Christina Kelsey Zigler | Scholars@Duke

Christina Kelsey Zigler
Assistant Professor in Population Health Sciences

Dr. Zigler is an Assistant Professor in the Department of Population Health Sciences at Duke University School of Medicine. A psychometrician and statistician by training, she uses rigorous, patient-centered methods to develop and evaluate clinical outcome measures. Specifically, her primary interest is in designing high quality, meaningful tools for individuals with rare diseases so that their voices and the voices of their families can be prioritized in research.

Dr. Zigler received her PhD in Research Methodology from the University of Pittsburgh and her MSEd in Counseling Psychology from the University of Miami. She has been involved in research since 2006 and has published applied work in rheumatology, pediatrics, human engineering, veterans’ affairs, and rehabilitation science. Her other methodological interests include multilevel modeling, structural equation modeling, small sample size statistical methods, and anchoring vignettes.

Areas of Expertise: Health Measurement, Health Behavior, and Health Services Research

Current Appointments & Affiliations

Assistant Professor in Population Health Sciences, Population Health Sciences, Basic Science Departments 2021

Contact Information

215 Morris Street, Suite 210, Durham, NC 27708
DUMC Box 104023, Durham, NC 27708
christina.zigler@duke.edu
The Department of Population Health Sciences' Center for Health Measurement

