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Dr. Boss leads federally funded research studying how patients, families, and clinicians communicate during medical decisions, and how those interactions influence trust, treatment decisions, variation in care, and healthcare delivery. Her work combines real clinical encounters, patient and clinician interviews, and health systems research to better understand how healthcare is experienced in practice.

The Boss Lab

The Boss Lab studies communication and decision-making during pediatric surgical care using dialogue from clinical visits, interviews, and mixed-methods research. The lab has recorded and analyzed more than 500 pediatric surgery consultations, uniquely allowing a portrayal of real-time care impacting patient outcomes and resource use.

Project CONNECTS: Communication and Outcomes that eNhaNce Engagement in Childhood Tonsillectomy and Sleep is a multi-institution study examining how surgeons and families communicate and make decisions about tonsillectomy for care of obstructive sleep-disordered breathing (snoring or sleep apnea) in children. The project examines how communication, parent engagement, clinician attitudes, and family factors influence decision-making and child health outcomes.

Lab Highlights

Recent milestones from the Johns Hopkins Boss Lab highlight national visibility, academic recognition, and mentorship in action.

Selected peer-reviewed work

100+ peer-reviewed publications addressing resource utilization, communication, equity, and outcomes in pediatric surgery.

Acad Pediatr 2026

Combined Effects of Race and Ethnicity With Rurality on Tonsillectomy Rates Among Children Enrolled in Medicaid

McLaughlin CC, Hawke JL, Boss EF, Brock GM, Lind MM, Padamsee TJ, Pattisapu P, Chisolm DJ, Chavez LJ.

Qual Manag Health Care 2025

Improving Care Quality Through Documented Shared Decisions

Thompson EC, Boss EF

JAMA Network Open 2025

Parent Race and Communication During Elective Pediatric Surgery Consultations

Lowe C, Beach MC, Saha S, Links AR, Boss EF

JAMA Otolaryngology-Head and Neck Surgery 2025

Communication With Families of Children With Overweight Status or Obesity During Consultation for Tonsillectomy

Reddy AR, Baek S, Links AR, Rodriguez L, Beach MC, Boss EF, Lowe C

JAMA Otolaryngology-Head and Neck Surgery 2023

The Unrealized Potential of the Reg-ent ENT Clinical Data Registry

Saraswathula A, Roy S, Blythe WR, Gourin CG, Boss EF

Otolaryngology-Head and Neck Surgery 2021

Understanding Bias in Surgery: Perceived Cultural Similarity Between Surgeons and Patient Families

Leu GR, Links AR, Tunkel DE, Walsh JM, Ryan MA, DiCarlo H, Jelin EB, Beach MC, Boss EF

Patient Education and Counseling 2021

Treatment recommendations to parents during pediatric tonsillectomy consultations: A mixed methods analysis of surgeon language

Links AR, Callon W, Wasserman C, Beach MC, Ryan MA, Leu GR, Tunkel D, Boss EF

Pediatric Quality and Safety 2021

Parent Experience of Communication about Children's Surgery: A Qualitative Analysis

Claus LE, Links AR, Amos J, DiCarlo H, Jelin E, Koka R, Beach MC, Boss EF

Patient Education and Counseling 2019

Surgeon use of medical jargon with parents in the outpatient setting

Links AR, Callon W, Wasserman C, Walsh J, Beach MC, Boss EF

JAMA Otolaryngology-Head and Neck Surgery 2019

Evaluation of Parental Perspectives and Concerns About Pediatric Tonsillectomy in Social Media

Hairston TK, Links AR, Harris V, Tunkel DE, Walsh J, Beach MC, Boss EF

Patient Education and Counseling 2018

An expanded framework to define and measure shared decision-making in dialogue: A 'top-down' and 'bottom-up' approach

Callon W, Beach MC, Links AR, Wasserman C, Boss EF

Clinical Pediatrics 2017

Physician Perspectives on Decision Making for Treatment of Pediatric Sleep-Disordered Breathing

Boss EF, Links AR, Saxton R, Cheng TL, Beach MC