SUMMARY Approximately 25% of diabetic patients experience diabetic foot ulcers (DFUs). This is a significant clinical problem since there are no effective biomarkers for predicting outcomes, no drug candidates that have recently been FDA-approved and no therapies that are widely effective in treatment. The Stanford Advanced Wound Care Center (AWCC) was opened in 2014 with the sole purpose of facilitating clinical trials, conducting translational research and providing care for patients with chronic wounds. Stanford AWCC receives patients from the University Healthcare Alliance, which spans 60 clinics and 2.5 million people in the San Francisco Bay Area. Despite being in a relatively prosperous area, Stanford AWCC treats patients from diverse socio- demographics. In the past two years, Stanford has treated 6000 patients with wounds, of whom 705 had DFUs. 50% of the patients enroll in clinical trials and there is a very low dropout rate (less than 5%). Under Dr. Geoffrey Gurtner’s leadership, the Stanford AWCC has conducted over 25 clinical trials, where we have measured biomarkers and tested novel therapeutic interventions (Aim 1). It is known that wound healing trials experience a significantly higher failure rate in Phase III studies compared to any other drug trial. This is primarily due to the poorly controlled procedural component of wound care. At Stanford, we address these issues by (i) practicing a multi-disciplinary approach overseen by physicians, (ii) standardizing the measuring and reporting of healing outcomes, (iii) emphasizing rigorous and efficient operational processes during clinical trial conduct and (iv) collaborating with other major academic centers (Aim 2). Looking forward, it is critical to optimize patient engagement during their treatment regimens and inculcate a shared decision-making process. Clinical studies in medical fields such as cancer have indicated that such patient-centered approaches lead to the adherence of treatment regimens and clinical trials. This is currently lacking in with patients with DFUs. With Dr. Arden Morris’s expertise, the Stanford AWCC practices new approaches that centers around the patient, with a focus on improvement in their quality of life (Aim 3). Dr. Nigam Shah, the Director of Bioinformatics at Spectrum, Stanford’s Clinical and Translational Sciences Award has worked with the Stanford AWCC and developed computational tools that predict wound healing outcomes. These models have been developed using data from the Healogics database, the country’s largest network of wound care clinics and a Stanford AWCC operational partner. Dr. Shah also has expertise in analyzing electronic health records of ...