Background
Education, Training, & Certifications
- Ph.D., University of Pittsburgh 2017
- M.S.Ed., University of Miami 2010
Previous Appointments & Affiliations
- Assistant Professor in Population Health Sciences, Population Health Sciences, Basic Science Departments 2019 - 2020
- Instructor in the Department of Population Health Sciences, Population Health Sciences, Basic Science Departments 2018 - 2019
Academic Positions Outside Duke
- Biostatistician, University of Pittsburgh. 2017 - 2018
Expertise
Subject Headings
Research
Selected Grants
- NIH Health Care Systems Research Collaboratory-Coordinating Center (U24 Clinical Trial Not Allowed) awarded by National Institutes of Health 2017 - 2028
- Expanding the Observer-Reported Communication Ability (ORCA) Measure: Measuring the communication ability of individuals with rare, neurodevelopmental disorders awarded by Food and Drug Administration 2021 - 2026
- Clinical Outcome Assessments for Acute Pain Therapeutics in Infants and your Children (COA APTIC) awarded by Food and Drug Administration 2019 - 2024
- Collaboratory Resource Coordinating Center for Pragmatic and Implementation Studies for the Management of Pain (PRISM) (U24) awarded by National Institutes of Health 2019 - 2024
- Designing Measures of Expressive Communication Ability in Individuals with Angelman Syndrome awarded by Foundation for Angelman Syndrome Therapeutics 2018 - 2023
- ACTIV -6 awarded by National Institutes of Health 2016 - 2023
- Evaluating the ORCA measure in Rett Syndrome awarded by Rett Syndrome Research Trust 2021 - 2023
- Facilitating international, multi-disciplinary collaboration in pediatric localized scleroderma research: International validation of outcome measures awarded by Childhood Arthritis & Rheumatology Research Alliance, Inc. 2021 - 2023
- Refining outcome measures through observational cohorts to advance trials in morphea awarded by University of Texas - Southwestern 2019 - 2023
External Relationships
- Angelman syndrome foundation
- Boston Children's Hospital
- Casimir
- Pattern Health
- Pediatric Rheumatology European Society/Paediatric Rheumatology INternational Trials Organisation
- University of Pittsburgh
Publications & Artistic Works
Selected Publications
- Academic Articles
  - Ali, Joseph, Stephanie R. Morain, P Pearl O’Rourke, Benjamin Wilfond, Emily C. O’Brien, Christina K. Zigler, Karen L. Staman, Kevin P. Weinfurt, and Jeremy Sugarman. “Responding to signals of mental and behavioral health risk in pragmatic clinical trials: Ethical obligations in a healthcare ecosystem.” Contemp Clin Trials 113 (February 2022): 106651. https://doi.org/10.1016/j.cct.2021.106651.
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  - Zigler, Christina K., Rachel L. Randell, and Bryce B. Reeve. “Assessing Patient-Reported Outcomes in Pediatric Rheumatic Diseases: Considerations and Future Directions.” Rheum Dis Clin North Am 48, no. 1 (February 2022): 15–29. https://doi.org/10.1016/j.rdc.2021.09.008.
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  - Richesson, Rachel L., Keith S. Marsolo, Brian J. Douthit, Karen Staman, P Michael Ho, Dana Dailey, Andrew D. Boyd, et al. “Enhancing the use of EHR systems for pragmatic embedded research: lessons from the NIH Health Care Systems Research Collaboratory.” J Am Med Inform Assoc 28, no. 12 (November 25, 2021): 2626–40. https://doi.org/10.1093/jamia/ocab202.
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  - Pruitt, David W., Christina K. Zigler, Teresa L. Massagli, and Amy J. Houtrow. “Assessing the Field of Pediatric Rehabilitation Medicine's Interest in Expanding Fellowship Training to Pediatricians.” Pm R 13, no. 10 (October 2021): 1136–47. https://doi.org/10.1002/pmrj.12549.
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  - Bailes, Anna H., Rohit Navlani, Stephen Koscumb, Amanda Malecky, Oscar C. Marroquin, Ajay D. Wasan, Howard B. Gutstein, et al. “Use of healthcare resources in patients with low back pain and comorbid depression or anxiety.” Spine J 21, no. 9 (September 2021): 1440–49. https://doi.org/10.1016/j.spinee.2021.03.031.
