CER Inventory

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All Results

Category Agency Type Project Title Institution Amount Summary Completion/
Closing Date
Link
Other AHRQ Patient Awareness and Consumer Education Research Center UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER $0 link
Other AHRQ Claims-based surveillance of surgical site infections following vascular surgery. BRIGHAM AND WOMEN»S HOSPITAL $0 This project will develop and validate a standardized claims based surveillance method to rank hospitals nationally based on diagnosis and procedure codes suggestive of surgical site infection SSI following vascular surgery. link
Communication of Research Results AHRQ Adaptation of Consumer Guides for Patients with Low Health Literacy University of Texas, MD Anderson Cancer Center $0 Osteoarthritis, rheumatoid arthritis and osteoporosis are among the most common chronic health problems. Patients with these disorders face many treatment options. This project will provide tools for patients with lower health literacy educational tools to assist them in making informed treatment decisions. 09/03/2010 link
Data Infrastructure NIH DEVELOPMENT OF A CONSUMER RESEARCH NETWORK FOR STUDYING OBESITY UNIVERSITY OF MINNESOTA TWIN CITIES $900,131 The primary goal of this proposal is to develop and implement an innovative consumer research network (CRN) that can advance the research in the science of improving health by creating a consumer based health information technology (HIT) infrastructure that allows investigators to connect directly with individual consumers to participate in research. 08/02/2010 link
Data Infrastructure AHRQ Chronic Care Warehouse (CCW) Enhancement to Support Comparative Effectiveness Research (CER) Buccaneer $15,500,000 The purpose of this Task Order is to enhance the Chronic Condition Data Warehouse (CCW) and continue to operate the Research Data Distribution Center (RDDC) to support Comparative Effectiveness Research (CER). These enhancements will enable CCW to provide a unique data resource to support CER. It will support longitudinal analysis of Medicare data from 1999 through present, link data across the continuum of care, be representative of the full Medicare population, and provide a large enough data set to support the study of small populations and relatively rare events. 06/27/2012 link
Data Infrastructure NIH NEUROIE: A TOOL FOR MINING THE NEUROANATOMIC VOLUMETRIC LITERATURE MASSACHUSETTS GENERAL HOSPITAL $219,301 Neuroimaging techniques such as MRI, fMRI and PET provide a wealth of quantitative information related to anatomy, function, development, and disease etiology of the nervous system. Experimental studies utilizing neuroimaging techniques have generated and reported growing amount of research results in the literature. The availability of these results allows neuroscience researchers to perform comparative and integrative studies to discover new knowledge and generate new hypotheses. However, because that much of these results are published in the full text body of the articles as tables and figures, in addition to the textural format, they are not readily available for systematic retrieval and access via most online databases of scientific literature, such as PubMed, that cover only the abstracts and citations. To address this problem, we have developed the Internet Brain Volume Database (IBVD), a web-based searchable database of neuroanatomic volumetric observations manually curated from the journal articles. However, it is becoming apparent that our current labor-intensive manual approach is inadequate to keep pace with the growing number of publications. 05/02/2010 link
Data Infrastructure AHRQ Improving Reporting of Race, Ethnicity, and Language in California UNIVERSITY OF CALIFORNIA LOS ANGELES $0 California is home to a large and diverse population of over 37 million individuals, including the largest Latino, Native American, Pacific Islander, and Asian populations in the U.S. A large percentage of these individuals are linguistically isolated. Disparities in care are well documented to be significantly higher among racial/ethnic minorities and among those with Language barriers. Although California requires Race, Ethnicity, and Language Reporting, a lack of specific guidelines for what, how, and when this data should be collected has contributed to inconsistency in Reporting, a significant barrier to better understanding the magnitude of health disparities. California's office of Statewide Health Planning and Development (OSHPD), a state agency, is responsible for the routine collection of patient-level hospital inpatient, emergency department, and ambulatory surgery data across the state. The Patient Discharge Database has over 4 million discharges annually and is the largest single constituent database contributing to the AHRQ National inpatient Sample and the largest inpatient database offered by AHRQ Healthcare Cost and Utilization Project. Over ten million emergency department encounters and 2.4 million ambulatory surgeries are reported to OSHPD annually. in response to RFA-HS-10-010, "ARRA OS: Recovery Act 2009 Limited Competition: Enhanced State Data for Analysis and Tracking of Comparative Effectiveness Impact: Improved Clinical Content and Race-Ethnicity Data (R01)," a team of allied researchers led by investigators from the University of California in collaboration with the leadership of the California office of Statewide Health Planning and Development, propose a three- year programmatic intervention to improve the reliability, validity, and completeness of self-reported Race, Ethnicity, and primary Language provided by hospitals in the three databases that are currently within OSHPD's regulatory mandate. 10/02/2010 link
Data Infrastructure HRSA ARRA-Community Health Applied Research Network: A Community Alliance for Technology Enabled Comparative Effectiveness Research Erie Family Health Center, Inc. $0 The Community Health Applied Research Network (CHARN) is being established in response to the funding opportunities made available under the Recovery Act for Comparative Effectiveness Research (CER) Data Infrastructure. The CHARN will be comprised of four Research Nodes and a Central Data Management Coordinating Center (CDMCC). Research Nodes are health center-led consortia of safety net providers in partnership with one or more academic institutions and will be funded through four separate cooperative agreements. This funding announcement is for four Research Node Centers to support the four Research Nodes. Each Research Node Center will serve as the coordinating arm of the Research Node and will maintain a research partnership with the other affiliate organizations within the Research Node. Support for the Research Node will include arranging and managing the participation of at least 3 affiliates, maintaining scientific and technical personnel for research protocol development and implementation, coordinating intra-node activities, and providing resources for intra-node activities. 08/27/2010 link
Research Methods AHRQ DOUBLY ROBUST ELIMINATION: BEST PRACTICES FOR COMPARATIVE EFFECTIVENESS RESEARCH UNIVERSITY OF NORTH CAROLINA CHAPEL HILL $0 The proposed research will systematically evaluate six key aspects of DR estimators: 1) quantify the degree to which DR estimation leads to bias reduction relative to standard methods, 2) evaluate estimated standard errors under a broad range of conditions, 3) determine the optimal covariate types for inclusion in the component models, 4) validate a new approach to variable and model-form selection, 5) develop and test strategies specific to DR estimation for the identification of non-uniform treatment effects, and 6) identify conditions under which DR methods perform worse than standard methods. 02/02/2011 link
Research Methods NIH CONJOINT ANALYSIS: OVERCOMING OBSTACLES TO ROUTINE FORMAL PREFERENCE ASSESSMENT I UNIVERSITY OF CALIFORNIA LOS ANGELES $319,550 This research aims to improve our ability to individualize prostate cancer care and improve decision quality for men with this disease. We will test whether a method taken from consumer marketing research can more accurately identify individual patients' values better than existing methods used in healthcare research. We will test whether use of this method improves the quality of the treatment decisions that are made by patients. 05/02/2010 link
Communication of Research Results HHS/ASPE TO DESIGN AND IMPLEMENT A PILOT OF NEW STRATEGIES TO DISSEMINATE CER TO PATIENTS AND PROVIDERS IDEO, LLC $2,973,753 The purpose of this task order is for the Contractor to support the Dissemination of Comparative Effectiveness Research (CER) to Patients and Providers to Increase Adoption. The contractor shall conceptualize, design, pilot, evaluate and recommend best methods for delivery of information to patients/consumers and providers at the point-of-care in ways that they will understand and utilize. 07/10/2010 link
Communication of Research Results HHS/ASPE Increasing Adoption of Patient-Centered Behavioral Health Research by Primary Care and Behavioral Health Providers and Systems MANILA Consulting Group, Inc. $1,944,004 The Substance Abuse Mental Health Services Administration is soliciting for the design and management of a study to evaluate the impact of using different strategies for disseminating and promoting adoption of patient-centered health research (also referred to as comparative effectiveness research) results among behavioral health providers and organizations, and primary care providers and organizations responsible for delivering behavioral health services. 07/29/2010 link
Communication of Research Results HHS/ASPE Enhancing the Adoption of Comparative Effectiveness Research in the Treatment of Serious Mental Illnesses in Medicaid Mathematica Policy Research, Inc. $299,374 This project will identify the combinations of benefit design, payment and organizational arrangements that best support the use of evidence-based practices. It will review the literature, analyze Medicaid claims and enrollment data to better understand how states currently treat schizophrenia and bi-polar disorder, and assess how current treatment patterns compare with evidence-based practices. 08/01/2010 link
Communication of Research Results AHRQ Citizens Forum on Effective Health Care American Institutes of Research $9,999,742 The Citizens’ Forum will develop and test methods to gather informed citizen and clinician opinion on value-based health care questions. The goal of this effort is to develop and demonstrate mechanisms to engage representatives of the public – both citizens and stakeholders – in processes that utilize comparative effectiveness evidence for making decisions concerning healthcare policy and practice, and in decisions related to the conduct of comparative effectiveness research itself. link
Communication of Research Results AHRQ-ASPE Dissemination of CER to Physicians, Providers, Patients and Consumers—Continuing Education Prime Education, Inc. $3,981,168 implement a program of online continuing education targeted to physicians, pharmacists, nurses, nurse practitioners, physician assistants, medical assistants, allied health professionals and other clinicians to provide information about comparative effectiveness research findings from the Effective Health Care Program. 09/30/2010 link
Communication of Research Results AHRQ Adapting Hypertension and Diabetes Guides for Hard-to-Reach African-American Men Philadelphia Health Management Corp. $0 The proposed project will have a significant impact on improving chronic disease management through 1) focusing on a hard-to-reach population of African American men with high rates of chronic illness, 2) collecting qualitative and quantitative data on the health information needs of African American men, 3) employing behavior change theory to adapt CERGS in print and video form for use with persons with low health literacy, 4) rigorously testing the effectiveness of both the print and video versions of the CERSGs in comparison to the current versions, and 5) assessing the feasibility and sustainability of disseminating this information in a range of community settings. 10/02/2010 link
Communication of Research Results AHRQ AHRQ's Ischemic Heart Disease Products Translated for High School Populations Baylor College of Medicine $0 Baylor College of Medicine will translate and adapt AHRQ-sponsored comparative effectiveness products on medical therapies for coronary heart disease to build health decision-making skills of high school audiences, specifically students, teachers and students' family members/caregivers. 08/14/2010 link
Communication of Research Results AHRQ Application and Dissemination of a Culture-Centered Approach to Tailoring Comparative Effectiveness Purdue University, West Lafayette $0 The goal of the proposed project is to use a community-based approach to modifying Comparative Effectiveness Research Summary Guides that offer information comparing different interventions for treating a wide range of medical conditions. The research team will collaborate with the Indiana Minority Health Coalition and its affiliates in Lake and Marion counties in Indiana to develop tailored guides on heart disease for African Americans. In order to accomplish this goal of developing and disseminating tailored messages, the research team will create a technology hub for posting information, collaborating online, offering feedback and building technology-based community infrastructures. 09/03/2010 link
Communication of Research Results AHRQ Comprehensive Informatics Framework for CER Dissemination JOHNS HOPKINS UNIVERSITY $0 The aim of this study is development and evaluation of individualized continuous patient education (iCOPE) platform for adaptation and dissemination of Comparative Effectiveness Research (CER) products in difficult-to-reach populations. We will enroll 318 elderly with diabetes in a controlled clinical trial to evaluate the impact of iCOPE platform on patient knowledge of CER results, medication self-efficacy, adherence, health beliefs, and satisfaction with diabetes medications. 09/03/2010 link
Communication of Research Results AHRQ Disseminating Adapted Diabetes Evidence to Clinicians Through a Patient Portal VANDERBILT UNIVERSITY $0 AHRQ has published a Comparative Effectiveness Research Summary Guide to treat Type 2 Diabetes Mellitus with oral medications. This project will adapt this Summary Guide to be concise, targeted, and easily actionable, and it will disseminate it to patients and healthcare providers through a patient portal and electronic health record system, respectively. The investigators will use qualitative and quantitative methodologies to evaluate understanding and application of the adaptation. 09/03/2010 link
