Mary Jo Pugh, PhD, RN

Research Interests

  • Epidemiology of Trauma
  • Phenotypes of Multimorbidity
  • Epidemiology Using Multimodal Biomarkers
  • Chronic Effects of Traumatic Brain Injury
  • Neuroepidemiology
  • Epilepsy Outcomes Research
  • Quality Measure Development
  • Quality of Epilepsy Care
  • Quality of Care for Traumatic Brain Injury
  • Health Services Research
  • Health-related Instrument and Survey Development
  • Experimental Design, Outcomes Research


Lab Website


  • English

Academic Information

  • Departments: Internal Medicine - Professor, Population Health Sciences - Adjunct Professor
  • Divisions: Epidemiology

Academic Bio

Mary Jo Pugh Ph.D., R.N., is a retired Air Force nurse and Professor, Department of Medicine, Division of Epidemiology at the University of Utah School of Medicine. She is an investigator at the Informatics, Decision-Enhancement and Analytic Sciences Center of Innovation (IDEAS COIN) and the VA Salt Lake City where she leads the COIN focus area that aims to identify and mitigate health risks in Veterans across periods of vulnerability.

Integrating her training as a Veteran, a nurse and a developmental psychologist, she has developed an epidemiological research program to examine the long-term sequelae and outcomes of military exposures. Early in her career she focused on outcomes associated with suboptimal quality of care in older Veterans. Over the past decade she has targeted her work using VA data to identify phenotypes in populations with complex comorbidity such as those with traumatic brain injury (TBI) and complex multi-symptom illness in Gulf War era Veterans. Dr. Pugh’s current work related to TBI includes longitudinal observational and prospective studies to identify the emergence of distinct neurodegenerative conditions such as cognitive impairment and epilepsy, and clusters of multimorbidity that may have similar or networked biological underpinnings. Her longitudinal observational studies of approximately 1.8 million Veterans currently link Department of Defense (DoD) combat theatre and health system data with VA health system data, and will further link with DoD serum repository data. These studies aim to understand which individuals are at highest risk of neurodegeneration, mental health conditions, and deficits in functional outcomes after mild TBI. They also investigate the possibility of using personalized medicine to address treatment choices. The next steps of this line of inquiry will use deep learning models to identify optimal treatment pathways for specific phenotypes to inform treatment guidelines for mild TBI in the context of multimorbidity.

Dr. Pugh is the author or co-author of over one hundred and eighty peer reviewed publications and book chapters, and numerous presentations at national and international scientific meetings. Her work is funded by VA Health Services Research and Development in addition to VA Rehabilitation Research and Development, the Department of Defense, and the National Institutes of Health. She regularly serves as a reviewer for national funding agencies including the National Institutes of Health, Department of Defense and VA, where she serves as chair for the HSR&D career development award panel. She also serves as a peer reviewer for scientific publications submitted to prominent scientific journals, including the Journal of the American Medical Association, Neurology, Medical Care, Journal of Head Trauma Rehabilitation, Brain Injury, Epilepsia, Epilepsy and Behavior and many others.

Dr. Pugh received a Bachelor of Arts degree in Nursing from the College of Saint Scholastica after which she entered the Air Force. Upon her medical retirement she earned a masters degree in Education from Boston University and masters and doctoral degrees in Psychology at the Catholic University of America.

Research Statement

Over the course of the past 20 years, I have integrated my training as an Air Force nurse, developmental psychologist, and health services research to develop a research program examining the long-term sequelae and outcomes of military exposures. My early research focused on outcomes associated with suboptimal prescribing in older Veterans. Over the past 15 years I re-focused my work to use national VA data to identify phenotypes in populations with complex comorbidity such as those with traumatic brain injury (TBI) and complex multi-symptom illness. My current work includes longitudinal observational and prospective studies to identify the emergence of distinct neurodegenerative conditions such as cognitive impairment and epilepsy, and clusters of multimorbidity that may have similar or networked biological underpinnings. The longitudinal observational studies of approximately one million veterans currently link DoD combat theatre and health system data with VA health system data. These studies seek to identify individuals at highest risk of neurodegeneration, mental health conditions, and deficits in functional outcomes after mild TBI. Next steps of this line of inquiry will use deep learning models to identify optimal treatment pathways for specific phenotypes which seek to inform treatment guidelines for mild TBI in the context of multimorbidity.