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  - Zigler, C. K., and A. Roberts. “A child's experience of itch: the first step towards patient-centred measures.” Br J Dermatol 184, no. 5 (May 2021): 795–96. https://doi.org/10.1111/bjd.19678.
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  - D’Innocenzo, Megan E., Jonathan L. Pearlman, Yasmin Garcia-Mendez, Stephanie Vasquez-Gabela, Christina Zigler, Perth Rosen, Eviana Hapsari Dewi, Ignatius Praptoraharjo, and Anand Mhatre. “Exploratory investigation of the outcomes of wheelchair provision through two service models in Indonesia.” Plos One 16, no. 6 (2021): e0228428. https://doi.org/10.1371/journal.pone.0228428.
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  - MenkinSmith, Lacey P., Elizabeth Tenney, Dean Gebler, Christina K. Zigler, and Edward C. O’Bryan. “Malaria Diagnosis by U.S. Providers on Short-term Medical Mission Trips to Uganda.” J Health Care Poor Underserved 32, no. 2 (2021): 830–42. https://doi.org/10.1353/hpu.2021.0108.
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  - Zigler, Christina K., Heidi Jacobe, Kaveh Ardalan, Theresa M. Coles, Suzane Lane, Kaila L. Schollaert, and Kathryn S. Torok. “The importance of development standards for anchoring vignettes: an illustrative example from pediatric localized scleroderma quality of life.” Qual Life Res 29, no. 12 (December 2020): 3263–72. https://doi.org/10.1007/s11136-020-02575-6.
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  - Zigler, C. K., K. Ardalan, A. Hernandez, A. E. Caliendo, K. E. Magee, M. A. Terry, C. M. Mann, and K. S. Torok. “Exploring the impact of paediatric localized scleroderma on health-related quality of life: focus groups with youth and caregivers.” Br J Dermatol 183, no. 4 (October 2020): 692–701. https://doi.org/10.1111/bjd.18879.
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  - Fridman, Ilona, Nicole Lucas, Debra Henke, and Christina K. Zigler. “Association Between Public Knowledge About COVID-19, Trust in Information Sources, and Adherence to Social Distancing: Cross-Sectional Survey.” Jmir Public Health Surveill 6, no. 3 (September 15, 2020): e22060. https://doi.org/10.2196/22060.
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  - Fridman, Ilona, Nicole Lucas, Debra Henke, and Christina K. Zigler. “Association Between Public Knowledge About COVID-19, Trust in Information Sources, and Adherence to Social Distancing: Cross-Sectional Survey (Preprint),” July 2, 2020. https://doi.org/10.2196/preprints.22060.
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  - Santa Barbara, Matthew T., Megan Cortazzo, Trent Emerick, Jessica Furnier, Jesse Duff, Steve Shapiro, Christine K. Zigler, Andrea Badway, and Gwendolyn Sowa. “Descriptive Analysis of an Interdisciplinary Musculoskeletal Program.” Pm R 12, no. 7 (July 2020): 639–46. https://doi.org/10.1002/pmrj.12288.
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  - Davis, W Austin, Christina K. Zigler, Theresa M. Crytzer, Sara Izzo, Amy J. Houtrow, and Brad E. Dicianno. “Factors Associated With Ambulation in Myelomeningocele: A Longitudinal Study From the National Spina Bifida Patient Registry.” Am J Phys Med Rehabil 99, no. 7 (July 2020): 586–94. https://doi.org/10.1097/PHM.0000000000001406.
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  - Houtrow, Amy J., David W. Pruitt, and Christina K. Zigler. “Gender-Based Salary Inequities Among Pediatric Rehabilitation Medicine Physicians in the United States.” Arch Phys Med Rehabil 101, no. 5 (May 2020): 741–49. https://doi.org/10.1016/j.apmr.2019.11.007.
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  - Zigler, C. K., K. Ardalan, S. Lane, K. L. Schollaert, and K. S. Torok. “A novel patient-reported outcome for paediatric localized scleroderma: a qualitative assessment of content validity.” Br J Dermatol 182, no. 3 (March 2020): 625–35. https://doi.org/10.1111/bjd.18512.
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  - Houtrow, Amy J., Christina K. Zigler, and David W. Pruitt. “The State of the Field: Results from the 2014 and 2017 Pediatric Rehabilitation Medicine Practice Surveys.” Pm R 12, no. 2 (February 2020): 168–79. https://doi.org/10.1002/pmrj.12235.
