Grand Rounds

June 1, 2022: This Week’s PCT Grand Rounds Will Feature MedSafer Deprescribing Study

Posted on by Damon Seils

Head shot of Dr. Emily McDonaldIn this Friday’s PCT Grand Rounds, Dr. Emily McDonald of McGill University will present “Results of the MedSafer Study: Electronic Decision Support for Deprescribing in Hospitalized Older Adults.” The Grand Rounds session will be held on Friday, June 3, 2022, at 1:00 pm eastern.

The MedSafer study was a cluster randomized clinical trial evaluating the effects of an electronic deprescribing decision support tool on adverse drug events after hospital discharge among older adults with polypharmacy.

Join the online meeting.

May 18, 2022: This Week’s COVID-19 Grand Rounds to Explore Long COVID in the RECOVER Platform

Posted on by Damon Seils

Headshot of Dr. Upinder SinghIn this Friday’s COVID-19 Grand Rounds, Dr. Upinder Singh of Stanford University will present “Long-COVID Studies Within the RECOVER Platform.” The Grand Rounds session will be held on Friday, May 20, at 1:00 pm eastern. The National Institutes of Health (NIH) created the RECOVER (Researching COVID to Enhance Recovery) Initiative to learn about the long-term effects of COVID.

The NIH Pragmatic Trials Collaboratory Coordinating Center is using its popular Grand Rounds platform to share late-breaking research and promote resources in support of clinical researchers affected by the COVID-19 public health emergency.

For previous COVID-19 Grand Rounds, and more news and resources related to the COVID-19 public health emergency, see the COVID-19 Resources page.

Join the online event.

May 6, 2022: N-of-1 Randomized Trials: CRAVE and I-STOP-AFib as Examples (Gregory Marcus, MD, MAS)

Posted on by terren.green@duke.edu

Speaker

Gregory Marcus, MD, MAS
Professor of Medicine
University of California, San Francisco

 

 

Keywords

Eureka; AFEQT; I-STOP-AFib; CRAVE; Atrial Fibrillation; PVC; PAC; alcohol; coffee

 

Key Points

  • Atrial Fibrillation (AFib) is fairly static and chronic, but recent studies have shown a reduction in AFib with weight loss in obese patients and a reduction in AFib with a reduction in alcohol consumption.
  • In an N-of-1 study each individual participant serves as their own case control. N-of-1 studies can show how a particular individual reacts to a given condition, but not all questions can be studied with n of 1 studies.
  • The I-STOP-AFib study was a randomized completely remote N-of-1 study to assesses quality of life and test for discreet triggers of AFib. Patients chose a trigger they could readily withhold or introduce, and used a mobile app, Eureka, to determine eligibility and record their consent to participate.
  • The control group tracked their trigger. The intervention group were told to expose themselves to the trigger or avoid it and track incidence of exposure. An Alivecor ECG monitor was sent to each patient to track occurrences of AFib.
  • No difference in primary outcome was found for either group, but the intervention group had a 40% reduction in days with AFib.
  • The I-STOP-AFib study showed an increased chance of AFib immediately following consumption of alcohol, and a lower risk of AFib with consumption of caffeine.
  • The CRAVE study found no evidence that caffeine consumption increases incidence of AFib.

Discussion Themes

– Patients are very interested in N-of-1 studies and enjoy participating in a study where they can learn about themselves. Explaining how the trial works can be more difficult.

– Conducting a study involving IT, apps, and wearable technology in language other than English can take considerable planning and collaboration. Not only do study documents need to be provided in additional languages, but IT support must be available in additional languages as well.

Read more about I-STOP-AFib and CRAVE.

Tags

#pctGR, @Collaboratory1

May 11, 2022: MOTIFS Investigation of Collateral Findings in Pragmatic Trials Will Be Featured in PCT Grand Rounds

Posted on by Damon Seils

Head shots of Dr. Jeremy Sugarman, Dr. Stephanie Morain, Juli Bollinger, and Dr. Kevin WeinfurtIn this Friday’s PCT Grand Rounds, Dr. Jeremy Sugarman, Dr. Stephanie Morain, and Juli Bollinger of Johns Hopkins University and Dr. Kevin Weinfurt of Duke University will present “Ethics and Collateral Findings in Pragmatic Clinical Trials: Implications of a Multi-Method Exploration.” The Grand Rounds session will be held on Friday, May 13, at 1:00 pm eastern.

The team will present lessons from MOTIFS, a recently completed multi-method investigation of the ethical and regulatory implications of “collateral findings” in pragmatic clinical trials.

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May 4, 2022: n-of-1 Randomized Trials to Be Featured in PCT Grand Rounds

Posted on by Damon Seils

Headshot of Dr. Gregory MarcusIn this Friday’s PCT Grand Rounds, Dr. Gregory Marcus of the University of California, San Francisco, will present “n-of-1 Randomized Trials: CRAVE and I-STOP-AFib as Examples.” The Grand Rounds session will be held on Friday, May 6, at 1:00 pm eastern.

The CRAVE trial investigated the real-time effects of caffeine intake on atrial and ventricular ectopy. The I-STOP-AFib trial assessed the efficacy of trigger-based testing for atrial fibrillation on quality of life. Both studies used n-of-1 designs.