Communication of Research Results AHRQ Disseminating Breast Cancer Prevention to African American Women UNIVERSITY OF PENNSYLVANIA $0 Despite overall improvements, African American women continue to experience excess rates of morbidity and mortality from breast cancer compared to women from ethnic and racial groups. Lack of awareness about behavioral and medical strategies for breast cancer prevention contributes to poorer outcomes among African American women. Our research will develop and evaluate a novel, community-based strategy for disseminating information about breast cancer prevention options to women at risk for poorer outcomes. 09/03/2010 link
Communication of Research Results AHRQ IA-ADAPT: Improving Antipsychotic Appropriateness in Dementia Patients UNIVERSITY OF IOWA $0 Cognitive impairment and dementia are major public health issues for the elderly and aging population, particularly nursing home residents. Behavioral problems in dementia place undue burden on caregivers, and current drug therapies for these problems are unsafe and have limited effectiveness. This research addresses AHRQ goals of assessing and improving the effectiveness of treatment strategies for dementia. 10/02/2010 link
Communication of Research Results AHRQ iADAPT: Off-Label Use of Antipsychotics in the Nursing Home University of Massachusetts Medical School, Worcester $0 Off-Label Use of Atypical Antipsychotics in the Nursing Home Dementia is extraordinarily common in the nursing home setting affecting between 40% and 60% of all residents. The off-label use of atypical antipsychotics in the treatment of behavioral disturbances or agitation associated with dementia is widespread and increasing among nursing home residents in the United States despite mounting evidence of serious safety concerns and modest efficacy. The complexity of the nursing home setting presents special challenges for fostering use of the atypical antipsychotic Comparative Effectiveness Research Summary Guide. 10/02/2010 link
Communication of Research Results AHRQ Informing Latinas about Medications to Reduce For Breast Cancer RAND CORPORATION $0 Lack of language-, literacy-, and culturally-appropriate evidenced-based information contributes to disparities in breast cancer health care and health between Latinas and non-Latina white women. The proposed project will pilot and compare three evidence- based patient-oriented educational prototypes targeting Latinas, for a potentially life- saving preventive treatment, and using alternative modes of delivery (print media, community health worker, computer delivery). 10/02/2010 link
Data Infrastructure NIH HYDROCEPHALUS CLINICAL RESEARCH NETWORK: A CONSORTIUM FOR PEDIATRIC HYDROCEPHALUS UNIVERSITY OF UTAH $497,260 This proposal is to establish a coordinated network to identify the areas of most urgent need in hydrocephalus research and conduct prospective studies to solve these problems. In the first 18 months of collaboration, the Network has developed a Core Data Project and three focussed studies, which will generate the pilot data needed to plan prospective trials in the future. 09/02/2010 link
Data Infrastructure NIH BUILDING A GENOME ENABLED ELECTRONIC MEDICAL RECORD UNIVERSITY OF VIRGINIA CHARLOTTESVILLE $1,945,779 This project embeds an expanded release of Health Heritage(c); a family history based genomic risk assessment and clinical decision support tool, into the largest provider of Electronic Medical and Personal Health Records in the United States (Epic). This will create a Genome Enabled Electronic Medical Record (GenE EMR) that will help clinicians and their patients better understand the meaning and personal implications of family history and other genomic data. GenE EMR will assist clinicians and patients in making decisions about which are the optimal preventative practices for an individual to follow to reduce the risk of inherited cancer. It will also help in making decisions about genomic testing and, should cancer occur, what are the best treatments. GenE EMR, while embedded initially into Epic, will be designed so it can be incorporated into all nationally certified electronic medical records. 09/02/2010 link
Data Infrastructure NIH CONCERT-CLINICAL EFFECTIVENESS RESEARCH (CONCERT-CER) UNIVERSITY OF CHICAGO $3,901,797 The COPD Outcomes-based Network for Clinical effectiveness and Research Translation (CONCERT; https://www.kpchr.org/concert/) proposes to develop a research infrastructure that will accelerate the development and conduct of multi-institutional, multi-disciplinary studies that are responsive to the COPD CER priorities of stakeholders. 09/02/2010 link
Data Infrastructure NIH IMPROVING BREAST CANCER SURGERY QUALITY THROUGH A COLLABORATIVE SURGERY DATABASE VAN ANDEL RESEARCH INSTITUTE $564,244 There is currently no available healthcare administrative database which will allow comparative effectiveness research of initial breast cancer surgery, as existing databases lack the specificity and detail of critical data elements that currently drive decisions for initial breast surgery We propose to develop a multicenter electronic breast cancer surgery outcomes database that will allow for an assessment of measures of surgical quality by examining variation in outcomes of initial breast cancer surgery. In addition, we will develop protocols and data capture tools that can be implemented elsewhere in order to extend this data network to future additional CRN sites. 09/02/2010 link
Data Infrastructure NIH COMPARATIVE EFFECTIVENESS OF BREAST IMAGING STRATEGIES IN COMMUNITY PRACTICE GROUP HEALTH COOPERATIVE $1,999,896 The overall goal of this project is to conduct comparative effectiveness research on breast cancer imaging modalities and strategies to inform evidence gaps on how to optimize breast cancer screening in community practice. We will use the BCSC infrastructure and network of mammography facilities to examine screening intervals, screening modalities, and risk factors to determine their influence on breast cancer detection and mortality and associated costs 09/02/2010 link
Data Infrastructure NIH RECRUITMENT AND RETENTION BEST PRACTICES IN PRIMARY CARE SETTINGS WAYNE STATE UNIVERSITY $500,000 This study will develop infrastructure to support primary care practice-based research networks (PBRNs) to participate in clinical research studies of any design. The objective is to identify best practices for recruiting and retaining diverse primary care patients into clinical research studies. This will be accomplished with a collaborative multi-site study that engages 5 geographically dispersed members of the Primary Care Multiethnic Network (PRIME Net) consortium of PBRNs. A tangible produce will be a Guide to Recruiting and Retention Best Practices. 09/02/2010 link
Data Infrastructure NIH CYCORE: CYBERINFRASTRUCTURE FOR COMPARATIVE EFFECTIVENESS RESEARCH UNIVERSITY OF TEXAS MD ANDERSON CAN CTR $1,931,695 To accelerate progress toward conducting comparative effectiveness (CE) research in cancer prevention and control, we have formed a consortium of investigators with expertise in behavioral research, cyberinformatics, telematics, oncology, and clinical trials to create and test an innovative infrastructure called CYCORE: CYberinfrastructure for comparative effectiveness REsearch. The overarching goal of CYCORE is to develop a comprehensive, state of the art cyberplatform that will enable large-scale and robust CE research across the neoplastic continuum, i.e., from cancer prevention, to cancer treatment and ultimately, to cancer control and survivorship care. 09/02/2010 link
Data Infrastructure NIH KAISER PERMANENTE FUNCTIONAL OUTCOMES SYSTEM KAISER FOUNDATION RESEARCH INSTITUTE $515,198 This project proposes to integrate the Activity Measure for Post- Acute Care (AM-PAC) CAT with the KPNC EMR This would result in the development of the Kaiser Permanente Functional Outcomes System (KP-FOS), an innovative clinical functional outcome system that can be used across all KPNC acute and PAC settings to monitor patient outcomes. 09/02/2010 link
Data Infrastructure NIH CARRA: ACCELERATING TOWARD AN EVIDENCE BASED CULTURE IN PEDIATRIC RHEUMATOLOGY DUKE UNIVERSITY $3,787,690 Through the creation of unifying, scalable informatics infrastructure and the engagement of families, patients, and communities, the Childhood Arthritis and Rheumatology Research Alliance (CARRA) will provide the opportunity for affected children at every CARRA site to participate in high quality clinical and translational research. 09/02/2010 link
Data Infrastructure AHRQ Using Clinically-Enhanced Claims Data to Guide Treatment of Acute Heart Failure Minnesota Hospital Association $0 The long term objective of this research is to develop a clinically-enhanced administrative Database that builds upon the foundation that has already been established in Minnesota by the Minnesota Hospital Association and to demonstrate its use in studying comparative effectiveness. Minnesota's administrative claims Database already is enhanced by present-on- admission coding and the addition of laboratory Data. This proposal will increase the number of hospitals submitting laboratory Data, will expand the Database to include inpatient pharmacy Data, and will link patient Data across hospitals and with Minnesota death certificates. The expanded Dataset will support better measurement of risk-adjusted clinical outcomes and comparative effectiveness analyses of pharmaceutical interventions. A comparative effectiveness analysis of alternative drug regimens used to treat patients hospitalized with Acute decompensated Heart Failure will be performed using the clinically-enhanced administrative hospital discharge Database. The care and clinical outcomes of subgroups of high interest patients (e.g., elderly, women, high-risk patients) also will be evaluated. Because of the complexity of Heart Failure and the therapies used to manage it, this study will be an excellent test to ability of clinically-enhanced administrative Databases to provide important information about comparative effectiveness in areas where randomized controlled clinical trials and prospectively designed clinical registries often fall short. 10/02/2010 link
Data Infrastructure HRSA ARRA-Community Health Applied Research Network: Building Research Infrastructure to Develop and Generate Comparative Effectiveness Studies (BRIDGES) Ochin, Inc. $0 The Community Health Applied Research Network (CHARN) is being established in response to the funding opportunities made available under the Recovery Act for Comparative Effectiveness Research (CER) Data Infrastructure. The CHARN will be comprised of four Research Nodes and a Central Data Management Coordinating Center (CDMCC). Research Nodes are health center-led consortia of safety net providers in partnership with one or more academic institutions and will be funded through four separate cooperative agreements. This funding announcement is for four Research Node Centers to support the four Research Nodes. Each Research Node Center will serve as the coordinating arm of the Research Node and will maintain a research partnership with the other affiliate organizations within the Research Node. Support for the Research Node will include arranging and managing the participation of at least 3 affiliates, maintaining scientific and technical personnel for research protocol development and implementation, coordinating intra-node activities, and providing resources for intra-node activities. 08/27/2010 link
Data Infrastructure AHRQ Scalable Architecture for Federated Therapeutic Inquiries Network (SAFTINet) University of Colorado, Denver $0 The overall goals of this project are to enhance the capacity and capability of a safety net focused distributed research network to conduct prospective comparative effectiveness research via a multi-setting, multi-state organization. The Scalable Architecture for Federated Translational Inquiries Network (SAFTINet) will federate geographically dispersed safety net entities that collectively serve markedly diverse underserved populations. SAFTINet will both leverage and extend the established governance and technologic capabilities of the Distributed Ambulatory Research in Therapeutics Network (DARTNet) to allow more flexible options for participants and improved grid technology. This multi-state project will allow researchers, health policy experts, payers, and clinicians to better understand the impact of a wide variety of health care interventions on health outcomes for minority, underserved and socioeconomically disadvantage populations by supporting observational comparative effectiveness research. We will assemble a learning community dedicated to the aforementioned populations and build secure technology to allow authorized and authenticated stakeholders to answer important questions regarding issues ranging from treatment options to care delivery options. The Specific Aims of this proposal are to: " Establish a broad, safety-net focused, research partnership and learning community to govern relationships, establish priorities, provide data quality oversight, and evaluate the purpose and value of the community's effort that leverages the established governance structure of DARTNet " Extend the DARTNet framework to build, deploy and assess a safety-net focused distributed research network which combines ambulatory and inpatient clinical data and Medicaid claims and eligibility data for clinical and research purposes " Develop and enhance four sentinel cohort pairs of patients with asthma (pediatric and adult), hypertension, and hypercholesterolemia distinguished by their care delivery characteristics that can support comparative effectiveness research 10/02/2010 link
Research Methods AHRQ Bundled Episode Payment and Gainsharing Demonstration Project Integrated Healthcare Association $0 The proposed project addresses an IOM research priority-strategies and interventions for improving care by redesigning payment-by proposing a real-world demonstration of bundled episode payment for several IOM priority conditions, including arthritis and non-traumatic joint disorders and cardiovascular disease. Results of the demonstration in terms of both clinical quality and costs will be rigorously evaluated in comparison to current payment mechanisms. Expansion of a current pilot in Los Angeles and Orange Counties to patient populations and delivery systems across the State of California will provide valuable information on the scalability of bundled episode payments in commercial populations that may be generalized to national efforts to implement payment reform. 10/02/2010 link
