Advances at the Intersection of Digital Health, EHRs, and PCTs: NIH-Hosted Workshop (May-July 2020)

May-July 2020: In 2020, NIH Collaboratory Grand Rounds held a special workshop series to explore challenges and opportunities in using electronic health records (EHRs) in pragmatic clinical trials. The series highlighted advances in digital health, new approaches and evolving standards for EHRs, and implications for researchers conducting pragmatic trials. The Grand Rounds series included moderated panel discussions that focused on the use of digital technologies in pragmatic clinical trials, case examples from the NIH Collaboratory Trials, and recent initiatives from the Office of the National Coordinator for Health Information Technology to reshape standards and drive the evolution of EHRs in healthcare and research. The series culminated with a podcast discussion from a panel of experts.

Agenda and Slides

 

Session 1: May 1, 2020: Keynote: Can the COVID-19 Crisis Lead to Reformation of the Evidence Generation Ecosystem?

Speaker: Robert Califf, MD, MACC

Session 2: May 8, 2020: Real World Evidence: Contemporary Experience and Future Directions

Speakers: Jacqueline Corrigan-Curay, JD, MD; Joshua C. Denny, MD, MS, FACMI
Moderator: Patrick J. Heagerty, PhD

Session 3: May 29, 2020: Experiences From the Collaboratory PCTs

Speakers: Jeffrey [Jerry] G. Jarvik, MD, MPH; Lynn DeBar, PhD; Doug Zatzick, MD; Vince Mor, PhD
Moderator: Wendy Weber, ND, PhD, MPH

Session 4: June 26, 2020: Keys to Success in the Evolving EHRs Environment

Speakers: Teresa Zayas-Cabán, PhD; George [Holt] Oliver, MD, PhD; Christopher A. Longhurst, MD, MS; Rachel Richesson, PhD, MPH
Moderator: Keith Marsolo, PhD

Session 5: July 8, 2020: Podcast: Summary Expert Panel Discussion

Speakers: Patrick J. Heagerty, PhD; Keith Marsolo, PhD; Wendy Weber, ND, PhD, MPH
Moderator: Lesley H. Curtis, PhD

EHR Video Modules

Watch our selection of short educational videos drawn from this 2020 EHR Workshop Grand Rounds Series. The series highlighted advances in digital health, new approaches and evolving standards for electronic health records (EHRs), and implications for researchers conducting pragmatic trials.

ePCT Seminar: American Society of Nephrology (November 2019)

November 8, 2019: This seminar, offered by the NIH Collaboratory in partnership with the American Society of Nephrology, was held in Washington, D.C. during ASN Kidney Week. The seminar sessions provided an introduction to concepts in the design of embedded pragmatic clinical trials (ePCTs), with a focus on interventions that are relevant to the nephrology research community. All presentations are downloadable in PDF format.

Logo for ASN Kidney Week 2019

Agenda and Slides

Embedded Pragmatic Clinical Trials: Accelerating Evidence Generation in Nephrology

Welcome and Introduction

Catherine M. Meyers, MD
Susan R. Mendley, MD

Session 1: Opportunities for Embedded Pragmatic Clinical Trials in Nephrology

Laura Dember, MD

Session 2: Design and Analysis: Strategies for Embedded Pragmatic Clinical Trials

Qilu Yu, PhD

Session 3: Engaging Stakeholders and Aligning with Health System Partners

Miguel Vazquez, MD

Session 4: Designing for Post-Trial Implementation

Wynne Norton, PhD

Essentials of ePCTs Workshop: AcademyHealth (June 2019)

June 1, 2019: The NIH Pragmatic Trials Collaboratory hosted a Pre-Conference Workshop at the AcademyHealth 2019 Annual Conference. This training workshop introduced concepts in the design, analysis, and implementation of embedded pragmatic clinical trials (ePCTs) and provided firsthand ePCT experiences from NIH Pragmatic Trials Collaboratory Trials.

