Carol A. Mancuso MD is a general internist and clinical epidemiologist with specific interests in patient-centered clinical research and medical education. As a clinical researcher, Dr. Mancuso focuses on treatment expectations and outcomes in patients with musculoskeletal conditions, and self-management and quality of life in patients with chronic diseases . In particular, Dr. Mancuso is interested in the interface of physical and mental health. Dr. Mancuso is actively involved in training physicians to be clinical researchers through her roles as an NIH-sponsored clinical mentor and the Director of the Master's Degree Program in Clinical Epidemiology and Health Services Research at the Weill Cornell Graduate School of Medical Sciences.
In collaboration with orthopedic surgeons at the Hospital for Special Surgery, Dr. Mancuso conducted a series of studies to ascertain patients' expectations of orthopedic surgery. This work led to the development of validated surveys to measure patients' expectations of hip, knee, shoulder, and spine surgery which have become gold standards used in national and international outcomes studies. Among patients with other musculoskeletal conditions, specifically rheumatoid arthritis and systemic lupus erythematosus, Dr. Mancuso studied major psychosocial adverse consequences of disease such as job loss, fatigue, and physical inactivity. Dr. Mancuso also conducted a trajectory of work assessing self-management, depressive symptoms, and quality of life in primary care and emergency department patients Dr. Mancuso continues to actively conduct research in these areas with support from institutional grants.
Dr. Mancuso is also dedicated to training future clinical researchers. She is the Director of the Master's Degree Program in Clinical Epidemiology and Health Services Research at Cornell focusing on teaching physicians to conduct investigator-initiated studies in actual clinical settings. In addition, Dr. Mancuso is the Director of the Mentoring Cores for NIAMS-supported T32 training grants in Rheumatology and Orthopedic Biomechanics. As a recipient of a clinical mentorship award from the National Heart Lung and Blood Institute, Dr. Mancuso continues to expand her role as a teacher and mentor to physicians and students throughout the Hospital for Special Surgery and the Cornell Medical Center. This includes appointment as the Director of the Faculty Mentoring Curriculum, which is dedicated to optimizing mentorship skills among clinical and research mentors.
Depressive symptoms
Health-related quality of life
Medical education
Outcomes research
Patients' experiences with medical care
Self-management
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Attending Physician, Hospital for Special Surgery
Senior Scientist, Hospital for Special Surgery
Professor of Medicine, Weill Cornell Medical College
Professor of Medicine, Weill Cornell Graduate School of Medical Sciences
Attending Physician, NewYork-Presbyterian Hospital
Internal Medicine
MD, CUNY - Mt. Sinai Medical School
The New York Hospital
The New York Hospital
Weill Cornell Medical College, Hospital for Special Surgery - CUMC
English
For all publications, please see the PubMed listing.
Carol A. Mancuso MD is a general internist and clinical epidemiologist whose research interests focus on quality of life outcomes in chronic diseases and patients' experiences with the health care system. Her areas of particular interest are elective orthopedic surgery, adverse lifestyle outcomes caused by rheumatoid arthritis and systemic lupus erythematosus, and self-management and quality of life in patients with chronic diseases. In addition, Dr. Mancuso is an NIH-sponsored educator to train physicians to become independent researchers.
Patients' Expectations and Satisfaction with Outcomes of Orthopedic Surgery
Dr. Mancuso conducted a series of studies to ascertain patients' expectations and satisfaction with hip, knee, shoulder, and spine surgery. She found that in addition to improvement in pain and function, major expectations included regaining independence and restoring psychological well-being. These studies resulted in the development and validation of patient-derived surveys that have become gold standards for measuring expectations in clinical practice and research. Dr. Mancuso used these surveys in a study supported by the Arthritis Foundation to assess fulfillment of expectations of total hip arthroplasty, in two randomized controlled trials supported by the National Institute on Aging to test the effectiveness of educational interventions to modify expectations of total hip and total knee arthroplasty, and a study supported by the Agency for Healthcare Research and Quality to compare patients' and surgeons' expectations of lumbar surgery. Current work focuses on fostering healthy lifestyle physical activity after lumbar surgery, predicting post-anesthesia intra-operative spinal instability, and comparing patients' and surgeons' expectations of outcome from cervical spine surgery.