Research Methods AHRQ Primary Care Practice Redesign--Successful Strategies UNIVERSITY OF UTAH $0 This project specifically addresses the purposes of the grant program to demonstrate the feasibility and value of implementing evidence-based care improvement strategies and interventions in delivery systems as well as a number of objectives of Healthy People 2010 including improving access to comprehensive, high-quality health care services. This project implements a comprehensive program of care management for patients with multiple chronic conditions and evaluates the impact of transformation to a PCMH delivery model of primary care practices in a University network serving a broad patient population. The project addresses a broad goal for Healthy People 2010, to "Achieve access to preventive services for all Americans" by implementing best practices reminders in our EMR, pre-visit planning, and registry-based outreach. 10/02/2010 link
Research Methods CDC Reducing Blood Pressure ad well as Colorectal Cancer Among African American Men by Encouraging Behavioral Change, Guiding Them Through the Health Care System, and Using a Combination of the Two Approaches NEW YORK UNIVERSITY SCHOOL OF MEDICINE $0 This CDC Funding Opportunity Announcement (FOA), supported by funds available to CDC under the American Recovery and Reinvestment Act of 2009 (“Recovery Act” or “ARRA”), Public Law 111-5, invites cooperative agreement (U48) applications from Health Promotion and Disease Prevention Research Centers (PRCs) to perform comparative effectiveness research (CER) that compares innovative public health strategies or interventions, in new settings or populations (such as minorities or people with disabilities), preferably includes CER that assesses the impact of policy and environmental interventions, and includes new endpoints such as biologic measures or combined clinical and social interventions. It should be noted, however, that if biologic measures are included, then related, validated, or generally accepted health outcomes should also be included as part of the same research proposal. 10/02/2010 link
Data Infrastructure HRSA ARRA-Community Health Applied Research Network: The Fenway Institute HIV/AIDS Research Node Fenway Community Health Center $0 The Community Health Applied Research Network (CHARN) is being established in response to the funding opportunities made available under the Recovery Act for Comparative Effectiveness Research (CER) Data Infrastructure. The CHARN will be comprised of four Research Nodes and a Central Data Management Coordinating Center (CDMCC). Research Nodes are health center-led consortia of safety net providers in partnership with one or more academic institutions and will be funded through four separate cooperative agreements. This funding announcement is for four Research Node Centers to support the four Research Nodes. Each Research Node Center will serve as the coordinating arm of the Research Node and will maintain a research partnership with the other affiliate organizations within the Research Node. Support for the Research Node will include arranging and managing the participation of at least 3 affiliates, maintaining scientific and technical personnel for research protocol development and implementation, coordinating intra-node activities, and providing resources for intra-node activities. 08/27/2010 link
Data Infrastructure HRSA CHARN Central Data Management Coordination Center Kaiser Foundation Hospitals $0 The Community Health Applied Research Network (CHARN) is being established in response to the funding opportunities made available under the Recovery Act for Comparative Effectiveness Research (CER) Data Infrastructure. The CHARN will be comprised of four Research Nodes and a Central Data Management Coordinating Center (CDMCC). Research Nodes are health center-led consortia of safety net providers in partnership with one or more academic institutions and will be funded through four separate cooperative agreements. This funding announcement is for the Central Data Management Coordinating Center (CDMCC) to support the Network. This cooperative agreement will fund a Center whose mission will be to coordinate activities across research nodes in the following areas: administrative support for inter-node coordinating functions (such as the management of the steering committee); central data management; technical assistance in study design, data infrastructure, and analytic methods. Support for the Network will include the provision of appropriate and capable leadership and expertise in biostatistics, developmental study design, data management, data analysis, clinical data review, and project management, including, but not limited to, staff and site training and quality assurance procedures. 08/27/2010 link
Other AHRQ Comprehensive EPC Comparative Effectiveness Reviews for Effective Health Care TUFTS MEDICAL CENTER $6,000,000 Contract HHSA290200710055I: Awardees will 1) Develop and refine topics for CERs that are informative to stakeholder decisional needs; 2) Conduct CERs with systematic and transparent methods; and 3) Identify and explicate future research needs that are important to answering real-world healthcare decisions. 10/27/2012 link
Other AHRQ Comprehensive EPC Comparative Effectiveness Reviews for Effective Health Care Research Triangle Institute $6,000,000 Contract Contract HHSA290200710056I: Awardees will 1) Develop and refine topics for CERs that are informative to stakeholder decisional needs; 2) Conduct CERs with systematic and transparent methods; and 3) Identify and explicate future research needs that are important to answering real-world healthcare decisions. 10/27/2012 link
Other AHRQ Comprehensive EPC Comparative Effectiveness Reviews for Effective Health Care Oregon EPC $5,998,777 Contract HHSA290200710057I: Awardees will 1) Develop and refine topics for CERs that are informative to stakeholder decisional needs; 2) Conduct CERs with systematic and transparent methods; and 3) Identify and explicate future research needs that are important to answering real-world healthcare decisions. 10/27/2012 link
Other AHRQ Comprehensive EPC Comparative Effectiveness Reviews for Effective Health Care Blue Cross Blue Shield Association $5,996,188 Contract HHSA290200710058I: Awardees will 1) Develop and refine topics for CERs that are informative to stakeholder decisional needs; 2) Conduct CERs with systematic and transparent methods; and 3) Identify and explicate future research needs that are important to answering real-world healthcare decisions. 10/27/2012 link
Other AHRQ Comprehensive EPC Comparative Effectiveness Reviews for Effective Health Care JOHNS HOPKINS UNIVERSITY $5,940,510 Contract HHSA290200710061I: Awardees will 1) Develop and refine topics for CERs that are informative to stakeholder decisional needs; 2) Conduct CERs with systematic and transparent methods; and 3) Identify and explicate future research needs that are important to answering real-world healthcare decisions. 10/27/2012 link
Other AHRQ IMPROVING METHODS FOR COMPARATIVE EFFECTIVENESS RESEARCH IN CARDIOVASCULAR CARE BRIGHAM & WOMEN»S HOSPITAL $157,686 link
Other AHRQ SEMI-AUTOMATED ABSTRACT SCREENING FOR COMPARATIVE EFFECTIVENESS REVIEWS NEW ENGLAND MEDICAL CENTER HOSPITALS, INC $362,692 link
Other AHRQ COMPARATIVE EFFECTIVENESS OF ACE INHIBITORS FOR AFRICAN AMERICANS NEW YORK UNIVERSITY MEDICAL CENTER $404,067 link
Other AHRQ LONGITUDINAL COMPARATIVE EFFECTIVENESS & SAFETY OF BIOLOGICS IN AUTOIMMUNITY UNIVERSITY OF ALABAMA AT BIRMINGHAM $389,340 link
Other AHRQ THE COMPARATIVE EFFECTIVENESS OF TIME-ADJUSTED TRAUMA CENTER CARE ON MORTALITY UNIVERSITY OF PENNSYLVANIA $152,017 link
Data Infrastructure AHRQ Building Modular Pediatric Chronic Disease Registries for QI and CE Research Children»s Hospital Medical Center Cincinnati $0 A learning healthcare system comprises a community of front-line clinicians, patients, and scientists who view each clinical encounter as an opportunity to learn and to improve patient outcomes. In its most advanced state, it combines comparative effectiveness (CE) research with quality improvement (QI) science to ensure the delivery of new knowledge at the point of care. Electronic health records have the potential to become the tool for learning at the point-of-care, although most are patient-focused and do not natively support the population management required by a learning healthcare system. Registries are designed to do this, but generally operate independently of institutional EHRs. We propose to change this by building upon existing open-source software to create a modular, versatile, and scalable registry that can be populated by EHRs. We will test its ability to support QI and CE research within the ImproveCareNow practice-based research and improvement initiative. Our specific aims are to: (Aim 1) enhance an existing registry to support a learning healthcare system for pediatric inflammatory bowel disease (IBD) by capturing needed data directly from electronic health records, improving the quality of collected data using new tools we have developed for recording clinical data during a patient encounter, and facilitating interventions to improve the quality of care for children; (Aim 2) use quality improvement methods to implement enhanced IBD-registry features to enable management of IBD care center populations and increase patient participation in care; (Aim 3) use data from the enhanced registry to compare the effectiveness of alternative treatment strategies for pediatric Crohn's Disease patients, with a special focus on timing of biologic agents; (Aim 4) develop governance structures for the network that engages patients and provides oversight of privacy, confidentiality, and data access, as well as scientific and technical concerns. The project will form a unique community of children, families, clinicians, informaticians, QI specialists, and CE researchers who work together to improve patient outcomes using learning healthcare system principles. Our long-term goal is to extend this work to other chronic disease communities devoted to advancing the health of children. 10/02/2010 link
Data Infrastructure FDA Building FDA CER Clinical Data and Standards Infrastructure, Tools, Skills, and Capacity: Partnership in Applied CE Science (PACES) and Host Workshops on FDA CER JOHNS HOPKINS UNIVERSITY $4,662,128 This upcoming requirement is for the Partnership in Applied Comparative Effectiveness Science (PACES) which is an initiative that seeks to advance the science for such CER studies through leveraging available data, in particular the joint ARRA FDA-CER efforts, to form an enhanced standardized database, Janus. The Contractor will provide biological and clinically relevant computational expertise. The Contractor will work with FDA scientific and statistical experts to define questions, datasets and approaches for performing complex analyses for comparative and multi-study analyses on FDA and other large clinical datasets. As part of this effort the Contractor will conduct analyses on defined datasets including datasets previously developed as part the joint Janus initiative, where FDA Center specific questions will drive the data transformed, standardized and loaded into the Janus data warehouse. Additionally, the Contractor will be expected to participate in FDA-hosted scientific workshops that address issues such as methods for cross-study and other comparative analyses, best practices in CER, and candidate studies and their design and analysis methods. These strategies will also encompass clinical trial designs that can help advance personalized medicine and health outcomes both within and outside of the FDA. 09/22/2010 link
Research Methods CDC Reducing Risk of Cardiovascular Disease by Changing Behaviors and Encouraging Appropriate Use of Medication Through a Web-Based Versus a Counselor-Based Program University of North Carolina at Chapel Hill $0 This CDC Funding Opportunity Announcement (FOA), supported by funds available to CDC under the American Recovery and Reinvestment Act of 2009 (“Recovery Act” or “ARRA”), Public Law 111-5, invites cooperative agreement (U48) applications from Health Promotion and Disease Prevention Research Centers (PRCs) to perform comparative effectiveness research (CER) that compares innovative public health strategies or interventions, in new settings or populations (such as minorities or people with disabilities), preferably includes CER that assesses the impact of policy and environmental interventions, and includes new endpoints such as biologic measures or combined clinical and social interventions. It should be noted, however, that if biologic measures are included, then related, validated, or generally accepted health outcomes should also be included as part of the same research proposal. 10/02/2010 link
Research Methods ASPE Patient Centered Care Collaboration to Improve Minority Health Westat, Inc. $1,993,000 The Government intends to solicit and award a GSA MOBIS schedule Delivery Task Order Contract to acquire services for the office of the Secretary (OS)/Office of Public Health and Science (OPHS), Office of Minority Health (OMH). The purpose of this Task Order is to develop, implement, and test strategies to increase the adoption and dissemination of existing comparative effectiveness research (CER) information for racial and ethnic minorities in selected geographic areas. Funds will be provided to 1) engage health care and community health systems organizations and patient representatives in identifying, disseminating, and promoting the adoption of evidence-informed CER that best responds to targeted health needs of racial and ethnic minority patients and/or minority-service health care providers; 2) and develop, pilot test, implement, and evaluate the PCCC initiative in selected geographic areas. 06/30/2010 link
Data Infrastructure AHRQ-Indian Health Service Computer Assisted Quality of Life and Symptom Assessment Hektoen Institute for Medical Research $0 Patients who have multiple chronic medical conditions can be challenging for clinicians and health services researchers. Often, interventions are targeted for a specific condition and fail to address the overall health of a patient. These patients are particularly vulnerable during transitions from the hospital to ambulatory settings. Our long-term objective is to establish routine collection of physical and mental components of their health-related quality of life in the hospital and ambulatory settings through audio computer-assisted interviews (A-CASI). We will link these data to clinical data (e.g., visit history and medication receipt) from the electronic medical record. Our specific aims are to develop modular (instruments can be added or removed by clinical site) and bilingual (English and Spanish) A-CASI software; incorporate clinic specific instruments that will increase the likelihood of sustaining these assessments; join these data to clinical data stored in our clinical data warehouse; populate the electronic medical record with summary scores; and, provide these results to clinicians, administrators and health services researchers. We have established an Advanced Illness Management Clinic within our General Medicine Clinic for the consultative care of complex patients who have a high symptom burden. We will incorporate A-CASI assessments of symptom burden and quality of life for all Advanced Illness Clinic patients, for a specific team in our General Medicine Clinic and for a General Medicine Clinic patients who have been hospitalized and who have a high chronic disease score. For our pilot research project, we will randomize the hospital patients to usual care vs. initial evaluation and management recommendations by the Advanced Illness Management Clinic. We will follow these patients longitudinally as outpatients and administer follow-up A-CASI interviews 1, 3 and 6 months after their hospitalization-the baseline interview will be their hospital discharge interview. We will evaluate their change in health-related quality of life and symptom burden. For those patients who do not follow-up in the clinic, we will administer computer-assisted telephone interviews by research assistants. 10/02/2010 link