Agenda and Slides

Welcome and Introduction

Catherine Meyers, MD

Session 1: What are Embedded Pragmatic Clinical Trials (ePCTs)?
Catherine Meyers, MD

Session 2: Engaging Stakeholders & Aligning with Health System Partners
Leah Tuzzio, MPH

Session 3: Measuring Outcomes
Emily O'Brien, PhD

Session 4: ePCT Design
David Murray, PhD

Session 5: ePCT Analysis
David Murray, PhD

Session 6: ePCTs in Context: Panel Discussion with NIH Collaboratory Trial PIs

Moderator: Kevin Weinfurt, PhD

Panel:

    • Susan Huang, MD, MPH (ABATE)
    • Vince Mor, PhD (PROVEN)

Session 7: Pilot & Feasibility Testing
Wendy Weber, ND, PhD, MPH

Session 8: Ethical & Regulatory Oversight Considerations
Kevin Weinfurt, PhD; Julie Kaneshiro, MA

Session 9: Dissemination & Implementation
Wynne Norton, PhD

Session 10: ePCTs in Context: Panel Discussion with NIH Collaboratory Trial PIs

Moderator: Kevin Weinfurt, PhD

Panel:

    • Susan Mitchell, MD, MPH (PROVEN)
    • Laura Dember, MD (TiME)

Session 11: Assembling an ePCT Team & Writing a Grant Application
Robin Boineau, MD, MA; Marcel Salive, MD, MPH

Next Steps

Kevin Weinfurt, PhD

 

Design and Analysis of Embedded Pragmatic Clinical Trials: NIH-Hosted Workshop (May 2019)

May 2, 2019: This NIH-hosted workshop included panel discussions on the challenges in the design and analysis of ePCTs.

Agenda and Slides

Welcome and Introduction

Helene Langevin, MD
Richard Hodes, MD
Catherine Meyers, MD
Wendy Weber, ND, PhD, MPH

Keynote: Pragmatic Trials Involving Group Randomization or Delivery of Interventions to Groups: GRTs, IRGTs, and SW-GRTs

David Murray, PhD

Panel 1: Measurement and Data: Outcomes, Exposures, and Subgroups Based on EHR Data

Moderator: Rui Wang, PhD

Panel:

    • Pragmatic Trial of Video Education in Nursing Homes (PROVEN) (Vince Mor, PhD; Roee Gutman, PhD)
    • STrategies to Reduce Injuries and Develop confidence in Elders (STRIDE) (Nancy Latham, PhD, PT; Dave Ganz, MD, MPH; Peter Peduzzi, PhD)
    • Active Bathing to Eliminate (ABATE) Infection (Susan Huang, MD, MPH; Ken Kleinman, ScD)

Panel 2: To Cluster or Not to Cluster?

Moderator: Keith Goldfeld, DrPH

Panel:

    • Improving Chronic Disease Management with Pieces (ICD-Pieces™) (Miguel Vazquez, MD; Chul Ahn, PhD)
    • Collaborative Care for Chronic Pain in Primary Care (PPACT) (Lynn DeBar, PhD, MPH; William Vollmer, PhD)
    • Suicide Prevention Outreach Trial (SPOT) (Greg Simon, MD, MPH; Susan Shortreed, PhD)

Panel 3: Choosing a Parallel Group or Stepped-Wedge Design

Moderator: Fan Li, PhD

Panel:

    • Lumbar Imaging with Reporting of Epidemiology (LIRE) (Jerry Jarvik, MD, MPH; Patrick Heagerty, PhD)
    • Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder (EMBED) (Ted Melnick, MD, MHS; Jim Dziura, MPH, PhD)
    • A Policy-Relevant U.S. Trauma Care System Pragmatic Trial for PTSD and Comorbidity (Trauma Survivors Outcomes and Support [TSOS]) (Doug Zatzick, MD; Patrick Heagerty, PhD)

Panel 4: Unique Complications

Moderator: Andrea Cook, PhD

Panel:

    • Pragmatic Trial of Higher vs. Lower Serum Phosphate Targets in Patients Undergoing Hemodialysis (HiLo) (Myles Wolf, MD; Hrishikesh Chakraborty, DrPH)
    • Strategies and Opportunities to Stop Colorectal Cancer in Priority Populations (STOP CRC) (Bev Green, MD, MPH; William Vollmer, PhD)
    • Time to Reduce Mortality in End-Stage Renal Disease (TiME) (Laura Dember, MD; J. Richard Landis, PhD; Jesse Hsu, PhD)

Summary and Concluding Remarks

ePCTs of Therapeutic A vs. B Interventions: NIH-Hosted Workshop (May 2018)

May 16, 2018: This workshop explored challenges and strategies for planning and implementing ePCTs that compare two or more therapeutic medical regimens.

Agenda and Slides

Welcome and Introduction

David Shurtleff, PhD
Richard Hodes, MD
Catherine Meyers, MD
Wendy Weber, PhD, MPH

 

Panel 1: Partnering With Stakeholders to Conduct Embedded A vs. B Trials: Keys to Success

Moderator: Rich Platt, MD, MSc

Panel:

    • Steve Friedhoff, MD
    • Kenneth Sands, MD, MPH
    • Joseph Chin, MD

Panel 2: Examples in Action: Embedded A vs. B Trials

Moderator: Beverly Green, MD, MPH

Panel:

    • Ryan Ferguson, ScD, MPH
    • Susan Huang, MD, MPH
    • Michael Kappelman, MD, MPH

Panel 3: Maximizing the Pragmatic: Understanding Approaches to Design of Embedded A vs. B Trials

Moderator: Greg Simon, MD, MPH

Panel:

    • Scott Solomon, MD
    • Rachael Fleurence, PhD
    • Kourtney Davis, PhD, MSPH

Panel 4: Regulatory Aspects of Clinical Research and the Regulation of Products for Embedded A vs. B Pragmatic Trials

Moderator: Adrian Hernandez, MD

Panel:

    • Jacqueline Corrigan-Curay, MD, JD
    • Owen Faris, PhD
    • Julie Kaneshiro, MA

Panel 5: Ethical and IRB Approaches for a Successful Embedded A vs. B Pragmatic Trials Moderator:

Moderator: David Wendler, PhD

Panel:

    • Barbara Bierer, MD
    • Spencer Hey, PhD
    • Judith Carrithers, JD, MPA

Summary and Concluding Remarks

Moderator: Cathy Meyers, MD

Panel:

    • Adrian Hernandez, MD
    • Rich Platt, MD, MSc
    • Beverly Green, MD, MPH
    • Greg Simon, MD, MPH
    • Dave Wendler, PhD

ePCT Training Workshop Course Materials (February 2018)

February 20-21, 2018: This workshop provided training to mid- to senior-level investigators who are interested in conducting embedded pragmatic clinical trials (ePCTs). During the workshop, the NIH Collaboratory piloted the educational materials for investigators and collected feedback on the quality and appropriateness of the materials.

Agenda and Slides

Day 1: February 20

Welcome and Introduction

Gloria Coronado, PhD
Doug Zatzick, MD

Session 1: What Are Embedded Pragmatic Clinical Trials?

Lesley Curtis, PhD
Gloria Coronado, PhD
Doug Zatzick, MD

Session 2: Engaging All Stakeholders and Aligning With Healthcare System Partners

Leah Tuzzio, MPH

Session 3: Designing With Implementation in Mind

Doug Zatzick, MD

Session 4: Design and Analytic Considerations

Liz Turner, PhD

Session 5: Regulatory and Ethical Challenges of ePCTs

Kevin Weinfurt, PhD

Day 2: February 21

Session 6: Measuring Outcomes

Rachel Richesson, PhD, MPH
Lesley Curtis, PhD

Session 7: Pilot and Feasibility Testing

Wendy Weber, ND, PhD, MPH

Session 8: Dissemination

Doug Zatzick, MD

Session 9: ePCT Team Composition

Lesley Curtis, PhD

Session 10: Developing a Compelling Application

Marcel Salive, MD, MPH

Disseminating, Implementing, and Sustaining Evidence-Based Practices Into Clinical Care: NIH-Hosted Workshop (May 2017)

May 24, 2017: This workshop identified best practices for the dissemination, implementation, and sustainability of ePCT findings. When conducted within integrated healthcare systems, ePCTs can leverage existing infrastructure to answer important clinical questions in a cost-effective manner.

