July 17, 2018: New Podcast: Clinical Trial Participants’ Views of the Risks and Benefits of Data Sharing

Listen to the episode here:

At least once a month, we will release interviews with Grand Rounds speakers that delve into their topic of interest and give listeners bonus time with these featured experts.

Please let us know what you think by providing your feedback through the podcast page. We also encourage you to listen and share the recordings with your colleagues!

July 16, 2018: JAMA Editorial Highlights mSToPS Trial, Discusses Strengths and Challenges of Pragmatic Clinical Trials

An recent editorial in JAMA highlights the mHealth Screening to Prevent Strokes (mSToPS) randomized clinical trial in a discussion of the strengths and challenges of pragmatic clinical trials. The mSToPS trial, which studied patients at increased risk of atrial fibrillation who used a self-applied electrocardiogram sensor patch, found that immediate monitoring, compared with delayed monitoring, led to a higher rate of diagnosis after 4 months.

The editorial’s authors, Dr. Eric Peterson of Duke University and Dr. Robert Harrington of Stanford University, describe the mSToPS trial as an “innovative example of the potential (and challenges) inherent in a pragmatic IT trial.” The trial “scores quite high for its pragmatic approach” while offering lessons in the trade-offs that such an approach often requires.

The editorial notes that efforts like the NIH Collaboratory are bringing about innovations in health systems collaborations and clinical data platforms that “could provide the ideal setting to conduct highly pragmatic and efficient [randomized clinical trials] of the benefits, risks, and costs associated with novel health IT solutions.”

July 3, 2018: New Podcast: Rethinking University Research with State Data

In a new episode of the NIH Collaboratory Grand Rounds podcast, Dr. Aaron McKethan discusses the idea of rethinking research with state-level data. Dr. McKethan serves as a faculty member in the Department of Population Health Sciences at Duke University and is the Chief Data and Analytics Officer for the NC Department of Health and Human Services. With his unique perspective, Dr. McKethan provides insight into how universities and local governments can best work together to improve data quality, reduce inefficiencies, and improve collaborations.

Listen to the episode here:

At least once a month, we will release interviews with Grand Rounds speakers that delve into their topic of interest and give listeners bonus time with these featured experts.

Please let us know what you think by providing your feedback through the podcast page. We also encourage you to listen and share the recordings with your colleagues!

June 28, 2018: RFA for a New HCS Research Collaboratory

NIA recently released an RFA for a new HCS Research Collaboratory focused on AD/ADRD, RFA-AG-19-009.

“The purpose of this FOA is to solicit applications for the AD/ADRD Health Care Systems Research Collaboratory (“Collaboratory,” henceforth) to improve care for persons with dementia (PWD) and their caregivers through health systems. Health and long-term systems for this FOA are defined broadly and include organizations providing care across settings to include primary and specialty outpatient care, acute inpatient care, skilled nursing and other rehabilitation facilities, residential long-term care, and home and community-based services. Organizations may be traditional health care systems (e.g., health maintenance organizations, or HMOs), health insurance companies, managed care plans, home health care providers, memory clinics, nursing homes, assisted living facilities, outpatient clinics, federally-designated health centers, hospitals, and other providers of acute and long-term care. The Collaboratory will: 1) serve as a national resource to promote development of pragmatic trials and demonstration projects to improve care and health outcomes for PWD and their caregivers; 2) support pilot pragmatic trials within the Collaboratory; 3) develop and disseminate technical and policy guidelines and best practices for effectively conducting AD/ADRD research studies in partnership with health care systems; 4) work collaboratively with researchers to provide technical support for scaling up pilot studies; and 5) disseminate best practices for engaging stakeholders, conducting ethical research in the special circumstances of dementia care, and involving long-term and acute-care providers.”

All applications are due September 6, 2018, by 5:00 PM local time of applicant organization. All types of non-AIDS applications allowed for this funding opportunity announcement are due on this date.

