prior systematic review to describe the setting, focus, core components, and complexity of interventions identified. Most interventions occurred in post-acute settings, followed by transitions between care settings and inpatient mental health settings. Identified interventions were highly complex and heterogeneous regarding the components assessed and the details reported. Intervention components focused on patients, healthcare workers, environmental, and multiple levels. Common patient-level components included individualized care plans, distress behavior detection, medical management, and symptom monitoring. Common staff-level components included education and healthcare team workflow. Current evidence does not provide sufficient detail to replicate these interventions. We provide a template for standardized intervention testing and reporting implementation.

  PublisherOA PDFDOI

• Correction: Family Planning and Rheumatoid Arthritis

  Current Rheumatology Reports · 2025-07-31

  erratumOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Impact of Antiphospholipid Syndrome on Reproductive Outcomes: Current Insights and Management Approaches

  Seminars in Reproductive Medicine · 2024-09-01 · 6 citations

  reviewOpen accessSenior author

  Antiphospholipid syndrome (APS) is a disease characterized by the presence of antiphospholipid (aPL) antibodies, thrombosis, and obstetric complications. While patients with APS can have successful pregnancies, many important considerations exist. APS can also cooccur with other systemic autoimmune diseases which can affect pregnancy, particularly systemic lupus erythematosus. This article reviews specific considerations for pregnancy and reproductive health in patients with APS. Similar to other autoimmune diseases, stable or quiescent disease and planning with a rheumatologist and obstetrician prior to conception are vital components of a successful pregnancy. Pregnancy management for patients with aPL antibodies or diagnosis of APS with aspirin and/or anticoagulation depending on disease profile is discussed, as well as the effects of physiologic changes during pregnancy in maternal and fetal outcomes for this population. Given the reproductive span lasts beyond conception through delivery, we include discussions on safe contraception options, the use of assistive reproductive technology, pregnancy termination, menopause, and male fertility. While APS is a relatively rare condition, the effects this disease can have on maternal and fetal outcomes even with available therapies demonstrates the need for more high-quality, evidence-based research.

  PublisherOA PDFDOI

Frequent coauthors

• Megan Shepherd‐Banigan

  Duke University

  20 shared

• Jennifer M. Gierisch

  Centre for the Observation and Modelling of Earthquakes, Volcanoes and Tectonics

  16 shared

• Karen M. Goldstein

  Durham VA Health Care System

  16 shared

• Sarah Cantrell

  Duke University

  14 shared

• Megan E. B. Clowse

  Duke University

  13 shared

• Christine Yeung

  University of Pennsylvania

  8 shared

• Aimee Kroll‐Desrosiers

  VA Central Western Massachusetts Healthcare System

  8 shared

• Eleanor S. McConnell

  Durham VA Health Care System

  6 shared

Labs

• Duke Center for Documentary StudiesPI

Awards & honors

• Baum Award for Emerging American Photographers (2010)
• Oxford American magazine 'new Superstars of Southern Art' (2…
• Arte Laguna Prize in Photographic Art (2015)
• Archie Green Fellow at the U.S. Library of Congress (2017)