Harry Wells Severance Jr.

Harry Wells Severance Jr.
Adjunct Assistant Professor in the Department of Medicine

Principle Investigator - Duke E.D. Site - "Speed" Study. Pilot phase of Gusto IV. Investigating Abciximab (a GP IIb-IIIa inhibitor) in combination with rapid access to cardiac cath. Funded through Duke Clinical Research Institute. Multi-center trial.

Principle Investigator - Project: proposed mechanisms for afferent pain transmission from myocardial cells to pain centers. Purpose is to identify potential biochemical markers for early anginal presentations. Funded: grants received from Merck & Co. and Roche-Boehringer-Mannheim. Pilot phase paper - in preparation.

Site PI - PROMISE Clinical Trial,

Other Interest Areas:
Blasts/Ballistics
Wounding and medical management of penetrating injuries derived from firearms and blast-related injuries.

Impact of Observation/short-stay strategies on clinical care and inpatient/outpatient systems.

Impact of Emerging Viral Threats on clinical management and social/economic/political systems,

Acute Cardiology - Chest Pain Presentations
Evolving Technology and AI in improving clinical care/management

Current Research Interests

Acute Emerging Viral Threats,

Evolving technology and AI in improving diagnosis and clinical care,

Current Appointments & Affiliations

Adjunct Assistant Professor in the Department of Medicine, Medicine, Cardiology, Medicine 2014