Education History

Type School Degree
Certification University of Utah
Leading with Diversity, Equity and Inclusion
Certification University of Utah
Women in Leadership
Postdoctoral Fellowship Center for Health Quality, Outcomes & Economic Research/Boston University School of Public Health
Health Services Research
Postdoctoral Fellow
Doctoral Training The Catholic University of America
Graduate Training The Catholic University of America
Graduate Training Boston University
Counseling Psychology
Undergraduate University of Central Florida
Undergraduate The College of St. Scholastica

Global Impact


Date Role Description Country
09/30/2018 Guest Lecturer Presented lecture on post-traumatic epilepsy via webinar to US and international Military and Veteran caregivers. Caregivers reported significantly increased knowledge in understanding of post-traumatic epilepsy, treatment for post-traumatic epilepsy, and quality of care for epilepsy. Europe

Selected Publications

Journal Article

  1. Bouldin ED, Delgado R, Peacock K, Hale W, Roghani A, Trevino AY, Viny M, Wetter DW, Pugh MJ (2022). Military Injuries-Understanding Posttraumatic Epilepsy, Health, and Quality-of-Life Effects of Caregiving: Protocol for a Longitudinal Mixed Methods Observational Study. JMIR Res Protoc, 11(1), e30975.
  2. Pugh MJ, Kennedy E, Prager EM, Humpherys J, Dams-OConnor K, Hack D, McCafferty MK, Wolfe J, Yaffe K, McCrea M, Ferguson AR, Lancashire L, Ghajar J, Lumba-Brown A (2021). Phenotyping the Spectrum of Traumatic Brain Injury: A Review and Pathway to Standardization. J Neurotrauma, 38(23), 3222-3234.
  3. Haarbauer-Krupa J, Pugh MJ, Prager EM, Harmon N, Wolfe J, Yaffe K (2021). Epidemiology of Chronic Effects of Traumatic Brain Injury. J Neurotrauma, 38(23), 3235-3247.
  4. Dams-OConnor K, Bellgowan PSF, Corriveau R, Pugh MJ, Smith DH, Schneider JA, Whitaker K, Zetterberg H (2021). Alzheimer's Disease-Related Dementias Summit 2019: National Research Priorities for the Investigation of Traumatic Brain Injury as a Risk Factor for Alzheimer's Disease and Related Dementias. J Neurotrauma, 38(23), 3186-3194.
  5. Lehinger E, Reed DE, Nabity P, Brackins N, Villarreal R, McGeary C, Blount T, Cobos B, Jaramillo C, Eapen BC, Pugh MJ, Potter J, Peterson A, Young-McCaughan S, Houle T, McGeary DD (2020). An Examination of Chronic Pain Indices and the Updated Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental-Disorders-Fifth Edition. Mil Med, 186(11-12), e1199-e1206.
  6. Pugh MJ, Kennedy E, Gugger JJ, Mayo J, Tate D, Swan A, Kean J, Altalib H, Gowda S, Towne A, Hinds S, Van Cott A, Lopez MR, Jaramillo CA, Eapen BC, McCafferty RR, Salinsky M, Cramer J, McMillan KK, Kalvesmaki A, Diaz-Arrastia R, MINUTE Study Group (2021). The Military Injuries: Understanding Post-Traumatic Epilepsy Study: Understanding Relationships among Lifetime Traumatic Brain Injury History, Epilepsy, and Quality of Life. J Neurotrauma, 38(20), 2841-2850.
  7. Frech TM, Murtaugh MA, Amuan M, Pugh MJ (2021). The frequency of Raynaud's phenomenon, very early diagnosis of systemic sclerosis, and systemic sclerosis in a large Veteran Health Administration database. BMC Rheumatol, 5(1), 42.