No late applications will be accepted for this Funding Opportunity Announcement.

Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.

To learn more, visit the NIH grants posting.

June 22, 2018: New Podcast: Research at Scale – Exploring What is Possible with High-Quality Real-World Data. Examples from Flatiron Health.

In a new episode of the NIH Collaboratory Grand Rounds podcast, Dr. Amy Abernethy discusses research at scale, with examples from Flatiron Health. In her discussion with moderator Adrian Hernandez, Dr. Abernethy focuses on the goals of Flatiron Health, approaches for building data-sets and underlying infrastructure, what’s next on the horizon for Flatiron Health, and more.

Listen to the episode here:

At least once a month, we will release interviews with Grand Rounds speakers that delve into their topic of interest and give listeners bonus time with these featured experts.

Please let us know what you think by providing your feedback through the podcast page. We also encourage you to listen and share the recordings with your colleagues!

June 14, 2018: NIH Collaboratory Members to Host Session on Embedded PCTs at AcademyHealth Annual Research Meeting

The upcoming AcademyHealth Annual Research Meeting, June 24-26, 2018, will feature a special session on Embedding Pragmatic Clinical Trials in Health Care Systems: Trials and Tribulations, Monday, June 25, at 5:15 pm, hosted by members of the Health Care Systems Interactions Core Working Group:

Chair: Cathy Meyers, MD, NIH/NICCH

Discussant: Eric B. Larson, MD, MPH, Kaiser Permanente Washington Health Research Institute

Speakers: Vince Mor, PhD, Brown University School of Public Health; Greg Simon, MD, MPH, Kaiser Permanente Washington Health Research Institute; and Lynn DeBar, PhD, MPH, Kaiser Permanente Washington Health Research Institute

Held at the Washington State Convention Center in Seattle, this large gathering of health services researchers and policy analysts will include workshops, poster and podium sessions, emerging issues panels, policy roundtables, and special topic sessions. Other NIH Collaboratory members planning to present at the meeting include Leah Tuzzio, MPH, Jerry Jarvik, MD, MPH, Miguel Vazquez, MD, Kathryn James, MPH, Gloria Coronado, PhD, and Beverly Green, MD, MPH.

 “Attendees will learn about the challenges of pilot testing, studying patient-reported outcomes, using existing data, and the multiple levels of implementation in dynamic systems.” – Leah Tuzzio, Kaiser Permanente Washington Health Research Institute

For details, visit the meeting event site at http://www.academyhealth.org/events/site/2018-annual-research-meeting.

June 7, 2018: NIH Releases First Strategic Plan for Data Science

On June 4, the National Institutes of Health (NIH) released its first Strategic Plan for Data Science. The plan outlines steps the agency will take to modernize research data infrastructure and resources and to maximize the value of data generated by NIH-supported research.

Data science challenges for NIH have evolved and grown rapidly since the launch of the Big Data to Knowledge (BD2K) program in 2014. The most pressing challenges include the growing costs of data management, limited interconnectivity and interoperability among data resources, and a lack of generalizable tools to transform, analyze, and otherwise support the usability of data for researchers, institutions, industry, and the public.

The goals of the NIH Strategic Plan for Data Science are to:

  • support an efficient, effective data infrastructure by optimizing data storage, security, and interoperability;
  • modernize data resources by improving data repositories, supporting storage and sharing of individual data sets, and integrating clinical and observational data;
  • develop and disseminate both generalizable and specialized tools for data management, analytics, and visualization;
  • enhance workforce development for data science by expanding NIH’s internal data science workforce and supporting expansion of the national research workforce, and by engaging a broader community of experts and the general public in developing best practices; and
  • enact policies that promote stewardship and sustainability of data science resources.

As part of the implementation of the strategic plan, the NIH will hire a chief data strategist. For information about the position, see the job announcement.