Adverse Psychosocial Outcomes in Patients with Connective Tissue Diseases
Most studies of employment in patients with rheumatoid arthritis (RA) focus on job loss; less is known about workplace experiences in patients who continue to work. To study these experiences, Dr. Mancuso conducted a longitudinal study comparing the incidence of negative workplace events between employed patients with RA and healthy controls. Compared to controls, negative events were associated primarily with more fatigue and more social stress in RA patients. In addition, RA patients were more likely not to meet national goals for daily physical activity and to become progressively more inactive over time. In a parallel study supported by the Mary Kirkland Center for Lupus Research, patients with systemic lupus erythematosus (SLE) also were more likely not to meet national activity goals.
Improving Quality of Life and Clinical Outcomes in Primary Care and Emergency Department Patients with Asthma
As a Robert Wood Johnson Generalist Physician Faculty Scholar, Dr. Mancuso conducted a longitudinal study to identify patient-centered predictors of functional decline and resource utilization in asthma patients. The results showed that more depressive symptoms, less self-efficacy and unrealistic expectations predicted worse outcomes. This work became the foundation for the development of a patient self-management program aimed at increasing asthma knowledge, self-efficacy, and asthma-related social support. The program was tested with primary care patients in a randomized controlled trial supported by a K-23 award from the National Heart Lung and Blood Institute, and determined that the intervention was particularly affective in patients with more depressive symptoms.
During these studies, Dr. Mancuso found that many asthma patients limit physical activity and avoid exercise because they are concerned about exacerbating their respiratory symptoms. In order to increase healthy lifestyle physical activity, Dr. Mancuso conducted a randomized controlled trial to study the effectiveness of a psychosocial intervention to foster healthy physical activities in primary care asthma patients. Supported by the National Heart Lung and Blood Institute, the trial resulted in clinically important increases in weekly physical activity, and was particularly effective in patients with more depressive symptoms.
Patients who present to urban emergency departments (ED) for asthma often do not have good self-management skills and do not have established sources of primary care. To address the educational needs of asthma ED patients, Dr. Mancuso conducted a randomized controlled trial supported by the National Heart Lung and Blood Institute aimed at fostering self-management in patients presenting for asthma to the ED at two inner city hospitals. Patients received interventions that addressed asthma knowledge, self-efficacy, and social support, and provided feedback regarding respiratory function. Quality of life and repeat ED visits improved in both groups, with particular benefit in younger patients.
A recurring theme throughout this trajectory of work has been the impact of depressive symptoms on asthma outcomes. Dr. Mancuso subsequently conducted a randomized trial supported by the National Heart Lung and Blood Institute to simultaneously modify asthma and major psychiatric disorders. The trial involved cognitive behavior therapy to concurrently improve self-management and was successful in improving outcomes for both respiratory and psychiatric symptoms.
Medical Education in Research
Dr. Mancuso is actively involved in training future clinical researchers through her roles as the Director of the Master's Degree Program in Clinical Epidemiology and Health Services Research at the Weill Cornell Graduate School of Medical Sciences, the Director of the Mentoring Cores for NIAMS-supported T32 training grants in Rheumatology and Orthopedic Biomechanics, and the Director of the Hospital for Special Surgery Faculty Mentoring Curriculum. Dr. Mancuso is a member of the Orthopedic Clinical Review Panel at the Hospital for Special Surgery which guides orthopedic surgeons in clinical research projects. She also is a sponsor for the Weill Cornell Graduate School of Medical Sciences Physicians' Assistant Master's Degree Program.
Dr. Mancuso is a Fellow of the American College of Physicians and is a member of the Society for General Internal Medicine, the American Thoracic Society, and the North American Spine Society.
Parallel Trials to Modify Patients' Expectations of Hip and Knee Arthoplasty
A Trial to Foster Lifestyle Physical Activity after Lumbar Surgery
A Trial of Positive Affect to Foster Healthy Physical Activity in Asthma Patients
A Trial of Self-Management Education to Improve Outcomes in Asthma Patients in Primary Care
A Trial of Self-Management Education to Improve Outcomes in Asthma Patients Seeking Care in the Emergency Department
A Trial of Cognitive Behavioral Therapy to Improve Outcomes in Patients with Comorbid Asthma and Psychiatric Disorders
HSS has a long history of supporting appropriate relationships with industry because they advance HSS's mission to provide the highest quality patient care, improve patient mobility, and enhance the quality of life for all, and to advance the science of orthopedic surgery, rheumatology, and their related disciplines through research and education.
As of May 11, 2024, Dr. Mancuso reported no relationships with the healthcare industry.
HSS and its physicians make this information available to patients and the public, thus creating a transparent environment for those who are interested in this information. Further, the HSS Conflicts of Interest and Commitment Policy prohibits physicians from collecting royalties on products they develop that are used on patients at HSS.