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  - Treble-Barna, Amery, Jamie Patronick, Srivatsan Uchani, Noelle C. Marousis, Christina K. Zigler, Ericka L. Fink, Patrick M. Kochanek, Yvette P. Conley, and Keith Owen Yeates. “Epigenetic Effects on Pediatric Traumatic Brain Injury Recovery (EETR): An Observational, Prospective, Longitudinal Concurrent Cohort Study Protocol.” Front Neurol 11 (2020): 460. https://doi.org/10.3389/fneur.2020.00460.
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  - Vasquez, Stephanie Gabela, Megan D’Innocenzo, Jon Pearlman, Christy Zigler, Yasmin Garcia Mendez, Perth Rozen, Eviana Hapsari Dewi, and Ignatius Praptoraharjo. “Wheelchair user’s voice: a pilot study in Indonesia,” 2020. https://doi.org/10.1101/2020.01.16.908772.
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  - Zigler, C. K., N. Lucas, D. M. Henke, and I. Fridman. “Fear & anxiety in the time of COVID-19: How they influence behavior.” Behavioral Science and Policy 6, no. 2 (January 1, 2020): 145–52. https://doi.org/10.1353/BSP.2020.0025.
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  - Dicianno, Brad E., James Joseph, Stacy Eckstein, Christina K. Zigler, Eleanor J. Quinby, Mark R. Schmeler, Richard M. Schein, Jon Pearlman, and Rory A. Cooper. “The future of the provision process for mobility assistive technology: a survey of providers.” Disabil Rehabil Assist Technol 14, no. 4 (May 2019): 338–45. https://doi.org/10.1080/17483107.2018.1448470.
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  - Kurzinski, K. L., C. K. Zigler, and K. S. Torok. “Prediction of disease relapse in a cohort of paediatric patients with localized scleroderma.” Br J Dermatol 180, no. 5 (May 2019): 1183–89. https://doi.org/10.1111/bjd.17312.
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  - Paulson, Andrea, Christina K. Zigler, Amy Houtrow, and David Pruitt. “Botulinum Toxin: Techniques Within Pediatric Physiatry.” Pm R 11, no. 1 (January 2019): 38–44. https://doi.org/10.1016/j.pmrj.2018.06.004.
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  - Zigler, Christina K., and Feifei Ye. “A Comparison of Multilevel Mediation Modeling Methods: Recommendations for Applied Researchers.” Multivariate Behav Res 54, no. 3 (2019): 338–59. https://doi.org/10.1080/00273171.2018.1527676.
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  - Dicianno, Brad E., Adam Sherman, Christian Roehmer, and Christina K. Zigler. “Co-morbidities Associated With Early Mortality in Adults With Spina Bifida.” Am J Phys Med Rehabil 97, no. 12 (December 2018): 861–65. https://doi.org/10.1097/PHM.0000000000000964.
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  - Dicianno, Brad E., James Joseph, Stacy Eckstein, Christina K. Zigler, Eleanor Quinby, Mark R. Schmeler, Richard M. Schein, Jon Pearlman, and Rory A. Cooper. “The Voice of the Consumer: A Survey of Veterans and Other Users of Assistive Technology.” Mil Med 183, no. 11–12 (November 1, 2018): e518–25. https://doi.org/10.1093/milmed/usy033.
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  - Ardalan, Kaveh, Galen E. Switzer, Christina K. Zigler, Nicole M. Hershey, and Kathryn S. Torok. “Psychometric properties of the Children's Dermatology Life Quality Index in pediatric localized scleroderma.” J Scleroderma Relat Disord 3, no. 2 (June 2018): 175–81. https://doi.org/10.1177/2397198318760768.
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  - Fisher, M. T., C. K. Zigler, and A. J. Houtrow. “Factors affecting procedural pain in children during and immediately after intramuscular botulinum toxin injections for spasticity.” J Pediatr Rehabil Med 11, no. 3 (2018): 193–97. https://doi.org/10.3233/PRM-170516.
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  - Worobey, Lynn A., Christina K. Zigler, Randall Huzinec, Stephanie K. Rigot, JongHun Sung, and Laura A. Rice. “Reliability and Validity of the Revised Transfer Assessment Instrument.” Top Spinal Cord Inj Rehabil 24, no. 3 (2018): 217–26. https://doi.org/10.1310/sci2403-217.
