Richard Mularski, MD, MSHS, MCR, is an academic physician who leads research at CHR and practices pulmonary and critical care medicine at Northwest Permanente (NWP). He has expertise in research methodology, clinical trials, real-world comparative effectiveness research (CER), quality measurement and improvement, translating research into practice, and implementing evidence-based medicine in obstructive lung disease, dyspnea, palliative care, and end-of-life care.
Dr. Mularski serves as KPNW site principal investigator on a number of clinical trials in chronic obstructive pulmonary disease (COPD), including the AERIFY and IBV Valve trials, as well as the pragmatic comparative effectiveness trial RELIANCE, comparing azithromycin with roflumilast. He led an effort to build a national infrastructure for patient-led research in COPD as a co-PI and medical director of the COPD Patient Powered Research Network, an entity funded by the Patient-Centered Outcomes Research Institute (PCORI) to build a national research infrastructure for patient-centered research (PCORnet). He is a leader in three other PCORI-funded pragmatic trials and recently served as co-PI for a pragmatic comparative effectiveness research study of palliative care delivery.
Since the COVID-19 pandemic, Dr. Mularski has led multiple hospital and outpatient COVID-19 trials and participated in vaccine phase III studies and CDC population research. He is a PI and founding steering committee member of a multi-center collaboration of investigators (COPD Outcomes-based Network for Clinical Effectiveness & Research Translation or CONCERT) whose mission is to employ effectiveness and translational research methodologies to improve care and outcomes for patients with COPD.
Dr. Mularski has held numerous leadership roles at NWP and CHR, including Director of Research and Evaluation, where he served as a liaison between CHR and the NWP/KPNW delivery system and fostered collaboration among researchers, quality improvement teams, and clinicians. He is currently CHR Clinic Medical Director. He is board certified in pulmonary, critical care, and palliative medicine. He has performed evidence-based reviews and performance measure development for multiple pulmonary and palliative projects and previously served KP nationally as a methodologist for the KP National Guideline Program with the Care Management Institute. He led the RAND Health pulmonary quality review for the QA Tools project and was lead author on a consensus statement describing 18 quality measures for palliative and end-of-life care for critically ill, hospitalized patients.
Dr. Mularski graduated from the University of Arizona College of Medicine. He completed clinical and research training at OHSU and subsequently at UCLA and RAND Health, where he led health services research within the VA before joining the Permanente Medical Group in 2006. He is a clinical professor of medicine and senior scholar of ethics at Oregon Health & Science University and professor of health systems science at the Kaiser Permanente Bernard J. Tyson School of Medicine. He is a fellow of the American Thoracic Society (ATS) and the American College of Chest Physicians (ACCP), was the inaugural chair of the ATS’ Quality Improvement Committee and is a past president of the Oregon Thoracic Society. He is a past recipient of the College of Palliative Care Research Scholar Award (American Academy of Hospice and Palliative Medicine) and the Roger C. Bone Award for Advances in End-of-Life Care (ACCP) and received the Lifetime Achievement Award from the ATS (BSHSR Assembly) in 2020. When he’s not working you can find him riding centuries on his bike, camping, hiking, fishing, and generally traveling the Pacific NW and beyond.
Selected Current Studies
- Prospective Observational Cohort Study to Assess SARS-CoV-2 Vaccine Effectiveness—CASCADIA (CDC)
- A Phase 3 Study to Evaluate the Efficacy, Immunogenicity, and Safety of Respiratory Syncytial Virus (RSV) Prefusion F Subunit Vaccine in Adults (Pfizer)
- A Phase 1/2, Placebo-Controlled, Randomized, Observer-Blind, Dose-Finding Study to Describe the Safety, Tolerability, Immunogenicity, and Potential Efficacy of SARS-CoV-2 RNA Vaccine Candidates Against COVID-19 in Healthy Adults (Pfizer)
- A Multicenter, Adaptive, Randomized Blinded Controlled Trial of the Safety and Efficacy of Investigational Therapeutics for the Treatment of COVID-19 in Hospitalized Adults (NIAID)
- Roflumilast or Azithromycin to prevent COPD Exacerbations—RELIANCE (PCORI)
Selected Publications
- Matthay MA, Arabi Y, Arroliga AC, Bernard G, Bersten AD, Brochard LJ, Calfee CS, Combes A, Daniel BM, Ferguson ND, Gong MN, Gotts JE, Herridge MS, Laffey JG, Liu KD, Machado FR, Martin TR, McAuley DF, Mercat A, Moss M, Mularski RA, Pesenti A, Qiu H, Ramakrishnan N, Ranieri M, Riviello ED, Rubin E, Slutsky A, Thompson BT, Twagirumugabe T, Ware LB, Wick KD. A New Global Definition of Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2024 Jan 1;209(1):37-47. doi: 10.1164/rccm.202303-0558WS.PMID: 37487152; PMCID: PMC10870872
- Babu TM, Feldstein LR, Saydah S, Acker Z, Boisvert CL, Briggs-Hagen M, Carone M, Casto A, Cox SN, Ehmen B, Englund JA, Fortmann SP, Frivold CJ, Groom H, Han PD, Kuntz JL, Lockwood T, Midgley CM, Mularski RA, Ogilvie T, Reich SL, Schmidt MA, Smith N, Starita L, Stone J, Vandermeer M, Weil AA, Wolf CR, Chu HY, Naleway AL. CASCADIA: a prospective community-based study protocol for assessing SARS-CoV-2 vaccine effectiveness in children and adults using a remote nasal swab collection and web-based survey design. BMJ Open. 2023 Jul 14;13(7):e071446. doi: 10.1136/bmjopen-2022-071446. PMID: 37451722; PMCID: PMC10350906.