Data Infrastructure AHRQ-HIS Expanding CER Capability through Complex Patient Relationship Management Denver Health and Hospital Authority $0 Many experts have called for the redesign of primary care to better serve patients with chronic disease. Chronic disease performance measures as well as patient and provider satisfaction will improve as health care systems address the following three issues: 1) the limitations of infrequently-occurring, provider-driven 20-minute visits; 2) medication non-adherence; 3) patient self-management for chronic conditions. The long-standing paradigm of chronic disease management through the standard provider-driven 20 minute visit, which may occur every 3 months at best in indigent populations, does not support the patients need to manage their diseases on a daily basis. Multiple competing priorities leave both the patient and the provider dissatisfied. The challenges of chronic disease management are exacerbated in the cases of "complex" patients who have multiple, comorbid chronic conditions. Traditional chronic disease management strategies take a "silo approach" in their focus on a single condition, and are not best designed to take into account disease treatments for one condition that may potentially be in conflict with treatments for another, coexisting chronic condition. The creation of an infrastructure to enable the study of chronic disease interventions that target at-risk patients and offer personalized support outside of clinic visits is essential to the advancement of chronic disease management in these three areas. This project proposes to both build data capacity for research by supporting the integration of patient-provided data into the legal electronic medical record and facilitating linked access to multiple clinical data sets within a data warehouse and to improve targeted and personalized outreach to complex patients with comorbid chronic diseases such as diabetes, mental health disorders, HIV, and cardiovascular disorders. 08/01/2010 link
Research Methods CDC Detecting Diabetic Retinopathy Among American Indians and Alaska Natives Through Eye Examinations by Traditional Means (In Eye Care Providers' Offices) and by Telemedicine OREGON HEALTH AND SCIENCE UNIVERSITY $0 This CDC Funding Opportunity Announcement (FOA), supported by funds available to CDC under the American Recovery and Reinvestment Act of 2009 (“Recovery Act” or “ARRA”), Public Law 111-5, invites cooperative agreement (U48) applications from Health Promotion and Disease Prevention Research Centers (PRCs) to perform comparative effectiveness research (CER) that compares innovative public health strategies or interventions, in new settings or populations (such as minorities or people with disabilities), preferably includes CER that assesses the impact of policy and environmental interventions, and includes new endpoints such as biologic measures or combined clinical and social interventions. It should be noted, however, that if biologic measures are included, then related, validated, or generally accepted health outcomes should also be included as part of the same research proposal. 08/25/2010 link
Research Methods CDC Preventing Falls Among Older Adults Through Usual Care, an Education Program, and an Education Plus Exercise Program University of Pittsburgh with the Pennsylvania Department of Health $0 This CDC Funding Opportunity Announcement (FOA), supported by funds available to CDC under the American Recovery and Reinvestment Act of 2009 (“Recovery Act” or “ARRA”), Public Law 111-5, invites cooperative agreement (U48) applications from Health Promotion and Disease Prevention Research Centers (PRCs) to perform comparative effectiveness research (CER) that compares innovative public health strategies or interventions, in new settings or populations (such as minorities or people with disabilities), preferably includes CER that assesses the impact of policy and environmental interventions, and includes new endpoints such as biologic measures or combined clinical and social interventions. It should be noted, however, that if biologic measures are included, then related, validated, or generally accepted health outcomes should also be included as part of the same research proposal. 10/02/2010 link
Data Infrastructure AHRQ-Indian Health Service Washington University Comparative Effectiveness Administrative Data Repository WASHINGTON UNIVERSITY $0 We propose to expand and enhance an administrative data repository to facilitate comparative effectiveness research (CER) in complex patients. The data repository was developed with start-up funds from the WU Institute of Clinical and Translational Sciences. The start-up funds were provided to store and maintain multiple large administrative datasets and provide data management and analytic expertise for health services and outcomes research throughout the University. The size and complexity of these data provide ample opportunities to investigate processes of care, procedures, and therapies used to treat patients with multiple underlying illnesses. Grant funds are requested to further develop the server infrastructure for efficient storage and analysis of the large administrative data files and to purchase additional administrative data to extend the breadth of available information. We will develop a library of standard programming code to manage the multiple large and complex data files and to translate diagnosis and procedure codes into clinically meaningful classification schemas for analysis. Development of the programming code library will create an economy of scale through modification of existing code, rather than recreation of new code by individual investigators, thus allowing future investigators to more efficiently use their funds to perform innovative CER. We will provide education in the ethnical and secure use of administrative data for CER and develop policies to ensure compliance with federal and institutional data use agreements. To demonstrate the capacity of this administrative data repository for CER in the complex patient, we will determine the incidence of device associated infection after initial placement of an implantable cardiac device and after device revision/replacements in all patients, and in subsets of patients with diabetes and renal failure. We will assess the impact of these complications on mortality in all patients, and patients with diabetes and renal failure, in relation to time of diagnosis and device removal. We will also determine the incidence of recurrent infections as a function of time to re-implantation after removal of an infected device. 08/01/2010 link
Data Infrastructure AHRQ-Indian Health Service Creating and Disseminating Public Use Data Sets Abt Associates $2,927,937 The Agency for Healthcare Research and Quality (AHRQ) intends to issue a competitive Task Order against an Indefinite Delivery Indefinite Quantity contract with the Prevention Care Management – Technical Assistance Center, (PCM-TAC), Master Contract holders. It is anticipated that AHRQ will award 1 Task Order. This Task Order is for; Technical Assistance to ARRA Complex Patient Grantees, funded by the American Recovery and Reinvestment Act of 2009 (ARRA). This opportunity is available to 5 Master Contract holders under the PCM-TAC multiple award contract which was previously competed and awarded in 2010. 09/29/2010 link
Data Infrastructure CMS Comparative Effectiveness Research Public Use Data Pilot Project IMPAQ International, LLC $8,699,454 The Government intends to award a competitive task order for a Contractor to take one or more HIPAA Privacy Rule de-identified data sets and, using methods and technologies that exclude "brute force" matching, demonstrate the ability or inability to re-identify the data. Re-identify means to accurately and unambiguously match the de-identified data record to an actual individual. It is important to note that the de-identification provision permits a covered entity to consider health information to be de-identified when it has removed all 18 identifiers and the covered entity does not have actual knowledge that the information could be used alone or in combination to identify the subject individual. Outcomes/Objectives of this project are to increase access to CMS data through the creation of public use data and a means of accessing these data, while continuing to strictly protect beneficiary and provider confidentiality. 06/04/2010 link
Data Infrastructure CMS Strategic Plan for Developing CER Data Sets Genova Technologies $496,510 This notice is provided for informational purposes only. This opportunity is only available to Genova Technologies. Genova Technologies is a part of the 8 (a) program; which is a legislatively-mandated set aside program for small and disadvantaged businesses. The purpose of this effort is to develop a strategic plan that identifies the short-term and longer-term optimization of CMS administrative and clinical data, current and future data sources, current and future data requirements, recommended data architecture, data access and user authentication strategies, and data reporting and audit functionality to maximize CER. The task order is expected to be completed in 9 months. The Contracting Officer has determined that the most appropriate contract type is Firm Fixed Price. For further information about contracting with the Small Business Administration (The 8(a) Program), reference the Federal Acquisition Regulation 19.8. 08/04/2010 link
Research Methods AHRQ MODERNIZING META-ANALYSIS TO FACILITATE COMPARATIVE EFFECTIVENESS REVIEWS TUFTS MEDICAL CENTER $402,750 We propose to develop statistical methods and software for collectively analyzing multiple treatments across multiple endpoints and apply them to rank treatments based on multiple dimensions of health and well- being. 1) Develop new and enhance existing techniques for the statistical analysis of possibly incomplete multivariate meta-analytic data involving multiple (> 2) treatments, multiple outcomes or categories of outcomes and multiple follow-up times; 2) Implement these methods in an ongoing open-source software project so users will have access to customized and customizable algorithms and support for their use through analytic wizards that will guide users to appropriate statistical methods and presentation quality graphics and reports; and 3) Apply multivariate methods to a set of key clinical questions that we have identified as well as to topics in the EPC program as they arise over the course of this application so as to gain empirical insight into their strengths and weaknesses and to demonstrate their contribution to improving comparative effectiveness reviews. 08/02/2010 link
Research Methods NIH EFFECTIVENESS STUDIES WITH SECURELY POOLED HEALTHCARE DATA AND ADJUSTED ANALYSES BRIGHAM AND WOMEN»S HOSPITAL $479,903 This proposal seeks to advance methods for pooling heterogeneous individuallevel electronic healthcare data in order to allow for pooled analyses with full multivariate adjustment with no sharing of private patient data.We will develop and test methods and algorithms for pooling both like and heterogeneous data elements, combining claims information from multiple health care providers and then augmenting these claims with electronic medical record and laboratory values. The methods will be neutral with respect to coding standards and will be robust to heterogeneous database structures. --- We will use the methods to perform three example studies, each of which requires pooled data due to infrequent exposure, small patient subgroups, rare outcomes, or a combination of these. We will explore, both statistically and operationally, when pooling of individual-level data will out-perform aggregate-level meta-analysis, and test the hypothesis that aggregate-level meta-analysis will yield substantially similar point estimates in most scenarios. --- We will publish and provide SAS code for all methods developed, and provide training sessions to relevant groups of researchers in order to broaden the scope and ensure lasting impact of the work performed. This 2-year project will significantly advance methodology for pooling individual-level information from diverse health care databases. 09/02/2010 link
Other AHRQ RAPID CLINICAL SNAPSHOTS FROM THE EMR AMONG PNEUMONIA PATIENTS KAISER FOUNDATION RESEARCH INSTITUTE $0 long term goal is to harness the power of the inpatient EMR for quality monitoring, quality improvement, and the identification of effective practices and interventions designed to prevent in-hospital deterioration. To achieve this goal, we have two specific aims: (1) Using a case-cohort methodology, we will develop models, suitable for embedding in the EMR, to predict the occurrence of critical illness within 72 hours of hospital admission among CAP patients who were not initially admitted to the ICU. (2) Using the results of Specific Aim 1, we will generate time-delimited "snapshots" of the characteristics of CAP patients who did and who did not develop critical illness 08/02/2010 link
Other AHRQ DISPARITIES IN CANCER PREVENTION AND CONTROL UNIVERSITY OF MINNESOTA TWIN CITIES $0 Initially develop a generalizable model that will serve as a framework for incorporating disparities in decision-analytic models. We will focus on disparities in cancer risk, cancer screening participation rates, treatment patterns, and their interactions. We will evaluate several hypothetical situations to highlight those areas where disparities are most concerning. In addition, we will leverage the work that we have already done to develop cohort-specific simulation models to address socially relevant policy questions that disproportionately affect certain segments of the population. We will conduct analyses for questions pertaining to three major cancers: colorectal, cervical and breast. 09/02/2010 link