Contact Information

0682 Hosp North, Durham, NC 27710
Box 3096 Med Ctr, Durham, NC 27710
harry.severance@duke.edu (919) 668-8821

Background
Education, Training, & Certifications
- M.D., Duke University School of Medicine 1981
Duke Appointment History
- Associate Clinical Professor of Surgery, Surgery, Emergency Medicine, Surgery 2001 - 2004
- Assistant Professor in Medicine, Medicine, Clinical Science Departments 1998 - 2004
- Associate Professor of Surgery, Surgery, Emergency Medicine, Surgery 2001
- Assistant Professor of Surgery, Surgery, Emergency Medicine, Surgery 1996 - 2000
- Assistant Professor in Medicine, Medicine, General Internal Medicine, Medicine 1996 - 1998
- Assistant Professor of Medicine, Medicine, Clinical Science Departments 1991 - 1996
Leadership & Clinical Positions at Duke
- Duke Collaborative Cardiovascular Society and Research Network ( DUCCS) - Board of Directors
Publications & Artistic Works
Selected Publications
- Academic Articles
  - Muhlestein, Joseph Brent, Joseph Boone Muhlestein, Jeffrey L. Anderson, Charles F. Bethea, Harry W. Severance, Robert J. Mentz, Gregory W. Barsness, et al. “Smartphone 12-lead ECG-Exciting but must be handled with care.” Am Heart J 226 (August 2020): 269. https://doi.org/10.1016/j.ahj.2020.03.004.
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  - Muhlestein, Joseph Boone, Jeffrey L. Anderson, Charles F. Bethea, Harry W. Severance, Robert J. Mentz, Gregory W. Barsness, Alejandro Barbagelata, et al. “Feasibility of combining serial smartphone single-lead electrocardiograms for the diagnosis of ST-elevation myocardial infarction.” Am Heart J 221 (March 2020): 125–35. https://doi.org/10.1016/j.ahj.2019.12.016.
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  - Barbagelata, Alejandro, Charles F. Bethea, Harry W. Severance, Robert J. Mentz, David Albert, Gregory W. Barsness, Viet T. Le, et al. “Smartphone ECG for evaluation of ST-segment elevation myocardial infarction (STEMI): Design of the ST LEUIS International Multicenter Study.” J Electrocardiol 51, no. 2 (March 2018): 260–64. https://doi.org/10.1016/j.jelectrocard.2017.10.011.
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  - Ladapo, Joseph A., Udo Hoffmann, Kerry L. Lee, Adrian Coles, Megan Huang, Daniel B. Mark, Rowena J. Dolor, et al. “Changes in Medical Therapy and Lifestyle After Anatomical or Functional Testing for Coronary Artery Disease.” J Am Heart Assoc 5, no. 10 (October 12, 2016). https://doi.org/10.1161/JAHA.116.003807.
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  - Mark, Daniel B., Jerome J. Federspiel, Patricia A. Cowper, Kevin J. Anstrom, Udo Hoffmann, Manesh R. Patel, Linda Davidson-Ray, et al. “Economic Outcomes With Anatomical Versus Functional Diagnostic Testing for Coronary Artery Disease.” Ann Intern Med 165, no. 2 (July 19, 2016): 94–102. https://doi.org/10.7326/M15-2639.
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  - Severance, Harry W., and Kevin M. Spiegel. “THE PROTOCOL-PROVIDED CLINICAL RESEARCH MODEL AS AN EVOLVING RESEARCH OPPORTUNITY FOR COMMUNITY-BASED HOSPITALS AND HEALTH CARE FACILITIES.” Technology & Innovation 17, no. 4 (March 8, 2016): 211–17. https://doi.org/10.3727/194982416x14520374943185.
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  - Severance, Harry W. “The Research RVU (rRVU): In Search of a Methodology to Incentivize and Compensate Clinicians for Participation in Clinical Research Activities.” Acad Med 91, no. 1 (January 2016): 10–19. https://doi.org/10.1097/ACM.0000000000000997.
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  - Ambrosy, Andrew P., Robert J. Mentz, Arun Krishnamoorthy, Stephen J. Greene, and Harry W. Severance. “Identifying Barriers and Practical Solutions to Conducting Site-Based Research in North America: Exploring Acute Heart Failure Trials As a Case Study.” Heart Fail Clin 11, no. 4 (October 2015): 581–89. https://doi.org/10.1016/j.hfc.2015.07.002.
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  - Muhlestein, Joseph Boone, Viet Le, David Albert, Fidela Ll Moreno, Jeffrey L. Anderson, Frank Yanowitz, Robert B. Vranian, et al. “Smartphone ECG for evaluation of STEMI: results of the ST LEUIS Pilot Study.” J Electrocardiol 48, no. 2 (March 2015): 249–59. https://doi.org/10.1016/j.jelectrocard.2014.11.005.
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  - Severance, Harry W. “DEVELOPING NEW PATHWAYS FOR CLINICAL RESEARCH THROUGH THE CHANGING ENVIRONMENT OF 21ST CENTURY HEALTHCARE.” Technology & Innovation 16, no. 2 (October 23, 2014): 167–70. https://doi.org/10.3727/194982414x14096821477063.
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  - Temple, Alton D., Francis M. Fesmire, David C. Seaberg, and Harry W. Severance. “Cardiac injury due to accidental discharge of nail gun.” J Emerg Med 44, no. 2 (February 2013): e161–63. https://doi.org/10.1016/j.jemermed.2012.01.054.
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  - Fesmire, Francis M., Ron C. Buchheit, Yu Cao, Harry W. Severance, Yi Jang, and Gregory W. Heath. “Risk stratification in chest pain patients undergoing nuclear stress testing: the Erlanger Stress Score.” Crit Pathw Cardiol 11, no. 4 (December 2012): 171–76. https://doi.org/10.1097/HPC.0b013e31826f367f.