- Potter GE, Bonnett T, Rubenstein K, Lindholm DA, Rapaka RR, Doernberg SB, Lye DC, Mularski RA, Hynes NA, Kline S, Paules CI, Wolfe CR, Frank MG, Rouphael NG, Deye GA, Sweeney DA, Colombo RE, Davey RT, Mehta AK, Whitaker JA, Castro JG, Amin AN, Colombo CJ, Levine CB, Jain MK, Maves RC, Marconi VC, Grossberg R, Hozayen S, Burgess TH, Atmar RL, Ganesan A, Gomez CA, Benson CA, Lopez de Castilla D, Ahuja N, George SL, Nayak SU, Cohen SH, Lalani T, Short WR, Erdmann N, Tomashek KM, Tebas P. Temporal Improvements in COVID-19 Outcomes for Hospitalized Adults: A Post Hoc Observational Study of Remdesivir Group Participants in the Adaptive COVID-19 Treatment Trial. Ann Intern Med. 2022 Dec;175(12):1716-1727. doi: 10.7326/M22-2116. Epub 2022 Nov 29. PMID: 36442063; PMCID: PMC9709721.
- Sullivan DR, Iyer AS, Enguidanos S, Cox CE, Farquhar M, Janssen DJA, Lindell KO, Mularski RA, Smallwood N, Turnbull AE, Wilkinson AM, Courtright KR, Maddocks M, McPherson ML, Thornton JD, Campbell ML, Fasolino TK, Fogelman PM, Gershon L, Gershon T, Hartog C, Luther J, Meier DE, Nelson JE, Rabinowitz E, Rushton CH, Sloan DH, Kross EK, Reinke LF. Palliative Care Early in the Care Continuum among Patients with Serious Respiratory Illness: An Official ATS/AAHPM/HPNA/SWHPN Policy Statement. Am J Respir Crit Care Med. 2022 Sep 15;206(6):e44-e69. doi: 10.1164/rccm.202207-1262ST. PMID: 36112774; PMCID: PMC9799127.
- Wolfe CR, Tomashek KM, Patterson TF, Gomez CA, Marconi VC, Jain MK, Yang OO, Paules CI, Palacios GMR, Grossberg R, Harkins MS, Mularski RA, Erdmann N, Sandkovsky U, Almasri E, Pineda JR, Dretler AW, de Castilla DL, Branche AR, Park PK, Mehta AK, Short WR, McLellan SLF, Kline S, Iovine NM, El Sahly HM, Doernberg SB, Oh MD, Huprikar N, Hohmann E, Kelley CF, Holodniy M, Kim ES, Sweeney DA, Finberg RW, Grimes KA, Maves RC, Ko ER, Engemann JJ, Taylor BS, Ponce PO, Larson L, Melendez DP, Seibert AM, Rouphael NG, Strebe J, Clark JL, Julian KG, de Leon AP, Cardoso A, de Bono S, Atmar RL, Ganesan A, Ferreira JL, Green M, Makowski M, Bonnett T, Beresnev T, Ghazaryan V, Dempsey W, Nayak SU, Dodd LE, Beigel JH, Kalil AC, ACTT-4 Study Group. Baricitinib versus dexamethasone for adults hospitalised with COVID-19 (ACTT-4): a randomised, double-blind, double placebo-controlled trial. Lancet Respir Med. 2022 Sep;10(9):888-899. doi: 10.1016/S2213-2600(22)00088-1. Epub 2022 May 23. PMID: 35617986; PMCID: PMC9126560.
- Gruß I, McCreary GM, Ivlev I, Houlihan ME, Yawn BP, Pasquale C, Clark W, Mularski RA. Developing a patient-driven chronic obstructive pulmonary disease (COPD) research agenda in the U.S. J Patient Rep Outcomes. 2021 Dec 4;5(1):126. doi: 10.1186/s41687-021-00399-7. PMID: 34865193; PMCID: PMC8643383.
- Mularski RA, Mittman B, Haupt E, Wang S, Scholle S, McMullen C, Henry M, Shen E, Nguyen HQ, HomePal Research Group. Performance of Patient-Reported Outcome Measures in a Large Pragmatic Trial of Home-Based Palliative Care (HomePal): Methodological and Practical Considerations for Embedded Patient-Centered Design. J Palliat Med. 2022 Apr;25(4):620-627. doi: 10.1089/jpm.2021.0164. Epub 2021 Nov 3. PMID: 34735285.