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April 27, 2022: This Week’s PCT Grand Rounds Will Feature BP Track, an EHR-Based National Blood Pressure Surveillance System

Posted on by Damon Seils

Head shots of Dr. Mark Pletcher, Dr. Rhonda Cooper-DeHoff, and Dr. Alanna ChamberlainIn this Friday’s PCT Grand Rounds, Dr. Mark Pletcher of the University of California, San Francisco, Dr. Rhonda Cooper-DeHoff of the University of Florida, and Dr. Alanna Chamberlain of the Mayo Clinic will present “BP Track: National Surveillance for Blood Pressure Control and Related Process Metrics Using PCORnet.” The Grand Rounds session will be held on Friday, April 29, at 1:00 pm eastern.

The BP Control Laboratory Surveillance System, or BP Track, is a serial, EHR-based, cross-sectional study of blood pressure control across the United States built on PCORnet. BP Track queries submitted through PCORnet are used to produce blood pressure control metrics for a series of 1-year measurement periods using blood pressure measurements obtained as part of standard clinical care, medication prescribing, and other EHR data linked to healthcare encounters.

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April 19, 2022: PCT Grand Rounds Will Feature Clinical Trial Conducted in Retail Settings

Posted on by Damon Seils

Head shots of Dr. Dylan Steen and Dr. Sarah CouchIn this Friday’s PCT Grand Rounds, Dr. Dylan Steen and Dr. Sarah Couch of the University of Cincinnati will present “Development of a Novel Research Collaboration With the Retail Industry” The Grand Rounds session will be held on Friday, April 22, at 1:00 pm eastern.

Dr. Steen, who is also the CEO of High Enroll LLC, a research participant recruitment company, will join Dr. Couch to discuss the results of SuperWIN, a clinical trial of a dietary intervention conducted in retail settings.

Join the online meeting.

April 8, 2022: COVID-19 Surveillance in PCORnet: Year 2 Update (Jason Block, MD, MPH; Thomas W. Carton, PhD, MS)

Posted on by terren.green@duke.edu

Speakers

Jason Block, MD, MPH
Associate Professor
Harvard Pilgrim Health Care Institute
Harvard Medical School

Thomas W. Carton, PhD, MS
Chief Data Officer
Louisiana Public Health Institute

 

 

Keywords

PCORnet; COVID-19; Electronic health record (EHR); Surveillance data

 

Key Points

  • PCORnet is a national network of 66 million people with EHR-derived data available for research.
  • After significant database modifications to effectively include COVID-19 related data, the CDC PCORnet COVID-19 project began in April 2020 with the first query. 43 participating institutions update data monthly.
  • There have been 40 queries of the PCORnet COVID-19 data completed to date looking at descriptive trends of COVID-19 by care setting and demographics, vaccinations, chronic disease, and treatments.
  • PCORnet COVID-19 data tracks percent hospitalized and relative risk of testing positive for COVID-19 by race over time.
  • Data also shows treatment disparities with monoclonal antibodies over time by race and ethnicity. White patients or non-Hispanic patients who tested positive for COVID-19 were more likely to be treated with monoclonal antibodies than any other race or ethnicity.
  • PCORnet COVID-19 data have also been used to investigate myocarditis and pericarditis after both COVID-19 vaccination and COVID-19 infection. Males ages 12 to 29 have increased risk of cardiac complications after COVID-19 infection compared with COVID-19 vaccination.
  • PCORnet is evolving to improve the capture of information, advance analytics, and provide better collaboration between federal public health and PCORnet investigators.

Discussion Themes

    • Complete surveillance data is difficult to obtain when not all testing or vaccination is being reported.
    • State vaccination data does not always get added the EHR until the patient has another primary care encounter.
    • The ability to continue doing this kind of work relies on a national public health infrastructure.

Read more about PCORnet.

Tags

#pctGR, @Collaboratory1

April 13, 2022: SODIUM-HF Trial Will Be Featured in This Week’s PCT Grand Rounds

Posted on by Damon Seils

Head shot of Dr. Justin EzekowitzIn this Friday’s PCT Grand Rounds, Dr. Justin Ezekowitz of University of Alberta will present “SODIUM-HF: Should Our Patients Consume Less Dietary Sodium?” The Grand Rounds session will be held on Friday, April 15, at 1:00 pm eastern.

The SODIUM-HF trial is open-label, randomized controlled trial conducted at 26 sites in Australia, Canada, Chile, Colombia, Mexico, and New Zealand to test whether reduction in dietary sodium reduces the incidence of future clinical events.

Join the online meeting.

April 6, 2022: COVID-19 Surveillance in PCORnet to Be Featured in Grand Rounds This Week

Posted on by Damon Seils

Headshots of Dr. Jason Block and Dr. Thomas CartonIn this Friday’s COVID-19 Grand Rounds session, Dr. Jason Block of Harvard Medical School and Dr. Thomas Carton of the Louisiana Public Health Institute will present “COVID-19 Surveillance in PCORnet: Year 2 Update.”

The Grand Rounds session will be held on Friday, April 8, at 1:00 pm eastern. Join the online meeting.

The NIH Pragmatic Trials Collaboratory Coordinating Center is using its popular Grand Rounds platform to share late-breaking research and promote resources in support of clinical researchers affected by the COVID-19 public health emergency. This week’s session will be the second presentation by Dr. Block and Dr. Carton about PCORnet’s COVID-19 surveillance. Access the previous session from June 5, 2020.

For previous COVID-19 Grand Rounds, and more news and resources related to the COVID-19 public health emergency, see the COVID-19 Resources page.