Department of Epidemiology and Biostatistics Dissertation Defense

Tuesday, April 14, 2026

1:00 PM-2:00 PM

Nicole Rafalko, MPH, Department of Epidemiology and Biostatistics, will present " The Clinical Epidemiology of Sepsis: Balancing Sepsis Program and Antibiotic Stewardship Initiatives."

Sepsis continues to be a major contributor of morbidity, mortality, and healthcare costs in the US. Sepsis patients require rapid clinical decision-making, yet current guidelines often apply a “one-size-fits-all” approach that may not account for patient heterogeneity and may contribute to unintended consequences of antibiotic use. This dissertation examines strategies to improve sepsis management and antibiotic stewardship in critically ill patients. The specific aims are to: 1) evaluate the effect of early antibiotic treatment on mortality among critically ill patients with suspected sepsis, 2) develop a predictive model using electronic health record data and machine learning to identify patients with suspected sepsis who are most likely to have positive cultures, and 3) assess the impact of antibiotic discontinuation among patients with culture-negative suspected sepsis on outcomes including Clostridioides difficile infection, hospital length of stay, and mortality. Together, these studies aim to improve evidence guiding antibiotic timing, identify patients most likely to benefit from early antibiotic treatment, and evaluate strategies to reduce unintended harms of antibiotic use in sepsis care.

Nicole is a PhD candidate in Epidemiology who worked primarily under the supervision of Neal Goldstein and, more recently, Brian Lee. During her doctoral training, her research has focused on infectious disease epidemiology, as well as clinical and health services research.

Contact Information

Nancy Colon-Anderson
nanderson@drexel.edu