- Kalil AC, Patterson TF, Mehta AK, Tomashek KM, Wolfe CR, Ghazaryan V, Marconi VC, Ruiz-Palacios GM, Hsieh L, Kline S, Tapson V, Iovine NM, Jain MK, Sweeney DA, El Sahly HM, Branche AR, Regalado Pineda J, Lye DC, Sandkovsky U, Luetkemeyer AF, Cohen SH, Finberg RW, Jackson PEH, Taiwo B, Paules CI, Arguinchona H, Erdmann N, Ahuja N, Frank M, Oh MD, Kim ES, Tan SY, Mularski RA, et. al. for ACTT-2 Study Group Members. Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19. N Engl J Med. 2021 Mar 4;384(9):795-807. doi: 10.1056/NEJMoa2031994. Epub 2020 Dec 11. PMID: 33306283; PMCID: PMC7745180
- Feemster LC, Saft H, Bartlett SJ, Parthasarathy S, Barnes T, Calverley P, Curtis JR, Hickam D, Mularski RA, Au DH, Chlan LL, Reinke LF, Cooke CR, Cox CE, Krishnan JA, Rubin E, Shah S, Sullivan DR, Kross EK on behalf of the Behavioral Sciences and Health Services Research Assembly and Nursing Assembly. Patient-centered outcomes research in pulmonary, critical care and sleep medicine: An official American Thoracic Society workshop report. Ann Am Thorac Soc. 2018 Sep;15(9):1005-1015. doi: 10.1513/AnnalsATS.201806-406WS. PMID: 30168741; PMCID: PMC6850728
- Criner GJ, Delage A, Voelker K, Hogarth DK, Majid A, Zgoda M, Lazarus DR, Casal R, Benzaquen SB, Holladay RC, Wellikoff A, Calero K, Rumbak MJ, Branca PR, Abu-Hijleh M, Maella JM, Kalhan R, Sachdeva A, Kinsey CW, Lamb CR, Reed MF, Abouzgheib WB, Kaplan PV, Marrujo GX, Johnstone DW, Gaspari MG, Meade AA, Hergott CA, Reddy C, Mularski RA, Case AH, Makani SS, Shepherd RW, Chen B, Holt GE, Martel S, for the EMPROVE Study Group. Improving lung function in severe heterogenous emphysema with the Spiration Valve System (EMPROVE). A multicenter, open-label randomized controlled clinical trial. Am J Respir Crit Care Med. 2019 Dec 1;200(11):1354-1362. doi: 10.1164/rccm.201902-0383OC. PMID: 31365298; PMCID: PMC6884033
- Guirguis-Blake JM, Senger CA, Webber EM, Mularski RA, Whitlock EP. Screening for chronic obstructive pulmonary disease: Evidence report and systematic review for the US Preventative Services Task Force. JAMA. 2016 Apr 5;315(13):1378-93. doi: 10.1001/jama.2016.2654. PMID: 27046366
- Press VG, Au DH, Bourbeau J, Dransfield MT, Gershon AS, Krishnan JA, Mularski RA, Sciurba FC, Sullivan J, Feemster LC on behalf of the American Thoracic Society Behavioral Science and Health Services Research, Clinical Problems, and Nursing Assemblies. Reducing Chronic Obstructive Pulmonary Disease hospital readmissions: An official American Thoracic Society Workshop Report. Am J Respir Crit Care Med. 2019 Dec 1;200(11):1354-1362. doi: 10.1164/rccm.201902-0383OC. PMID: 31365298; PMCID: PMC6812156
- Mularski RA, Reinke LF, Carrieri-Kohlman V, Fischer MD, Campbell ML, Rocker G, Schneidman A, Jacobs SS, Arnold R, Benditt JO, Booth S, Byock I, Chan GK, Curtis JR, Donesky D, Hansen-Flaschen J, Heffner J, Klein R, Limberg TM, Manning HL, Morrison RS, Ries AL, Schmidt GA, Selecky PA, Truog RD, Wang ACC, White DB for the ATS Crisis Dyspnea Ad Hoc Committee. An Official American Thoracic Society Workshop Report: Assessment and Palliative Management of Dyspnea Crisis. Ann Am Thorac Soc. 2013 Oct;10(5):S98-106. doi: 10.1513/AnnalsATS.201306-169ST. PMID: 24161068
- Criner GJ, Bourbeau J, Diekemper RL, Ouellette DR, Goodridge D, Hernandez P, Curren K, Balter MS, Bhutani M, Camp PG, Celli BR, Dechman G, Dransfield MT, Fiel SB, Foreman MG, Hanania NA, Ireland BK, Marchetti N, Marciniuk DD, Mularski RA, Ornelas J, Road JD, Stickland MK. Prevention of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: American College of Chest Physicians and Canadian Thoracic Society Guideline. Chest. 2015 Apr;147(4):894-942. doi: 10.1378/chest.14-1676. PMID: 25321320; PMCID: PMC4388124