Other AHRQ THE COMPARATIVE EFFECTIVENESS OF TIME-ADJUSTED TRAUMA CENTER CARE ON MORTALITY UNIVERSITY OF PENNSYLVANIA $0 The specific aims are: (1) to produce valid estimates of prehospital travel time, (2) to complete the first nationally representative analysis of the effect of trauma center hospitals on injury mortality, and (3) to investigate the impact of prehospital time on the relationship between trauma centers and injury mortality. 04/02/2011 link
Other HHS Analytical Support for Comparative Effectiveness Research Inventory and Strategic Framework The Lewin Group $599,458 As the Council attempts to categorize types of CER spending and determine how to spend OS funds to fill gaps, a strategic framework will be essential. This framework should be agreed upon by the Council but an external contractor with knowledge of CER would facilitate development of the strategic framework, especially if the contractor has experience with CER and prioritization frameworks domestically and/or internationally. 06/10/2010 link
Other NIH RESEARCH AND TREATMENT IN COMPARATIVE EFFECTIVENESS, QI AND IND RESEARCH JOHNS HOPKINS UNIVERSITY $489,396 This project is intended to begin to fill the knowledge and policy gap in research ethics created by the increasing integration of research with treatment. Useful policy guidance is critically needed that is responsive to the integrated nature of research and treatment across research approaches, including the three research areas on which this project will focus: " Traditional clinical trials of unapproved drugs/devices; " comparative effectiveness research; " Quality Improvement research. 09/02/2010 link
Other NIH FINE-SCALE RECOMBINATION RATE VARIATION WITHIN AND BETWEEN DROSOPHILA SPECIES UNIVERSITY OF IOWA $898,496 The results of our comprehensive study on how recombination rates vary within populations of Drosophila - a commonly used model system for association studies - will reshape how human WGA are performed and lay out the foundation for a new generation of WGA models and tools. 09/02/2010 link
Other AHRQ CONFLICT OF INTEREST IN CLINICAL PRACTICE GUIDELINE DEVELOPMENT OREGON HEALTH AND SCIENCE UNIVERSITY $0 Many groups produce clinical practice guidelines to help physicians provide the best health care, based on evidence of what works well. If someone involved in preparing these guidelines has a financial relationship with companies that sell medications or equipment related to that healthcare condition, this conflict of interest may interfere with the quality of the guidelines. In this project we will look at different types of conflict of interest, and how these conflicts might affect healthcare recommendations about the control of blood sugar in diabetes. 10/01/2010 link
Other AHRQ HOSPITAL MEDICINE AND ECONOMICS CENTERS FOR EDUCATION & RESEARCH FOR THERAPEUTICS UNIVERSITY OF CHICAGO $0 The purpose of this application is to request support to establish a Center for Education and Research on Therapeutics (CERT) focused on hospital medicine with a major methodological focus on clinical economics. 09/02/2010 link
Other AHRQ DUKE CARDIOVASCULAR CERTS DUKE UNIVERSITY $0 Our Duke CERTs Specific Aims are to: 1. Promote the optimization of professional society-led CV registries as national surveillance systems for evaluating and assuring the safety and effectiveness of CV therapeutics and devices in community based settings; and meeting the informational needs of FDA, CMS, NIH, and AHRQ. 2. Identify specific barriers to both the translation of CV therapeutic and device evidence into routine clinical practice and long-term patient adherence to effective CV therapeutics. 3. Develop and rigorously evaluate patient- and provider-based interventions designed to improve the safe, effective, and efficient use of CV therapies and to improve long-term treatment adherence. 4. Widely disseminate those interventions found to be effective. 5. Train the next generation of CV outcomes researchers. 09/02/2010 link
Other AHRQ CERT COORDINATING CENTER KAISER FOUNDATION RESEARCH INSTITUTE $0 The CERTs program is organized as a network of 11 research centers, each focusing on a broad therapeutic theme. In general, themes represent areas where limited comparative information exists on the risks, benefits, and interactions of newer and older therapeutic agents. The CERTs intend to bring together all the stakeholders in the process of discovering, testing, marketing, prescribing, consuming, and evaluating therapeutics. Working from the organizational context of evidence-driven, capitated, population-based medicine, KP offers an important policy counterbalance to fee-for-service academic medicine. The CERTs' research agenda is also clearly focused on translational science. 09/02/2010 link
Other AHRQ PURSUING PERFECTION IN PEDIATRIC THERAPEUTICS CHILDREN»S HOSPITAL MED CTR (CINCINNATI) $0 our specific aims are to: 1) Create a research core that brings together individuals with broad expertise in evaluation, health services research, quality improvement methods, analysis of large databases, quality of life, chronic illness, and medication adherence and, 2) Develop and implement a range of educational approaches that will result in broad improvements in the use of therapeutics in the pediatric population. 09/02/2010 link
Other AHRQ DEEP SOUTH MUSCULOSKELETAL (DSM) CERTS UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 The specific aims of the proposed Deep South Musculoskeletal (DSM) CERTs are to: 1) Improve safety and effectiveness of MSD therapeutics through four demonstration projects that effectively build on our major research domains of safety and effectiveness evidence generation and translating research into practice: (a) The Alabama NSAID Patient Safety Study, Phase II: Reducing Disparities in Risk Assessment and Communication; (b) Improving Osteoporosis Care for High-Risk Home Health Patients by a High-intensity Intervention; (c) Defining Serious Adverse Events from Biologic Therapies; and (d) Osteonecrosis of the Jaw: An Emerging Threat for Bisphosphonate Users; 2) Educate health care practitioners, insurers, and policy makers while broadening the public health impact of our research and educational portfolio about musculoskeletal therapeutics; and 3) In cooperation with AHRQ, other CERTs, and our network of partners, and building upon the themes, experience, and investigator talent pool of our CERTs, develop seed projects into full proposals that will be submitted to external funding agencies for peer review. 09/02/2010 link
Other AHRQ HMO RESEARCH NETWORK CERT III Harvard Pilgrim Health Care, Inc. $0 The CERT will focus on studies requiring detailed data and/or the ability to engage providers and plan members. It will also provide critical infrastructure support for ongoing DEcIDE (AHRQ) and FDA contracts, and collaborate with the NCI-funded HMORN Cancer Research Network and NIH-funded Clinical Translational Science Centers. 09/02/2010 link
Other AHRQ CENTER FOR EDUCATION AND RESEARCH IN THERAPEUTICS UNIVERSITY OF PENNSYLVANIA $0 The theme of the PennCERT will continue to be infectious diseases (anti-infective therapy) with the following new subthemes (i.e., areas of methodologic focus where we can be a resource for the whole CERT network): 1) pharmacoepidemiology, 2) patient safety, and 3) health information technology. 09/02/2010 link
Other AHRQ Center for Education and Research on Mental Health Therapy RUTGERS THE STATE UNIVERSITY OF NEW JERSEY - NEW BRUNSWICK $0 Work of the cores and projects will be organized around seven initiatives developed in the planning stage as areas of high potential impact for CERTs work: Toward Safer, More-Effective Treatment of Childhood Depression; Balancing Risks and Benefits in Childhood Antipsychotic Use; Guideline Development and Prescriber Training for Better Childhood Mental Health Treatment and Outcomes: A Two-State Initiative; Reducing the Duration Gap to Improve Adult Schizophrenia Outcomes; Improving Psychotropic Use Among Frail Elderly and Adults with Medical Illnesses; Furthering Guideline-Consistent Management of Antidepressant Treatment in Community Adult and Elderly Populations; and Assessing and Addressing Medicare Modernization Act Impacts for Beneficiaries with Mental Illness. 04/02/2011 link
Other AHRQ OREGON MULTIDISCIPLINARY TRAINING PROGRAM IN HEALTH SERVICES RESEARCH OREGON HEALTH AND SCIENCE UNIVERSITY $0 The primary aim of the program is to prepare postdoctoral trainees (clinician-scientists, doctorally-trained health scientists) and predoctoral students for successful academic and scientific careers in the broad field of health services research. We will provide intensive mentored experience in this research and practice in a multidisciplinary environment. 07/02/2010 link
Research Methods AHRQ Request for Registries Academy Health Electronic Data Methods (EDM) Forum for Comparative Effectiveness Research $0 AcademyHealth is pleased to submit to the Agency for Healthcare Research and Quality (AHRQ) this application to convene the Electronic Data Methods (EDM) Forum for Comparative Effectiveness Research (CER) ("EDM Forum"). The EDM Forum will advance methods related to development of the infrastructure and methodology for collecting and analyzing prospective data from electronic clinical data bases for CER. A key task of this initiative is to support investigators conducting the Prospective Outcome Systems using Patient-specific Electronic data to Compare Tests and therapies (PROSPECT) studies, and to assemble relevant stakeholders with an interest in addressing and resolving (when feasible) the infrastructure and methods challenges for these projects. Working closely with AHRQ staff, AcademyHealth will coordinate a series of meetings with key PROSPECT project staff and the EDM Forum Steering Committee, and convene a series of stakeholder symposia. AcademyHealth will also develop and broadly disseminate useful and timely products (needs assessments, issue briefs, papers, reports, and other analytic products) on scientific, clinical, technical, organizational, and data governance topics. AcademyHealth is ideally suited to the tasks outlined by AHRQ for the EDM Forum due to the organization's unique combination of content knowledge in CER and established processes and platforms for convening stakeholders and disseminating information. Equally important, AcademyHealth is a trusted partner among the primary stakeholders identified by AHRQ -- experts in clinical registries, distributed research methods, health information technology and outcomes and effectiveness research; practicing clinicians; and other relevant stakeholders including patients, business leaders and policymakers. By undertaking the convening efforts outlined, developing relevant and timely products, and disseminating EDM Forum and PROSPECT materials widely, AcademyHealth is confident the EDM Forum can successfully support development of the infrastructure and methods needed to ensure a sustainable and scalable foundation for the use of electronic clinical databases for CER over time. 09/02/2010 link
Other AHRQ Comprehensive EPC Comparative Effectiveness Reviews for Effective Health Care Minnesota EPC $6,000,000 Contract HHSA290200710064I: Awardees will 1) Develop and refine topics for CERs that are informative to stakeholder decisional needs; 2) Conduct CERs with systematic and transparent methods; and 3) Identify and explicate future research needs that are important to answering real-world healthcare decisions. 10/27/2012 link
Other AHRQ Comprehensive EPC Comparative Effectiveness Reviews for Effective Health Care Vanderbilt University Medical Center $5,970,037 Contract HHSA290200710065I: Awardees will 1) Develop and refine topics for CERs that are informative to stakeholder decisional needs; 2) Conduct CERs with systematic and transparent methods; and 3) Identify and explicate future research needs that are important to answering real-world healthcare decisions. 10/27/2012 link
Other AHRQ Comprehensive EPC Comparative Effectiveness Reviews for Effective Health Care DUKE UNIVERSITY $6,000,000 Contract HHSA290200710066I: Awardees will 1) Develop and refine topics for CERs that are informative to stakeholder decisional needs; 2) Conduct CERs with systematic and transparent methods; and 3) Identify and explicate future research needs that are important to answering real-world healthcare decisions. 10/27/2012 link
Other NIH ENHANCING THE OBESITY PREVENTION PROGRAM AT HARVARD'S DACP Harvard Pilgrim Health Care, Inc. $701,233 The goal of the proposed NHLBI PSO Core Center is to support Dr. Block's salary and startup research activities along with a pilot grants program. so that the Obesity Prevention Program can expand and intensify its research in health services, health policy, and comparative effectiveness research. 08/02/2010 link
Other NIH CANCER CENTER SUPPORT GRANT (CER INITIATIVES) DARTMOUTH COLLEGE $173,963 Establish a new inter-programmatic Office of Cancer comparative effectiveness Research (OCCER) to further develop Dartmouth CER resources, provide access and expertise for working with Medicare claims data and other major Dartmouth databases, promote application of these capabilities to currently funded cancer research through educational forums, new informatics approaches and statistical methodology development for important issues in CER. 10/01/2010 link
Other NIH COMPARATIVE EFFECTIVENESS AND OUTCOMES IMPROVEMENT (CEOI) CENTER UNIVERSITY OF CALIFORNIA LOS ANGELES $1,864,353 Propose to establish a research center-the California comparative effectiveness and Outcomes Improvement (CEOI) Center-that would support the goals of the RCI while also significantly increasing the available evidence base on the comparative effectiveness of different strategies for improving the primary and secondary prevention of cardiovascular disease (CVD). 08/02/2010 link
Other AHRQ University of Iowa Older Adults CERT UNIVERSITY OF IOWA $0 Aim 1 To establish the infrastructure for an interdisciplinary RC of excellence to conduct and support research and educational initiatives related to health communication for patients and consumers. Aim 2 To develop a comprehensive research program to evaluate methods, application and outcomes of health communication strategies. This aim will be achieved by: (i) Developing the methodological infrastructure to support investigator-initiated efforts in these areas (e.g. assistancewith grant proposals, collaborative efforts, contribution of resources); (ii) Conducting four demonstration projects Aim 3 To establish a Consumer Health Advisory Information Network (CHAIN) to deploy a system for rapid response to emerging therapeutic issues. Aim 4 To disseminate and implement the information developed by the RC. These operationalaims will be achieved through the creation of three cores within the RC: (i) Research and Training Core; (ii) Methods Core; and (iii) Education and Dissemination Core (including CHAIN). 04/02/2011 link