Agenda and Slides

Welcome and Introduction

Josephine Briggs, MD
Richard Hodes, MD
Catherine Myers, MD
Wendy Weber, ND, PhD, MPH

Keynote: An Orientation to Dissemination, Implementation, Sustainability De-Implementation and the Science of Making Science Matter

David Chambers, DPhil

Panel 1: Setting the Stage for Dissemination and Implementation

Moderator: David Chambers, DPhil

Panel:

    • Susan Huang, MD, MPH
    • Doug Zatzick, MD
    • Gloria Coronado, PhD

Panel 2: Health System Engagement: Partnership, Relationships, and Transparency

Moderator: Eric Larson, MD, MPH

Panel:

    • Miguel Vazquez, MD
    • John Warner, MD
    • Lynn DeBar, PhD, MPH
    • Andrew Bertagnolli, PhD
    • Vincent Mor, PhD

Panel 3: Swimming with the Sharks - Translation of Pragmatic Trial Results

Moderator: Lesley Curtis, PhD
Presenter: Greg Simon, MD, MPH

Panel:

    • Susan Mullaney, MHA
    • Edward Septimus, MD
    • Matt Hough, MD

Panel 4: Designing for Sustainability

Moderator: Amy Kilbourne, PhD, MPH

Panel:

    • Laura Dember, MD
    • Jerry Jarvik, MD, MPH
    • Patrick Luetmer, MD
    • Greg Simon, MD, MPH

Panel 5: Stakeholder Reactions Panel Discussion

Moderator: Catherine Myers, MD

Panel:

    • John Warner, MD
    • Susan Mullaney, MHA
    • Amy Kilbourne, PhD, MPH

Summary and Concluding Remarks

Ethical and Regulatory Issues of Pragmatic Clinical Trials: NIH-Hosted Workshop (May 2016)

May 10, 2016: This workshop focused on unique ethical and regulatory issues identified by the NIH Collaboratory Trials supported by the NIH Health Care Systems Research Collaboratory Program.

Agenda and Slides

Welcome and Introduction

Catherine Myers, MD
Wendy Weber, ND, PhD, MPH

Keynote: Addressing the Ethical and Regulatory Issues in Pragmatic Clinical Trials

Jeremy Sugarman, MD, MPH

Panel 1: Options for Altered Consent and the Importance of Minimal Risk Determination

Moderator: Kevin Weinfurt, PhD

Panel:

    • Laura Dember, MD
    • Gregory Simon, MD, MPH
    • John Lantos, MD
    • Emma Meagher, MD

Panel 2: Oversight of Pragmatic Clinical Trials: Institutional Review Boards and Data and Safety Monitoring Boards

Moderator: Adrian Hernandez, MD, MHS

Panel:

    • Douglas F. Zatzick, MD
    • P. Pearl O'Rourke, MD
    • Susan S. Ellenberg, PhD

Panel 3: Privacy Issues for Pragmatic Clinical Trials

Moderator: Valerie Bonham, JD

Panel:

    • Sarah M. Greene, MPH
    • Valery Gordon, PhD, MPH
    • Miguel Bazquez, MD

Panel 4: Vulnerable Populations

Moderator: David Wendler, PhD

Panel:

    • Susan S. Huang, MD
    • Mary Jane Welch, DNP, APRN, BC

Panel 5: Expert Panel Q&A

Moderator: Jeremy Sugarman, MD, MPH

    • Kevin Weinfurt, PhD
    • Adrian Hernandez, MD, MHS
    • Valerie Bonham, JD
    • David Wendler, PhD

Summary and Concluding Remarks