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  - Limaye, Milind R., and Harry Severance. “Pandora's boxes: questions unleashed in airport scanner debate.” J Am Osteopath Assoc 111, no. 2 (February 2011): 87–119.
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  - Bledsoe, Bryan E., Kevin Nowicki, James H. Creel, Dale Carrison, and Harry W. Severance. “Use of pulse co-oximetry as a screening and monitoring tool in mass carbon monoxide poisoning.” Prehosp Emerg Care 14, no. 1 (January 2010): 131–33. https://doi.org/10.3109/10903120903349853.
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  - Tempel, R., and H. W. Severance. “Proposing short-term observation units for the management of decompression illness.” Undersea Hyperb Med 33, no. 2 (March 2006): 89–94.
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  - Ghim, Michael, and Harry W. Severance. “Ice storm-related carbon monoxide poisonings in North Carolina: a reminder.” South Med J 97, no. 11 (November 2004): 1060–65. https://doi.org/10.1097/01.SMJ.0000144614.38668.60.
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  - Severance, Harry W. “Mass-casualty victim "surge" management. Preparing for bombings and blast-related injuries with possibility of hazardous materials exposure.” N C Med J 63, no. 5 (September 2002): 242–46.
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  - Wilkinson, K., and H. Severance. “Identification of chest pain patients appropriate for an emergency department observation unit.” Emerg Med Clin North Am 19, no. 1 (February 2001): 35–66. https://doi.org/10.1016/s0733-8627(05)70167-x.
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  - Bell, S. J., P. N. Leibrandt, J. C. Greenfield, R. H. Selvester, J. Clifton, S. Zhou, C. Maynard, et al. “Comparison of an automated thrombolytic predictive instrument to both diagnostic software and an expert cardiologist for diagnosis of an ST elevation acute myocardial infarction.” J Electrocardiol 33 Suppl (2000): 259–62. https://doi.org/10.1054/jelc.2000.20300.
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  - Graff, L. G., J. Dallara, M. A. Ross, A. J. Joseph, J. Itzcovitz, R. P. Andelman, C. Emerman, S. Turbiner, J. A. Espinosa, and H. Severance. “Impact on the care of the emergency department chest pain patient from the chest pain evaluation registry (CHEPER) study.” Am J Cardiol 80, no. 5 (September 1, 1997): 563–68. https://doi.org/10.1016/s0002-9149(97)00422-0.
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  - Dallara, J., H. W. Severance, B. Davis, and G. Schulz. “Differences between chest pain observation service patients and admitted "rule-out myocardial infarction" patients.” Acad Emerg Med 4, no. 7 (July 1997): 693–98. https://doi.org/10.1111/j.1553-2712.1997.tb03762.x.
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  - Graff, L., T. Joseph, R. Andelman, R. Bahr, D. DeHart, J. Espinosa, B. Gibler, J. Hoekstra, L. Mathers-Dunbar, and J. P. Ornato. “American College of Emergency Physicians information paper: chest pain units in emergency departments--a report from the Short-Term Observation Services Section.” Am J Cardiol 76, no. 14 (November 15, 1995): 1036–39. https://doi.org/10.1016/s0002-9149(99)80291-4.
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  - Brillman, J., L. Mathers-Dunbar, L. Graff, T. Joseph, J. B. Leikin, C. Schultz, H. W. Severance, and C. Werne. “Management of observation units. American College of Emergency Physicians.” Ann Emerg Med 25, no. 6 (June 1995): 823–30. https://doi.org/10.1016/s0196-0644(95)70215-6.
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  - Graff, L. G., L. Dunbar, W. B. Gibler, L. Goldfrank, J. Leikin, C. Schultz, H. Severance, R. Watkins, D. M. Yealy, and L. S. Zun. “Observation medicine curriculum. Observation Medicine Committee, Society for Academic Emergency Medicine.” Ann Emerg Med 21, no. 8 (August 1992): 963–66. https://doi.org/10.1016/s0196-0644(05)82936-1.
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  - Sanders, D. Y., H. W. Severance, and C. V. Pollack. “Sickle cell vaso-occlusive pain crisis in adults: alternative strategies for management in the emergency department.” South Med J 85, no. 8 (August 1992): 808–11. https://doi.org/10.1097/00007611-199208000-00005.
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  - Graff, L., L. Dunbar, W. B. Gibler, L. Goldfrank, J. Leikin, H. Severance, C. Schultz, D. Yealy, R. Watkins, and L. Zun. “Observation medicine: an annotated bibliography.” Am J Emerg Med 10, no. 1 (January 1992): 84–93. https://doi.org/10.1016/0735-6757(92)90134-j.
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  - Pollack, C. V., D. Y. Sanders, and H. W. Severance. “Emergency department analgesia without narcotics for adults with acute sickle cell pain crisis: case reports and review of crisis management.” J Emerg Med 9, no. 6 (November 1991): 445–52. https://doi.org/10.1016/0736-4679(91)90216-3.