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  - Ardalan, Kaveh, Christina K. Zigler, and Kathryn S. Torok. “Predictors of Longitudinal Quality of Life in Juvenile Localized Scleroderma.” Arthritis Care Res (Hoboken) 69, no. 7 (July 2017): 1082–87. https://doi.org/10.1002/acr.23101.
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  - Poff, S., S. C. Li, C. E. Kelsey, I. Foeldvari, and K. S. Torok. “Durometry as an outcome measure in juvenile localized scleroderma.” Br J Dermatol 174, no. 1 (January 2016): 228–30. https://doi.org/10.1111/bjd.14103.
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  - Torok, Kathryn S., Katherine Kurzinski, Christina Kelsey, Jonathan Yabes, Kelsey Magee, Abbe N. Vallejo, Thomas Medsger, and Carol A. Feghali-Bostwick. “Peripheral blood cytokine and chemokine profiles in juvenile localized scleroderma: T-helper cell-associated cytokine profiles.” Semin Arthritis Rheum 45, no. 3 (December 2015): 284–93. https://doi.org/10.1016/j.semarthrit.2015.06.006.
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  - Kelsey, Christina E., and Kathryn S. Torok. “The Localized Scleroderma Cutaneous Assessment Tool: responsiveness to change in a pediatric clinical population.” J Am Acad Dermatol 69, no. 2 (August 2013): 214–20. https://doi.org/10.1016/j.jaad.2013.02.007.
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  - Magee, Kelsey E., Christina E. Kelsey, Katherine L. Kurzinski, Jonhan Ho, Logan R. Mlakar, Carol A. Feghali-Bostwick, and Kathryn S. Torok. “Interferon-gamma inducible protein-10 as a potential biomarker in localized scleroderma.” Arthritis Res Ther 15, no. 6 (2013): R188. https://doi.org/10.1186/ar4378.
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- Conference Papers
  - Lucas, Nicole, Molly McFatrich, Christina K. Zigler, Allyson Berent, Paula Evans, Kelly Gordon, Harrison N. Jones, Jennifer Panagoulias, and Bryce B. Reeve. “Designing measures of communication ability in individuals with Angelman syndrome.” In Quality of Life Research, 28:S117–S117. SPRINGER, 2019.
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  - Treble-Barna, Amery, Christina Zigler, Srivatsan Uchani, and Yvette Conley. “LATENT CLASS TRAJECTORY ANALYSIS OF CSF BRAIN-DERIVED NEUROTROPHIC FACTOR METHYLATION FOLLOWING SUBARACHNOID HEMORRHAGE IN ADULTS.” In Journal of Neurotrauma, 36:A58–59, 2019.
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  - Brunner, Emily, Laura Tasan, Kathryn S. Torok, Bonny Rockette-Wagner, Christina K. Zigler, Kaila Schollaert-Fitch, Diane Koontz, Chester V. Oddis, and Rohit Aggarwal. “Stepping It up: The Use of Physical Activity Monitors As an Outcome Measure in Juvenile Myositis.” In Arthritis & Rheumatology, Vol. 70, 2018.
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  - Tasan, Laura, Emily Brunner, Judy Squires, Rohit Aggarwal, Chester V. Oddis, Christina K. Zigler, Kaila Schollaert-Fitch, Emily Mirizio, and Kathryn S. Torok. “Analyze Myositis with Ultrasound and Exercise (AMUSE) Kids- Initial Analysis of Longitudinal Data.” In Arthritis & Rheumatology, Vol. 70, 2018.
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  - Zigler, Christina K., Kaveh Ardalan, Kaila Schollaert-Fitch, Heidi Jacobe, and Kathryn S. Torok. “The Localized Scleroderma Quality of Life Instrument (LoSQI): Initial Validation in Pediatric Localized Scleroderma.” In Arthritis & Rheumatology, Vol. 69. WILEY, 2017.
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  - Zigler, Christina K., Kaveh Ardalan, and Kathryn S. Torok. “Establishing Quality of Life Content Domains in Pediatric Localized Scleroderma.” In Arthritis & Rheumatology, Vol. 68. WILEY, 2016.
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  - Ardalan, Kaveh, Kaila Schollaert-Fitch, Christina K. Zigler, Makenzie A. Zidek, and Kathryn S. Torok. “Patient and Parent Global Assessments of Disease Impact in Pediatric Localized Scleroderma: Correlates of Patient Reported Health-Related Quality of Life and Parent Reported Family Impact Domains.” In Arthritis & Rheumatology, Vol. 68, 2016.
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  - Ardalan, Kaveh, Christina Kelsey, and Kathryn S. Torok. “Prospective, Standardized, Longitudinal Assessment Reveals Higher Prevalence of Extracutaneous Manifestations in a Pediatric Localized Scleroderma Cohort.” In Arthritis & Rheumatology, Vol. 67. WILEY-BLACKWELL, 2015.