Other AHRQ AHRQ NATIONAL RESEARCH SERVICE AWARD INSTITUTIONAL RESEARCH TRAINING GRANT DUKE UNIVERSITY $0 The objectives of this proposal are to make fellows into excellent health services researchers by 1) offering a didactic curriculum that will teach fellows the fundamental skills required to perform clinical research; and 2) providing the time and outstanding mentorship fellows need to develop their own research ideas and complete their own research projects. Methods. 07/02/2010 link
Other AHRQ UNIVERSITY OF MINNESOTA AHRQ NRSA DOCTORAL TRAINING PROGRAM UNIVERSITY OF MINNESOTA TWIN CITIES $0 This proposal is a request for pre-doctoral training funds for the doctoral training program in Health Services Research, Policy and Administration (HSRPA) at the University of Minnesota in response to RFA HS-08-001. We are requesting a total of 13 slots with the intent of guaranteeing support for five students for their first year and four students for their second and third years. 07/02/2010 link
Other AHRQ ECRI INSTITUTE TECHNOLOGY ASSESSMENT POLICY CONFERENCE 2009 ECRI INSTITUTE $0 The 2010 conference, "Comparative Effectiveness and Personalized Medicine: An Uneasy but Essential Interface," is programmatically linked to ECRI last two conferences on comparative effectiveness. These events are constructed like collaboratively edited books aimed at telling a story behind an emerging issue that is important for policy and practice, and that needs the support of rigorous methodologies to bring evidence into the deliberations. The 2007 and the 2008 ECRI conferences, and the one planned for 2009, all address different, critical aspects of comparative effectiveness. They should be seen as three parts of an effort to provide a fuller understanding of key issues in comparative effectiveness for policymakers and practitioners in the public and private sectors. 12/02/2010 link
Other AHRQ NETWORK FOR JUSTICE HEALTH GEORGE MASON UNIVERSITY $0 The Network for Justice Health Conference will coordinate research on evidence based practices to combat these health disparities, identify high-priority areas of research, and develop open-access dissemination and training tools for decision-makers and care providers. 08/02/2010 link
Other AHRQ TEACHING EVIDENCE ASSIMILATION FOR COLLABORATIVE HEALTH CARE (TEACH) NEW YORK ACADEMY OF MEDICINE $0 The TEACH (Teaching Evidence Assimilation for Collaborative Healthcare) program will provide practitioners in all specialties and disciplines access to skills required to harness the fruits of the very best scientific research for the purpose of improving the health of the public and of individual patients. It offers an innovative approach to creating opportunities within practitioners' own care centers to practice and reinforce skills acquired in an intensive workshop experience. If this model proves to be effective, an entirely new approach to training in scientifically informed medical practice could emerge. 07/02/2010 link
Other AHRQ Generating, Evaluating, and Integrating Evidence for Drug-Drug Interactions in Health Information Technology to Improve Patient Safety: A Multi Stakeholder Conference. UNIVERSITY OF ARIZONA $0 Drug-drug interactions are a preventable medication error but yet millions of Americans are exposed to clinically important interactions each year. The incorporation of evidence for drug interactions into health technology systems is occurring with marginal improvements in safety. The broad and long-term goal of the conference is to improve the DDI evidence base and how it is utilized to ultimately decrease the occurrence of these preventable medication errors. 08/02/2010 link
Other AHRQ EXPERT PANEL MEETING ADVANCING THE SCIENCE OF CONTINUOUS QUALITY IMPROVEMENT RAND CORPORATION $0 Quality improvement intervention practitioners and evaluators seek to improve public health by engaging healthcare organizations and their providers in developing and implementing better approaches to care delivery. This project aims to establish a checklist of key features that, when incorporated into evaluations, will indicate acceptable study and publication quality which in turn will help to assess the existing evidence and allow recommendations to improve public health. A meeting with influential experts and stakeholders and contemporary consensus finding methods are necessary to achieve useful criteria. 07/02/2010 link
Other AHRQ Extended Learning Curriculum for the Cleveland Clinic Orthopaedic & Rheumatology CLEVELAND CLINIC FOUNDATION $0 The educational content of this multidisciplinary conference which is devoted to exploring the current state of the art in the assessment and management of quality in Musculoskeletal Medicine from the perspective of each of the stakeholders in this process will be extended to reach a global audience for a 2 year period by capturing and re purposing selected presentations during the program as an accredited webcast series link
Other AHRQ ANNUAL MEETING OF THE SOCIETY FOR MEDICAL DECISION MAKING UNIVERSITY OF ILLINOIS AT CHICAGO $0 A conference grant to support the Annual Meeting of the Society for Medical Decision Making" For 30 years, the Society for Medical Decision Making and its members have been leaders in the promotion of rational, systematic analysis of clinical decision making to improve individual and public health and health care and inform health policy. The Society and its members have been on the cutting edge of developing, refining and disseminating state-of-the-art methods for assessing health, economic and social benefits, risks and costs of medical interventions and innovations. The annual meeting is the key educational and training activity of the Society. 07/02/2010 link
Other AHRQ HMORN Conference on Clinical Effectiveness WEIS CENTER FOR RESEARCH-GEISINGER CLINC $0 This proposal requests support from AHRQ for the HMO Research Network HMORN Conference to be held April 26 29 2 9 in Danville PA These funds will supplement the support of 25 already received from the Geisinger Foundation as well as 25 that is being sought from NCI to offset costs associated with the conference The HMORN is a collaboration of 5 nationally recognized research programs based within integrated healthcare delivery systems which conduct non proprietary clinical epidemiologic and health services research. link
Other AHRQ SETTING EFFECTIVENESS AND TRANSLATIONAL RESEARCH PRIORITIES TO IMPROVE COPD CARE UNIVERSITY OF CHICAGO $0 The health and economic burden from COPD is growing. Many patients are not benefiting from advances in care identified in clinical trial settings. The proposed consensus conferences will identify and prioritize a research agenda and potential strategies to improve care in real-world, clinical settings. 09/02/2010 link
Other AHRQ CONSUMERS UNITED FOR EVIDENCE-BASED HEALTHCARE (CUE) JOHNS HOPKINS UNIVERSITY $0 Evidence-based healthcare (EBHC) is the integration of best research evidence with clinical expertise and patient values. Patients and consumers can contribute to high quality healthcare by increasing their understanding of critical issues, informed advocacy, and scientist-consumer partnerships. The United States Cochrane Center, in conjunction with Consumers United for Evidence-based Healthcare (CUE) proposes to host a series of conferences related to translating research into practice and policy, with a focus on methodological and technical issues of major importance in the field of health services research, and the target audience will be health consumer advocacy groups interested in integrating understanding and interpretation of EBHC into their advocacy activities. 10/01/2012 link
Other AHRQ CECS SUMMER INSTITUTES IN INFORMED PATIENT CHOICE DARTMOUTH COLLEGE $0 The overarching motivation for the annual SIIPCs is to share intellectual capital, to identify and mentor the next generation of scientists prepared to investigate key basic/applied problems in DS/PtDAs, and to foster collaboration between basic/applied decision scientists in furthering translational research in DS/PtDAs. 09/02/2010 link
Other AHRQ USCC CONFERENCE GRANT JOHNS HOPKINS UNIVERSITY $0 This package of proposed meetings will foster communication among the diverse groups within the US and beyond who are conducting and using reviews to inform EBHC. Increased communication across disciplines will further development of improved designs and methods used to conduct and disseminate results of systematic reviews by bringing together the best methods of each group. To increase the probability of having a direct impact on US healthcare, the USCC will collaborate with the AHRQ Evidence-based Practice Centers and other groups (e.g., Blue Cross Blue Shield, the Centers for Disease Control and Prevention, the US Preventive Services Task Force) conducting and using systematic reviews, who will be invited to serve as conference faculty and as part of the planning process. 08/02/2010 link
Other AHRQ ROCKY MOUNTAIN EVIDENCE-BASED HEALTH CARE WORKSHOP 2007-2009 UNIVERSITY OF COLORADO DENVER $0 In addition to its stated objectives of improving practice and outcomes of care by teaching individual participants the basics of evidence-based practice, the workshop also strives to disseminate information by working with health care systems and diverse professional audiences to facilitate adoption of evidence-based practice on a system-wide basis (translational research). 07/02/2010 link
Other AHRQ GUIDELINE ADHERENCE AND HEALTH OUTCOMES IN MEDICARE FFS PATIENTS WITH DIABETES UNIVERSITY OF WISCONSIN MADISON $0 Unless new information is obtained to modify guidelines appropriately, financial incentives to adhere tightly to recommendations could have perverse effects that might actually diminish the quality of care. Our specific aims are to: (1) examine the relationship between patients' control levels for A1c, LDL, and BP and short-term negative health outcomes (ER visits, hospitalizations, and death), and to determine whether this relationship depends on (2) the presence of comorbid congestive heart failure and chronic kidney disease, and (3) different definitions for assigning patients to providers. 08/02/2010 link
Other NIH CER COLLABORATION: UNIVERSITY OF ARIZONA AND MARINO CENTER FOR INTEGRATIVE HEALTH CHILDREN»S HOSPITAL BOSTON $402,379 To create a model project to establish the protocols, based on previously developed methods, by which clinical research from existing data (perhaps modestly supplemented with new data acquisition) can be envisioned, designed, carried out, and analyzed. The long-term goal of the project is to scale this model up to multiple clinics, cumulating an ever larger and more research-useful database for a broad variety of both disease states and therapeutic approaches, which provides patient-centered evidence-based recommendations that apply to the populations of patients who actually present themselves for medical care. 09/22/2011 link
Other NIH WEBSYSTEM TO INCREASE RESEARCH PARTICIPATION OF UNDERREPERESENTED POPULATIONS WASHINGTON UNIVERSITY $950,662 The ultimate goal of this 2 year NIH-NHLBI RC2 GO Grant (RFA-OD-09-004), "comparative effectiveness", is to develop a web system that facilitates Community Based Participatory Research (CBPR) to identify populations underrepresented in research. 08/02/2010 link
Other NIH STANDARDIZING COMMUNITY CARE COORDINATION MEASURES LINKED TO IMPROVEMENTS IN QUALITY Westat, Inc. $794,445 This project will create new and newly validated measures for assessing the impact of community-based care coordination on health and well-being, as well as begin to build an evidence base. The participating study sites coordinate care for primarily unserved and/or underserved populations. 09/02/2010 link
Other NIH CENTER FOR COMPARATIVE EFFECTIVENESS RESEARCH IN CANCER GENOMICS - CANCERGEN FRED HUTCHINSON CANCER RESEARCH CENTER $2,041,110 We propose to develop a Center for comparative effectiveness Research in Cancer Genomics (CANCERGEN), a sustainable, multidisciplinary, collaborative consortium including the Fred Hutchinson Cancer Research Center, the Center for Medical Technology Policy, University of Washington, and the Southwest Oncology Group, one of the largest of the National Cancer Institute-supported cancer clinical trials cooperative groups in the United States. CANCERGEN will integrate expertise in decision modeling, database linkage, ethics, policy, and clinical trial design in order to leverage and build upon the existing strengths of the SWOG clinical trials network to facilitate the rapid design and implementation of prospective CER studies of GPM technologies. Moreover, CANCERGEN will create a unique and valuable partnership with the Center for Medical Technology Policy, whereby multidisciplinary stakeholders will collaborate with CANCERGEN to identify research priorities. 09/02/2010 link
Other AHRQ CHILD HEALTH SERVICES RESEARCH TRAINING PROGRAM CHILDREN»S HOSPITAL BOSTON $0 In this renewal application, we highlight new initiatives in frontier areas in child HSR including: use of genetic information in pediatrics; IT innovations in personal health records to promote family centered care; comparative effectiveness research using large integrated databases to inform clinical and policy decisions; approaches to improving population health through collaborations among health care and public health systems, payers, and community partners; quasi-experimental methods for evaluating Ql interventions (including initiatives to reduce disparities); and new methods for detecting and preventing harm 07/02/2010 link
Other AHRQ EXPLORING THE INTERSECTION BETWEEN SAFETY CULTURE AND HOSPITAL NURSING PRACTICE UNIVERSITY OF MISSOURI-COLUMBIA $0 Results of the proposed research will advance knowledge about safety and safety culture in hospitals. Specifically, this study will provide information about how nurses keep patients safe in hospitals, as well as how hospitals might improve or strengthen their safety culture to better enable nurses to keep patients safe. 03/02/2011 link
Other AHRQ COMPARATIVE EFFECTIVENESS OF CARE FOR THE INJURED CHILD BY HOSPITAL TYPE CHILDREN»S HOSPITAL OF PHILADELPHIA $0 Therefore, we propose the first in a series of studies looking at the comparative effectiveness of pediatric trauma care by hospital type. In this study, we will examine differences in mortality, on a national level, for injured children cared for at hospitals with varying levels of trauma designation. 10/02/2010 link