  8. Brown-Taylor L, Jaramillo C, Eapen BC, Kretzmer T, Gavin LP, Cooper T, Pugh MJ (2021). Accumulation of Good Intentions: How Individual Practice Guidelines Lead to Polypharmacy in the Treatment of Patients with Polytrauma. PM R, 13(10), 1169-1175.
  9. Blakey SM, Halverson TF, Evans MK, Patel TA, Hair LP, Meyer EC, DeBeer BB, Beckham JC, Pugh MJ, Calhoun PS, Kimbrel NA (2021). Experiential avoidance is associated with medical and mental health diagnoses in a national sample of deployed Gulf War veterans. J Psychiatr Res, 142, 17-24.
  10. Altalib H, McMillan KK, Padilla S, Pugh MJ (2021). Epilepsy quality performance in a national sample of neurologists and primary care providers: Characterizing trends in acute and chronic care management. Epilepsy Behav, 123, 108218.
  11. Bornovski Y, Jackson-Shaheed E, Argraves S, Hitchins A, Tolchin B, Galluzzo D, Cheung KH, Goulet J, Skanderson M, Brandt CA, Pugh MJ, Altalib H (2020). Suicide and Seizures: A National Cohort Study in Veterans. Neurol Clin Pract, 11(5), 372-376.
  12. Villareal H, Al-Bayati S, Wang CP, Pugh MJ, Liss MA (2020). Transitional Care of Service Members With Genitourinary Injury. Mil Med, 186(9-10), 969-974.
  13. Swan AA, Akin FW, Amuan ME, Riska KM, Hall CD, Kalvesmaki A, Padilla S, Crowsey E, Pugh MJ (2021). Disruptive Dizziness Among Post-9/11 Veterans With Deployment-Related Traumatic Brain Injury. J Head Trauma Rehabil.
  14. Delgado RE, Peacock K, Wang CP, Pugh MJ (2021). Phenotypes of caregiver distress in military and veteran caregivers: Suicidal ideation associations. PLoS One, 16(6), e0253207.
  15. Tate DF, Dennis EL, Adams JT, Adamson MM, Belanger HG, Bigler ED, Bouchard HC, Clark AL, Delano-Wood LM, Disner SG, Eapen BC, Franz CE, Geuze E, Goodrich-Hunsaker NJ, Han K, Hayes JP, Hinds SR 2nd, Hodges CB, Hovenden ES, Irimia A, Kenney K, Koerte IK, Kremen WS, Levin HS, Lindsey HM, Morey RA, Newsome MR, Ollinger J, Pugh MJ, Scheibel RS, Shenton ME, Sullivan DR, Taylor BA, Troyanskaya M, Velez C, Wade BS, Wang X, Ware AL, Zafonte R, Thompson PM, Wilde EA (2021). Coordinating Global Multi-Site Studies of Military-Relevant Traumatic Brain Injury: Opportunities, Challenges, and Harmonization Guidelines. Brain Imaging Behav, 15(2), 585-613.
  16. Haney LJ, Pugh MJV, Copeland LA, Wang CP, MacCarthy DJ, Amuan ME, Shireman PK (2020). Persistent Pain, Physical Dysfunction, and Decreased Quality of Life After Combat Extremity Vascular Trauma. Ann Vasc Surg, 71, 167-180.
  17. Bouldin ED, Swan AA, Norman RS, Tate DF, Tumminello C, Amuan ME, Eapen BC, Wang CP, Trevino A, Pugh MJ (2020). Health Phenotypes and Neurobehavioral Symptom Severity Among Post-9/11 Veterans With Mild Traumatic Brain Injury: A Chronic Effects of Neurotrauma Consortium Study. J Head Trauma Rehabil, 36(1), 10-19.
  18. Valera EM, Joseph AC, Snedaker K, Breiding MJ, Robertson CL, Colantonio A, Levin H, Pugh MJ, Yurgelun-Todd D, Mannix R, Bazarian JJ, Turtzo LC, Turkstra LS, Begg L, Cummings DM, Bellgowan PSF (2020). Understanding Traumatic Brain Injury in Females: A State-of-the-Art Summary and Future Directions. J Head Trauma Rehabil, 36(1), E1-E17.