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  - Ardalan, Kaveh, Christina Kelsey, and Kathryn S. Torok. “Predictors of Longitudinal Quality of Life Impact in Pediatric Localized Scleroderma.” In Arthritis & Rheumatology, Vol. 67. WILEY-BLACKWELL, 2015.
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  - Torok, Kathryn S., Jonathan Yabes, Qi Mi, Christina Kelsey, and Kelsey Magee. “Tumor Necrosis Factor-a (TNF-a) and Interferon Gamma Inducible Protein-10 (IP-10) As Predictors of Active Disease Status in Localized Scleroderma.” In Arthritis & Rheumatology, Vol. 67, 2015.
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  - Torok, Kathryn S., Katherine Kurzinski, Christina Kelsey, Kelsey Magee, Jonathan Yabes, Abbe N. Vallejo, Thomas A Jr Medsger, and Carol A. Feghali-Bostwick. “Circulating T-Helper Cell-Associated Cytokines and Chemokines in Localized Scleroderma.” In Arthritis & Rheumatology, 66:S834–35, 2014.
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  - Torok, Kathryn S., Katherine Kurzinski, and Christina Kelsey. “Predictors of Disease Relapse in Juvenile Localized Scleroderma.” In Arthritis & Rheumatology, 66:S582–S582, 2014.
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  - Ardalan, Kaveh, Christina Kelsey, and Kathryn S. Torok. “Relationships Between Physician and Patient Scored Clinical Outcome Measures In Pediatric Localized Scleroderma.” In Arthritis and Rheumatism, 65:S928–S928. WILEY-BLACKWELL, 2013.
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  - Li, Suzanne C., Kathryn S. Torok, Mara L. Becker, Fatma Dedeoglu, Robert C. Fuhlbrigge, Gloria C. Higgins, Sandy D. Hong, et al. “A Pilot Study Of Juvenile Localized Scleroderma (jLS) Consensus Treatment Plans.” In Arthritis and Rheumatism, 65:S928–S928, 2013.
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  - Brown, Kristin M., Darren Smith, Christina Kelsey, Katherine Kurzinski, and Kathryn S. Torok. “Children's Hospital of Pittsburgh Pediatric Onset En Coup De Sabre and Parry-Romberg Syndrome Cohort.” In Arthritis and Rheumatism, 64:S863–S863, 2012.
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  - Kurzinski, Katherine, Carol A. Feghali-Bostwick, Christina Kelsey, Kelsey Magee, and Kathryn S. Torok. “Gamma Interferon-Induced Protein-10 (IP-10) As a Potential Biomarker for Disease Activity in Pediatric Localized Scleroderma.” In Arthritis and Rheumatism, 64:S139–40, 2012.
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  - Li, Suzanne C., Kathryn S. Torok, Christina Kelsey, Mara L. Becker, Fatma Dedeoglu, Robert C. Fuhlbrigge, Gloria C. Higgins, et al. “Initial Evaluation of a Localized Scleroderma (LS) Clinical Activity Measure.” In Arthritis and Rheumatism, 64:S851–52, 2012.
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  - Torok, Kathryn S., Suzanne C. Li, Christina Kelsey, Mara L. Becker, Fatma Dedeoglu, Robert C. Fuhlbrigge, Gloria Higgins, et al. “Reliability of Scoring a Disease Damage Measure for Juvenile Localized Scleroderma.” In Arthritis and Rheumatism, 64:S860–S860, 2012.
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  - Kurzinski, Katherine, Christina Kelsey, Thaschawee Arkachaisri, Carol A. Feghali-Bostwick, and Kathryn S. Torok. “Circulating IP-10 and MCP-1 Levels in Active Localized Scleroderma.” In Arthritis and Rheumatism, 63:S115–S115, 2011.
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  - Torok, Kathryn S., Katherine Kurzinski, Christina Kelsey, and Carol A. Feghali-Bostwick. “Increasing Serum IL-17F Levels in Pediatric Localized Scleroderma As Disease Enters Remission.” In Arthritis and Rheumatism, 63:S712–13, 2011.
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Scholarly, Clinical, & Service Activities
Presentations & Appearances

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Education, Training, & Certifications

Previous Appointments & Affiliations

Academic Positions Outside Duke

Subject Headings

Selected Grants

External Relationships

Selected Publications

Academic Articles

Conference Papers

Presentations & Appearances