Other AHRQ COMPARATIVE EFFECTIVENESS METHODS FOR EVALUATION OF IN-HOSPITAL EXPOSURES BRIGHAM AND WOMEN»S HOSPITAL $0 The aims of this project are to (1) assess hospital variability in use of treatments, specifically as it informs instrumental variable (IV) analysis for CE; (2) develop a linked in- and out-of-hospital database and to evaluate that database's ability to provide confounding adjustment; (3) develop and extend instrumental variable and propensity score techniques; and (4) develop techniques to provide automated confounding adjustment from electronic medical record (EMR) data. Three CVD-related exposures will be considered, two drugs (bivalirudin and nesirtide) and a device (drug-eluting stents). Each will be compared to established treatments 07/02/2010 link
Other AHRQ SEMI-AUTOMATED ABSTRACT SCREENING FOR COMPARATIVE EFFECTIVENESS REVIEWS TUFTS MEDICAL CENTER $0 Propose to build a computerized system that automatically excludes a large number of the irrelevant abstracts, thereby accelerating the process and expediting the application of the systematic review findings to patient care. 08/02/2010 link
Other AHRQ FACTORS IMPACTING STAFF NURSE CARE COORDINATION FOR HOSPITALIZED PATIENTS EMORY UNIVERSITY $0 The purpose of this study is to examine the structure-process link: structural characteristics of hospital patient care units and the process of staff nurse care coordination. The specific aim of this study is to explore the association between the nurses' perceived professional practice environment and the impact of antecedents to that practice environment, on the activities of staff nurse care coordination as perceived by registered nurses on acute care medical-surgical units. 05/02/2011 link
Other AHRQ CREIGHTON RESEARCH INFRASTRUTURE PROGRAM TO ACHIEVE SUSTAINABILITY PROJECT CREIGHTON UNIVERSITY $0 The first research pilot project explores the interactions of community infrastructures, health professionals and consumers. It is a mixed methods study of how consumers receive and use health information and health data in communities. This project is responsive to the HIT, patient safety, prevention/care management and innovations and emerging issues portfolio. The second research pilot project is a comparative effectiveness pilot study of personal health records (PHRs) vs. traditional methods of tracking health information clinical outcomes in patients with diabetes 08/02/2010 link
Other AHRQ FACTORS AFFECTING THE RACIAL DISPARITIES IN SIDS CHILDREN»S RESEARCH INSTITUTE $0 The overall purpose of these investigations, therefore, is to better understand factors contributing to the comparatively high incidence of prone sleep positioning and bedsharing in African American infants. Ultimately, we will use the information gained to develop interventions that are more culturally appropriate and that will better address the concerns of African American families. In order to achieve this, we will address the following Specific Aims: 1) To compare knowledge, attitudes, and practices regarding infant sleep position and bedsharing in African American parents of higher and lower SES. 2) To identify risk factors for bedsharing and non-use of the recommended supine sleep position in African American families with higher SES and lower SES. 3) To develop a phenomenologic understanding of the decisions made by African American parents of higher SES and lower SES who do not use recommended sleep position and location, and how various decisions regarding infant care may relate to and influence other decisions, using qualitative techniques. 07/02/2010 link
Communication of Research Results AHRQ-ASPE Dissemination of CER to Physicians, Providers, Patients and Consumers—Academic Detailing Total Therapeutic Management, Inc. $11,680,060 Building relationships with clinician groups and organizations that can use comparative effectiveness reports to make decisions takes time and involves multiple visits and follow up through additional dissemination and marketing techniques. The three year duration ensures that these relationships will be built in a way that not only encourages these groups and organizations to use the comparative effectiveness research products, but that also has them seek out these products once this contract ends. 09/30/2010 link
Communication of Research Results AHRQ Innovative Adaptation & Dissemination of CER Porudcts: Autism (iADAPT-ASD) University of Southern California $0 We will develop, implement, and evaluate highly interactive and engaging evidence-based interventions for disseminating information about treatments for autism and autism spectrum disorders to over 16,000 individuals in important clinician, parent and teacher audiences. We partner with a social networking site for parents, public school districts and a state healthcare delivery system. Our novel approaches to both content and delivery will enhance the translation of new scientific evidence on ASD therapeutics in an accelerated format and its integration into practice and decision-making in families, the education system, the health care system and public policy. 10/02/2010 link
Data Infrastructure NIH INTERACTIVE EXPLORATION OF TEMPORAL PATTERNS IN ELECTRONIC HEALTH RECORDS UNIVERSITY OF MARYLAND COLLEGE PK CAMPUS $337,534 Specifying useful but more complex temporal queries with SQL or other languages is impossible for most medical researchers, and data mining results are found questionable and hard to interpret as users cannot control the blind mining process and problems with "dirty" data remain unseen and unaddressed. Novel interface designs are needed for 1) interactive query interfaces allowing researchers and clinicians to find data that show temporal patterns of interest in both numerical and categorical data 2) event history operators to align, rank, filter and group by the results visually, allowing researchers and clinicians to see patterns, exceptions, and possibly data quality problems in the data they retrieved 3) powerful comparison tools to explore alternatives (e.g. to conduct comparative effectiveness research), and annotation mechanisms to record findings and prepare reports. 09/02/2010 link
Communication of Research Results AHRQ-ASPE Dissemination of CER to Physicians, Providers, Patients and Consumers—Publicity Center Ogilvy Public Relations Worldwide $17,999,988 The selected firm will create a Publicity Center to market comparative effectiveness research reports and associated materials to specific audiences, including healthcare providers (clinicians) nationwide and healthcare consumers (patients) nationwide. 10/02/2010 link
Communication of Research Results AHRQ-ASPE Dissemination of CER to Physicians, Providers, Patients and Consumers—Regional Dissemination Centers Ogilvy Public Relations Worldwide $8,613,876 The Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services (DHHS) intends to issue a Request For Quote under the GSA Advertising and Integrated Marketing Solutions (AIMS) Federal Supply Schedule, SIN 541-5 (Integrated Marketing Services) to firms who have the capability to assist the Agency in translating and disseminating comparative effectiveness concepts and content. The selected firm would be required to create and operate dissemination and partnership regional offices that would be located in New York, Atlanta, Chicago, Dallas and Denver. 09/25/2010 link
Communication of Research Results AHRQ-ASPE Dissemination of CER to Physicians, Providers, Patients and Consumers—Evaluation IMPAQ International $2,371,179 The Agency for Healthcare Research and Quality (AHRQ) intends to issue a competitive task order against an Indefinite Delivery Indefinite Quantity Task Order with the Planning Evaluation and Analysis Task Order Contracts master contract holders. It is anticipated that AHRQ will award 1 task order. The purpose of this Task Order is to conduct an evaluation of the effectiveness of the various dissemination and implementation approaches undertaken by the Office of Communications and Knowledge Transfer (OCKT) related to AHRQ’s comparative effectiveness research as part of the Effective Healthcare Program (EHC). 09/11/2010 link
Communication of Research Results AHRQ Accelerating Utilization of CE Findings in Medicaid Mental Health Rutgers, The State University of New Jersey, New Brunswick $0 State Medicaid programs play a central role in the provision of mental health services in the U.S., particularly for lower-income youth and adults with severe mental illness, whose mental health treatment is often sub- optimal and varies widely, often without apparent clinical rationale. Building on an existing network partnership, the Network for Evidence Based Treatment (NET) will bring together seven state Medicaid programs accounting for 33% of Medicaid enrollment nationally, together with experts from the Rutgers-Columbia mental health CERTs and other partners, into a consortium that will implement an innovative, multi-component initiative to increase the utilization of evidence-based clinical and delivery system practices in the provision of mental health treatment for beneficiaries of state Medicaid programs. We will put into place in collaborating states an integrated system of quality improvement tools including baseline and follow-up state profiles of use to identify and track variation in treatment patterns; implementation and systematic use of a set of quality metrics and a system of provider feedback utilizing the metrics; and development of a multi-stakeholder quality collaborative, a state quality improvement plan, and a continuous quality improvement process in each state. Results will be evaluated and disseminated nationally; the potential impact is extremely large given the large number of beneficiaries affected. 10/02/2010 link
Communication of Research Results AHRQ Leveraging Practice Based Research Networks to Accelerate Implementation and Diffusion of Chronic Kidney Disease University of Oklahoma Health Sciences Center $0 We propose to facilitate, using evidence-based strategies, implementation of chronic kidney disease guidelines in one practice in each of 32 different communities in four different states. We will then help each of those practices spread the guidelines to two additional practices within those same communities, reaching a total of 96 practices. Strategies will include performance feedback, academic detailing, practice facilitation, IT support, local learning collaborative, and inter-practice site visits. 10/02/2010 link
Communication of Research Results AHRQ Teen Mental Health Project DARTMOUTH COLLEGE $0 The proposed Teen Mental Health program addresses a major public health issue affecting youth. By ages 19-20 twenty-three percent (23%) of youth have had an episode of depression and suicide is nationally the 3rd leading cause of death for 15-24 year olds. Enhanced primary care screening and management can play an important role in prevention and early treatment. 10/02/2010 link
Communication of Research Results AHRQ Comparative Effectiveness of Asthma Interventions Within an AHRQ PBRN CAROLINAS MEDICAL CENTER $0 This project will develop a centralized database for comparative effectiveness research using hospital as well as community data in order to evaluate three interventions implemented with the goal of improving asthma outcomes within 75 practices and 171 schools in North and South Carolina. The interventions will include: (1) an integrated care model with an electronic medical record decision support system, an electronic asthma action plan, links to community resources, and training in practice redesign and rapid cycle process improvement; (2) a shared decision making intervention for underserved community members designed to enhance patient input in the development of the treatment plan and improve self-management; and (3) a school-based intervention lead by school nurses with links to primary care providers. Results from this study and the means to implement the interventions in everyday clinical settings will be disseminated across the state via the statewide AHRQ practice-based research networks and area health education centers. 10/02/2010 link
Communication of Research Results AHRQ Implementing Behavioral Health in Primary Care by Leveraging AHRQ Networks Pittsburgh Regional Health Initiative $0 The research initiative, which is being organized by three CVEs and the Network for Regional Healthcare Improvement, targets depression and substance use, which affects 17.6 million2 and 22 million16 Americans, respectively. The goal is to identify unhealthy substance use and depression in the primary care setting before these chronic diseases become debilitating by removing barriers and introducing strategies, training, and tools to widely disseminate and implement comparative effectiveness research-based models that integrate behavioral health services into primary care-Screening, Brief Intervention, and Referral to Treatment (SBIRT) and Improvement Mood-Promoting Access to Collaborative Treatment (IMPACT). Identifying and managing these behavioral health conditions is critical for increasing physical and social role function, for improving the ability to manage co-morbid physical diseases,5,67,8,15 for reducing the economic costs of untreated behavior health problems,9 and for reducing the current and large treatment gap for people with substance use disorders. 10/02/2010 link
Communication of Research Results AHRQ Innovative Diffusion of Comparative Effectiveness Research UNIVERSITY OF ARIZONA $0 Millions of Americans are treated in hospitals and managed care organizations that have pharmacy and therapeutic (P&T) committees whose primary purpose is to encourage safe and effective prescribing of medications. These committees continually evaluate the evidence to ensure that patients' receive the most appropriate therapy. This proposal provides a strategy to increase awareness and adoption of the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program's comparative effectiveness research (CER) guides by these committees. 10/02/2010 link
Communication of Research Results AHRQ A Low Literacy Multimedia Approach to Disseminate Bilingual Diabetes CERSGs Northwestern University $0 This project is relevant to two public health priorities: eliminating health disparities and improving diabetes self-management activities. Use of a bilingual, low literacy, multimedia health information system has the potential to increase English- and Spanish-speaking diabetes patients' access to comparative effectiveness research findings, to improve their understanding of their diagnosis and treatment, and to lead to better adherence to recommended treatment and follow-up care. 09/03/2010 link