  19. Haney LJ, Bae E, Pugh MJV, Copeland LA, Wang CP, MacCarthy DJ, Amuan ME, Shireman PK (2020). Patency of arterial repairs from wartime extremity vascular injuries. Trauma Surg Acute Care Open, 5(1), e000616.
  20. Weiner DK, Holloway K, Levin E, Keyserling H, Epstein F, Monaco E, Sembrano J, Brega K, Nortman S, Krein SL, Gentili A, Katz JN, Morrow LA, Muluk V, Pugh MJ, Perera S (2020). Identifying biopsychosocial factors that impact decompressive laminectomy outcomes in veterans with lumbar spinal stenosis: a prospective cohort study. Pain.
  21. Mansi IA, English JL, Alvarez CA, Mortensen EM, Pugh MJ (2020). Statins in survivors of traumatic brain injury: a propensity score-matched analysis. Brain Inj, 34(10), 1367-1374.
  22. Marceaux JC, Soble JR, ORourke JJF, Swan AA, Wells M, Amuan M, Sagiraju HKR, Eapen BC, Pugh MJ (2019). Validity of early-onset dementia diagnoses in VA electronic medical record administrative data. Clin Neuropsychol, 34(6), 1175-1189.
  23. Alvarez CA, Halm EA, Pugh MJV, McGuire DK, Hennessy S, Miller RT, Lingvay I, Vouri SM, Zullo AR, Yang H, Chansard M, Mortensen EM (2020). Lactic acidosis incidence with metformin in patients with type 2 diabetes and chronic kidney disease: A retrospective nested case-control study. Endocrinol Diabetes Metab, 4(1), e00170.
  24. Faruqui SHA, Alaeddini A, Chang MC, Shirinkam S, Jaramillo C, NajafiRad P, Wang J, Pugh MJ (2020). Summarizing Complex Graphical Models of Multiple Chronic Conditions Using the Second Eigenvalue of Graph Laplacian: Algorithm Development and Validation. JMIR Med Inform, 8(6), e16372.
  25. Swan AA, Nelson JT, Pogoda TK, Akin FW, Riska KM, Hall CD, Amuan ME, Yaffe K, Pugh MJ, Chronic Effects of Neurotrauma Consortium (2019). Association of Traumatic Brain Injury With Vestibular Dysfunction and Dizziness in Post-9/11 Veterans. J Head Trauma Rehabil, 35(3), E253-E265.
  26. Reyes-Miranda A, Chan S, Gowda S, Kean J, Cramer JA, Pugh MJ (2020). Assessing the personal impact of epilepsy in a population-based cohort of Veterans. Epilepsy Behav, 106, 107047.
  27. Kumar RG, Kesinger MR, Juengst SB, Brooks MM, Fabio A, Dams-OConnor K, Pugh MJ, Sperry JL, Wagner AK (2019). Effects of hospital-acquired pneumonia on long-term recovery and hospital resource utilization following moderate to severe traumatic brain injury. J Trauma Acute Care Surg, 88(4), 491-500.
  28. Sagiraju HKR, ivkovi S, VanCott AC, Patwa H, Gimeno Ruiz de Porras D, Amuan ME, Pugh MJV (2019). Amyotrophic Lateral Sclerosis Among Veterans Deployed in Support of Post-9/11 U.S. Conflicts. Mil Med, 185(3-4), e501-e509.
  29. Correa DJ, Milano L, Kwon CS, Jett N, Dlugos D, Harte-Hargrove L, Pugh MJ, Smith JK, Mosh SL (2020). Quantitative readability analysis of websites providing information on traumatic brain injury and epilepsy: A need for clear communication. Epilepsia, 61(3), 528-538.
  30. Song K, Wang CP, McGeary DD, Jaramillo CA, Eapen BC, Amuan M, McGeary CA, Potter JS, Pugh MJ (2020). Five-year Pain Intensity and Treatment Trajectories of Post-9/11 Veterans With Mild Traumatic Brain Injury. J Pain, 21(9-10), 1005-1017.
  31. McGeary C, Nabity P, Reed D, Cobos B, Eapen B, Pugh MJ, Jaramillo C, Potter J, Houle T, Young-McCaughan S, Peterson A, McGeary D (2020). A test of the fear avoidance model to predict chronic pain outcomes in a polytrauma sample. NeuroRehabilitation, 47(1), 35-43.