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  - Ward, G., R. C. Jorden, and H. W. Severance. “Treatment of pyelonephritis in an observation unit.” Ann Emerg Med 20, no. 3 (March 1991): 258–61. https://doi.org/10.1016/s0196-0644(05)80935-7.
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  - Severance, H. W. “Assault rifles; definitions, evolutionary history and medical consequences.” J Miss State Med Assoc 31, no. 12 (December 1990): 403–7.
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  - Pollack, C. V., and H. W. Severance. “Sialolithiasis: case studies and review.” J Emerg Med 8, no. 5 (September 1990): 561–65. https://doi.org/10.1016/0736-4679(90)90450-a.
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  - Severance, H. W., J. C. Kolb, F. B. Carlton, and R. C. Jorden. “Acute carbon monoxide poisoning: emergency management and hyperbaric oxygen therapy.” J Miss State Med Assoc 30, no. 10 (October 1989): 321–25.
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  - Pressley, J. C., H. W. Severance, M. P. Raney, R. A. McKinnis, M. W. Smith, M. C. Hindman, B. H. Wilson, and G. S. Wagner. “A comparison of paramedic versus basic emergency medical care of patients at high and low risk during acute myocardial infarction.” J Am Coll Cardiol 12, no. 6 (December 1988): 1555–61. https://doi.org/10.1016/s0735-1097(88)80025-1.
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  - “MANAGEMENT OF OBSERVATION UNITS.” Annals of Emergency Medicine 17, no. 12 (December 1, 1988): 1348–52.
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  - Severance, H. W., T. Holt, N. A. Patrone, and L. Chapman. “Profound muscle weakness and hypokalemia due to clay ingestion.” South Med J 81, no. 2 (February 1988): 272–74. https://doi.org/10.1097/00007611-198802000-00033.
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  - Pressley, J. C., B. H. Wilson, H. W. Severance, M. P. Raney, R. A. McKinnis, M. W. Smith, M. C. Hindman, and G. S. Wagner. “Basic emergency medical care of patients with acute myocardial infarction: initial prehospital characteristics and in-hospital complications.” J Am Coll Cardiol 4, no. 3 (September 1984): 487–92. https://doi.org/10.1016/s0735-1097(84)80091-1.
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  - Crimm, A., H. W. Severance, K. Coffey, R. McKinnis, G. S. Wagner, and R. M. Califf. “Prognostic significance of isolated sinus tachycardia during first three days of acute myocardial infarction.” Am J Med 76, no. 6 (June 1984): 983–88. https://doi.org/10.1016/0002-9343(84)90846-5.
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  - Pressley, J. C., M. P. Raney, B. H. Wilson, H. W. Severance, and G. S. Wagner. “Assessment of out-of-hospital resuscitation.” Am J Emerg Med 2, no. 3 (May 1984): 215–16. https://doi.org/10.1016/0735-6757(84)90006-8.
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  - Wilson, B. H., H. W. Severance, M. P. Raney, J. C. Pressley, R. A. McKinnis, M. C. Hindman, M. Smith, and G. S. Wagner. “Out-of-hospital management of cardiac arrest by basic emergency medical technicians.” Am J Cardiol 53, no. 1 (January 1, 1984): 68–70. https://doi.org/10.1016/0002-9149(84)90685-4.
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  - Severance, H. W., and F. H. Bassett. “Rupture of the plantaris--does it exist?” J Bone Joint Surg Am 64, no. 9 (December 1982): 1387–88.
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  - Severance, H. W., K. G. Morris, and G. S. Wagner. “Criteria for early discharge after acute myocardial infarction: validation in a community hospital.” Arch Intern Med 142, no. 1 (January 1982): 39–41.
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- Other Articles
  - Severance, Harry. “Opinion: Caution Required with COVID-19 Antibody/Immune Testing.” Acep Now. Wiley, n.d.
- Conference Papers
  - Muhlestein, Joseph B., Charles F. Bethea, Harry W. Severance, Alejandro Barbagelata, Robert J. Mentz, David Albert, Gregory W. Barsness, et al. “Determination of the Diagnostic Accuracy of a Mobile Smartphone ECG Device Compared to a Standard 12-Lead ECG for Evaluation of ST-Segment Elevation Myocardial Infarction (STEMI). Primary Results of the ST LEUIS International Multicenter Study.” In Circulation, Vol. 138, 2018.
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  - Clinkscales, Jeffrey D., Francis M. Fesmire, Jacob R. Hennings, Harry W. Severance, David C. Seaberg, and Nirav Patil. “The Effect of Emergency Medicine Residents on Clinical Efficiency and Staffing Requirements.” In Acad Emerg Med, 23:78–82, 2016. https://doi.org/10.1111/acem.12834.
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  - Ladapo, Joseph A., Udo Hoffmann, Kerry L. Lee, Adrian Coles, Megan Huang, Daniel B. Mark, Rowena L. Dolor, et al. “Changes in Medical Therapy and Lifestyle After Anatomical Versus Functional Testing for Coronary Artery Disease: The PROMISE Trial (PROspective Multicenter Imaging Study for Evaluation of Chest Pain).” In Circulation, Vol. 132. LIPPINCOTT WILLIAMS & WILKINS, 2015.
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Education, Training, & Certifications

Duke Appointment History

Leadership & Clinical Positions at Duke

Selected Publications

Academic Articles

Other Articles

Conference Papers