June 4, 2018: New Article Explores Misleading Use of the Label “Pragmatic” for Some Randomized Clinical Trials

A recent study published in BMC Medicine found that many randomized controlled trials (RCTs) self-labeled as “pragmatic” were actually explanatory in nature, in that they assessed investigational medicines compared with placebo to test efficacy before licensing. Of the RCTs studied, one-third were pre-licensing, single-center, or placebo-controlled trials and thus not appropriately described as pragmatic.

Appropriately describing the design and characteristics of a pragmatic trial helps readers understand the trial’s relevance for real-world practice. The authors explain that RCTs suitably termed pragmatic compare the effectiveness of 2 available medicines or interventions prescribed in routine clinical care. The purpose of such pragmatic RCTs is to provide real-world evidence for which interventions should be recommended or prioritized.

The authors recommend that investigators use a standard tool, such as the CONSORT Pragmatic Trials extension or the PRECIS-2 tool, to prospectively evaluate the pragmatic characteristics of their RCTs. Use of these tools can also assist funders, ethics committees, and journal editors in determining whether an RCT has been accurately labeled as pragmatic.

The BMC Medicine article cites NIH Collaboratory publications by Ali et al. and Johnson et al., as well as the Living Textbook, in its discussion of pragmatic RCTs and the tools available to assess their relevance for real-world practice.

“Submissions of RCTs to funders, research ethics committees, and peer-reviewed journals should include a PRECIS-2 tool assessment done by the trial investigators. Clarity and accuracy on the extent to which an RCT is pragmatic will help [to] understand how much it is relevant to real-world practice.” (Dal-Ré et al. 2018)

May 23, 2018: New Podcast: Dr. Rachael Fleurence on Launching the NESTcc Data Network to Improve the Use of Real-World Evidence in the Medical Device Ecosystem

In a new episode of the Grand Rounds podcast which is now available, Dr. Rachael Fleurence, Executive Director of the National Evaluation System for health Technology Coordinating Center (NESTcc) and the Medical Device Innovation Consortium (MDIC), discusses the mission, challenges, and long term goals of NESTcc with moderator Dr. Adrian Hernandez. Dr. Fleurence describes how NESTcc is working to accelerate the development and translation of new and safe health technologies, and explains where she hopes the program will be in the next three years.

Listen to the episode here:

At least once a month, we will release interviews with Grand Rounds speakers that delve into their topic of interest and give listeners bonus time with these featured experts.

Please let us know what you think by providing your feedback through the podcast page. We also encourage you to listen and share the recordings with your colleagues!

May 5, 2018: New Article Explores Opportunities for Funding the Training of Future Health Services Researchers

In a new article, Dr. Vincent Mor, an NIH Collaboratory investigator, and Dr. Paul Wallace describe the history, current status, and opportunities for funding training in health services research (HSR). While the number of organizations seeking to solve problems with health services research has been expanding, direct government support for HSR is declining. The authors project 5 key challenges for the field and its professional development:

  • Formulating and prioritizing research topics
  • Whether to use team- or individual-based approaches
  • How new data sources, analytic methods, and the need for faster results affect supply and demand for HSR
  • Shifts from public to institutional funding and the associated effects on generalizability
  • Balancing proprietary concerns regarding data, predictive models, and study results with the need to improve public health and rapidly disseminate information

According to the authors, sustainable solution will involve active collaboration between those who use HSR as a part of decision-making (and will likely pay for it) and those who produce it.

“We believe that the key change needed to productively address the above challenges will be a closer collaboration between HSR users, especially health systems, and academic HSR training programs to work towards producing timely, internally relevant, and externally generalizable knowledge (Mor and Wallace 2018).”

Dr. Mor is a principal investigator for the Pragmatic Trial of Video Education in Nursing Homes (PROVEN) trial, one of the NIH Collaboratory Demonstration Projects.

Mor V, Wallace P. 2018.  Funding the Training of Future Health Services Researchers. Health Services Research. doi:10.1111/1475-6773.12844.