  32. Altalib HH, Galluzzo D, Argraves S, Goulet J, Bornovski Y, Cheung KH, Jackson-Shaheed E, Tolchin B, Fenton BT, Pugh MJ (2019). Managing Functional Neurological Disorders: Protocol of a Cohort Study on Psychogenic Non-Epileptic Seizures Study. Neuropsychiatr Dis Treat, 15, 3557-3568.
  33. Pugh MJ, Swan AA, Amuan ME, Eapen BC, Jaramillo CA, Delgado R, Tate DF, Yaffe K, Wang CP (2019). Deployment, suicide, and overdose among comorbidity phenotypes following mild traumatic brain injury: A retrospective cohort study from the Chronic Effects of Neurotrauma Consortium. PLoS One, 14(9), e0222674.
  34. Altalib HH, Lanham HJ, McMillan KK, Habeeb M, Fenton B, Cheung KH, Pugh MJ (2019). Measuring coordination of epilepsy care: A mixed methods evaluation of social network analysis versus relational coordination. Epilepsy Behav, 97, 197-205.
  35. Delgado RE, Peacock K, Elizondo B, Wells M, Grafman JH, Pugh MJ (2018). A Family's Affair: Caring for Veterans with Penetrating Traumatic Brain Injury. Mil Med, 183(suppl_1), 379-385.
  36. Kazanis W, Pugh MJ, Tami C, Maddry JK, Bebarta VS, Finley EP, McGeary DD, Carnahan DH, Potter JS (2018). Opioid Use Patterns Among Active Duty Service Members and Civilians: 2006-2014. Mil Med, 183(3-4), e157-e164.
  37. Alaeddini A, Jaramillo CA, Faruqui SHA, Pugh MJ (2018). Mining Major Transitions of Chronic Conditions in Patients with Multiple Chronic Conditions. Methods Inf Med, 56(5), 391-400.
  38. Jaramillo CA, Cooper DB, Wang CP, Tate DF, Eapen BC, York GE, Pugh MJ (2015). Subgroups of US IRAQ and Afghanistan veterans: associations with traumatic brain injury and mental health conditions. Brain Imaging Behav, 9(3), 445-55.
  39. Pugh MJ, Marcum ZA, Copeland LA, Mortensen EM, Zeber JE, Nol PH, Berlowitz DR, Downs JR, Good CB, Alvarez C, Amuan ME, Hanlon JT (2013). The quality of quality measures: HEDIS® quality measures for medication management in the elderly and outcomes associated with new exposure. Drugs Aging, 30(8), 645-54.
  40. Shafer PO, Buelow J, Ficker DM, Pugh MJ, Kanner AM, Dean P, Levisohn P (2011). Risk of adverse events on epilepsy monitoring units: a survey of epilepsy professionals. Epilepsy Behav, 20(3), 502-5.
  41. Pugh MJ, Berlowitz DR, Rao JK, Shapiro G, Avetisyan R, Hanchate A, Jarrett K, Tabares J, Kazis LE (2011). The quality of care for adults with epilepsy: an initial glimpse using the QUIET measure. BMC Health Serv Res, 11, 1.
  42. Zeber JE, Noel PH, Pugh MJ, Copeland LA, Parchman ML (2012). Family perceptions of post-deployment healthcare needs of Iraq/Afghanistan military personnel. Ment Health Fam Med, 7(3), 135-43.


  1. Leykum LK, Penney LS, Dang S, Trivedi RB, Nol PH, Pugh JA, Shepherd-Banigan ME, Pugh MJ, Rupper R, Finley E, Parish-Johnson J, Delgado R, Peacock K, Kalvesmaki A, Van Houtven CH (2022). Recommendations to Improve Health Outcomes Through Recognizing and Supporting Caregivers. J Gen Intern Med.


  1. Dang S, Penney LS, Trivedi R, Noel PH, Pugh MJ, Finley E, Pugh JA, Van Houtven CH, Leykum L (2020). Caring for Caregivers During COVID-19. [Letter to the editor]. J Am Geriatr Soc, 68(10), 2197-2201.