Communication of Research Results AHRQ Medication Summary Guides for Vulnerable Populations with Rheumatoid Arthritis University of California, San Francisco $0 A complex, chronic disease such as rheumatoid arthritis (RA) requires thorough knowledge of the disease and its treatments in order for patients to make informed decisions regarding their care. Despite advances in treatment, some patients continue to have more pain, worse function, and less use of certain drugs; especially patients who are racial or ethnic minorities, those who do not speak English very well, were born outside the U.S., or have less education. The proposed project will advance our current understanding of barriers to providing accurate, interpretable evidence-based information on the effectiveness, efficacy, harms and benefits of RA medications to those patients at greatest risk of poorer outcomes and allow for the successful development of innovative, appropriate summary medication guides and a decision aid tool for vulnerable populations with RA and their rheumatologists. 09/03/2010 link
Communication of Research Results AHRQ A National Academic Detailing Resource to Adapt and Disseminate CER Findings BRIGHAM AND WOMEN»S HOSPITAL $0 AHRQ-supported CER reviews and clinician guides identify best approaches to prescribing, but their impact on care could be far greater if they were more actively disseminated. Academic detailing, built on the techniques of social marketing, is a powerful and proven means of educational outreach to change prescribing practice. We propose creating a national resource center to adapt AHRQ's CER products for AD, as well as create a resource to train outreach educators in implementing this approach. 10/02/2010 link
Communication of Research Results AHRQ The New England RAPiD (Regional Adaptation for Payer Policy Decisions) Project Grant MASSACHUSETTS GENERAL HOSPITAL $0 Project Narrative AHRQ comparative effectiveness research evidence reviews can help meet the needs of state and regional payers by enhancing the application of evidence in payer policy decisions. This proposal would facilitate the dissemination of AHRQ reviews through the creation of the New England Comparative Effectiveness Council and the adaptation of AHRQ reviews by the Institute for Clinical and Economic Review. 08/14/2010 link
Communication of Research Results AHRQ Story Guides--Making Comparative Effectivness Useful for Vulnerable Patients University of Massachusetts Medical School, Worcester $0 StoryGuides - Making Comparative Effectiveness Useful for Vulnerable Patients will develop interactive, culturally tailored, and literacy appropriate interventions to promote use of comparative effectiveness information to vulnerable populations. The intervention will be based on the effective and powerful technique of community-based storytelling, or narrative communication. 09/03/2010 link
Communication of Research Results AHRQ Technologically Enhanced Community Health Worker (CHW) Delivery of Personalized Patient Education Materials University of Michigan at Ann Arbor $0 We propose to develop and evaluate in a randomized controlled trial a computer tailored intervention to assist community health workers (CHWs) or other outreach workers to provide personalized patient education materials on oral anti-hyperglycemic medications and insulin to low-literacy, diabetic African American and English and Spanish-speaking Latino adults with poor glycemic control. 10/02/2010 link
Communication of Research Results AHRQ Translation of Comparative Effectiveness of Depression Medications into Practice Mayo Clinic $0 Routinely, patients with major depression do not have accessible information about the pros and cons of antidepressants, do not participate in choosing the medicine they will take, do not take their antidepressant, and enjoy less than maximum benefit from this treatment. In this study, a multidisciplinary team plans to adapt the available summary of evidence about antidepressants produced by the AHRQ for use as a decision aid -- a tool that helps patients, including those with low health literacy, understand the pros and cons of these medicines. With active participation from patients, clinicians, and other stakeholders, we will develop the decision aid and test its efficacy in primary care. We hypothesize that use of the decision aid will improve patient knowledge about the options, increase the chance that patients will stick to their choice over time by choosing a medicine that better fits with their context and preferences, and improve their depression outcomes. 09/03/2010 link
Communication of Research Results AHRQ Using CERs to Optimize Quality of Life for Persons with Diabetes and Chronic Pain UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 We propose a randomized trial to test a Community Health Worker (CHW) intervention to improve chronic pain and diabetes for patients with pain, diabetes and osteoarthritis in vulnerable, hard-to-reach patients living in Alabama's rural and impoverished Black Belt. The trial will test whether the CHW intervention has greater impact than provider education alone. In the course of the trial, we will examine how five Comparative Effectiveness Reviews can be adapted to best impact clinical decision-making to improve health outcomes. 10/02/2010 link
Other AHRQ The Centers for Education and Research on Therapeutics WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY $0 Our proposal combines the research experience and resources of the Department of Public Health at Weill Medical College of Cornell University with the Hospital for Special Surgery (HSS), the largest and one of the most well-respected orthopedic institutions in the country. The proposed CERT will have particular strength and focus in prosthetic orthopedic devices through HSS, and will add geographic diversity through a partnership with The Methodist Hospital in Houston, Texas. Additionally, the New York Presbyterian Healthcare System, which includes hospitals in highly diverse communities in the NY Metro region, provides a ready laboratory for conducting multi-center studies on therapeutic medical devices, for inclusion of disadvantaged populations, and for dissemination of research findings. 04/02/2011 link
Communication of Research Results ASPE Care Management Technology to Facilitate Depression Care in Safety Net Diabetes University of Southern California $0 09/29/2010 link
Other AHRQ Research Enhancement, Compliance, Orientation, and Resource Development Conference QUEENS HOSPITAL CENTER $0 To bring HHC and academic partners in NYC together to discuss opportunities and methods in specific areas of interest to minority researchers that will help address the quality safety and effectiveness of clinical and health care services among inner city New Yorkers The main theme of the HHC RECORD Conference 2 is to enhance clinical and health services research for inner city minority New Yorkers via collaboration training planning and resource development within HHC minority research staff and academic partners in NYC link
Other AHRQ To develop a plan for molecular imaging comparative effectiveness research SOCIETY OF NUCLEAR MEDICINE $0 The main objective of this meeting is to educate investigators in molecular imaging clinical cancer care and health services research with each other s disciplines particularly as they relate to the use of molecular imaging in cancer patient care link
Other AHRQ 2010 HMO Research Network Annual Conference SCOTT AND WHITE MEMORIAL HOSPITAL $0 The objectives of the conference are to: Communicate and disseminate state of the science research findings with a specific emphasis on translational research focused sessions; 2 Present empirical findings that define the state of the science and stimulate innovation across healthcare research delivery and policy; 3 Define emerging topics and methodologies related to healthcare research and delivery and 4 Advance comparative effectiveness and implementation research via cluster randomized clinical trials formation of collaborative research networks virtual data warehouses and inclusion of diverse populations link
Other AHRQ Quality of Public Health Nursing Care: Prioritizing the Research Agenda UNIVERSITY OF ILLINOIS AT CHICAGO $0 The specific conference objectives are to: examine the quality and safety parameters of PHN interventions and identify gaps in the evidence linking PHN interventions to population health outcomes; 2 prioritize research needed to establish quality and safety standards for PHN interventions and address the identified gaps linking PHN interventions to population health outcomes; 3 specify the methodological and data barriers to understanding the relationships among quality of care safety cost and type of PHN interventions and population health outcomes; 4 recommend strategies to overcome identified barriers to research linking PHN intervention type quality safety and cost with population health outcomes; and 5 disseminate the prioritized research agenda to nursing researchers and public health systems scholars and potential funders including federal agencies and foundations with the objective of health improvement and reduction of health disparities link
Other AHRQ Rocky Mountain Evidence-Based Health Care Workshop 2010-2012 UNIVERSITY OF COLORADO DENVER $0 The Evidence Based Health Care Workshop seeks to impact the practice and decision making of healthcare providers at the individual and system level by teaching strategies for asking questions accessing and appraising research literature for validity and applicability and applying evidence in patient care Such use of the evidence will create better informed practitioners and consumers ultimately leading to higher standards and quality of care link
Other AHRQ VANDERBILT CENTER FOR EDUCATION/RESEARCH ON THERAPEUTICS VANDERBILT UNIVERSITY $0 The Vanderbilt Center for Education and Research on Therapeutics (CERT) is proposed as part of a national collaboration to systematically improve therapeutics. Our theme is Promoting Optimal Pharmacotherapy in Medicaid and Veterans' Health Administration Populations. Within these populations, we will conduct multi-disciplinary research and education programs with our partners that will: 1. Fill critical gaps in the knowledge base through carefully selected studies of drug effects; 2. Optimize therapy by identifying suboptimal practices and conducting educational programs; 3. Evaluate potentially counterproductive policies. 09/02/2010 link
Other AHRQ TOOLS FOR OPTIMIZING PRESCRIBING, MONITORING AND EDUCATION UNIVERSITY OF ILLINOIS AT CHICAGO $0 the TOP-MED CERT will pursue the following specific aims: 1. Revitalize the drug formulary as an evidenced based tool for directing drug therapy decisions. 2. Re-engineer drug usage review (DUR) systems and processes so that data analysis is easier, more timely and more likely to yield valid generalizations. 3. Reduce prescribing errors and enhance recognition of adverse drug effects in high hazard contexts by linking lab and pharmacy information systems and generating clinical alerts when problems are detected. 4. Develop, deploy and evaluate an N-of-1 trial service, integrated into a formulary restriction program, in order to support the goal of individualized therapy without succumbing to the unsafe, unscientific experimentation that is often now the norm. 5. Implement and study the impact of pharmacoeconomic support to enhance formulary decision making, as well as evaluate the cost-effectiveness of other interventions. 09/02/2010 link
Data Infrastructure CMS Medicaid Analytic Extracts (MAX) Data Warehouse to Support Comparative Effectiveness Research (CER) Buccaneer $10,249,783 MAX Data Warehouse objectives: Establish a MAX data warehouse and load MAX 1999-2006 data. Add additional years of MAX data as they become available. Build a data extraction system to deliver customized MAX data extract files with minimum data necessary to the research community. Support CER researchers by providing MAX data. 06/27/2012 link
Data Infrastructure AHRQ Clinically Enhanced Multi-Purpose Administrative Dataset for Comparative Effectiveness Research University of South Florida $0 The paucity of critical comparative cost-effectiveness information to assess intervention options that will enable care providers, consumers, decision-making parties as well as other stakeholders to make informed decisions and choices on available alternatives could hamper the realization of the potentially accruable benefits of the new health care reform. The state of Florida suffers from a very costly health care system with global annual health care expenditure growth, personal health care and per capita health care expenditures that exceed the national average. The virtual absence of reliable and rigorously validated large, clinically enhanced administrative databases statewide hinders the ability of public health and other researchers to offer evidence-based data that could inform decision-making and improve efficient utilization of health care resources in the state. It is for this reason that the project in this grant proposal is capital for the state because it envisages filling this gap, which is a necessary step if Florida is to succeed in achieving a cost-effective and efficient health care delivery system in the future under the newly enacted national health care reform. The 09/22/2013 link
Data Infrastructure NIH SEARCH: CANCER SCREENING EFFECTIVENESS AND RESEARCH IN COMMUNITY-BASED HEALTHCARE GROUP HEALTH COOPERATIVE $40,421 Improvements in cancer screening effectiveness, higher participation rates and faster introduction of new screening tests could have pronounced effects on the health of the community by reducing cancer burden. Cancer screening effectiveness in real-world settings depends not only on the efficacy of individual tests but also on patients, health care providers, and the systems and context in which health care is delivered. Large and well defined populations of enrollees with diverse data sources are fundamental for comparative effectiveness research that addresses health policy questions about cancer screening delivery. In response to the Grand Opportunity (GO), we propose to create an innovative and sustainable multi-disciplinary and multi-institutional virtual center for cancer SEARCH: Screening Effectiveness And Research in Community-based Healthcare within the NCI-funded Cancer Research Network (CRN). Because SEARCH is set in CRN-affiliated health care delivery systems across the United States, it will benefit directly from the strong foundation of an existing and well-established network of NCI-funded research infrastructure. An innovative portion of SEARCH will be our ability to translate and disseminate of our findings directly into practice. We have identified and engaged a national Advisory Board of cancer screening experts and have proposed a new collaboration with the Cancer Intervention and Surveillance Modeling Network (CISNET). Together, we will pursue high priority comparative effectiveness research (CER) that has relevance to clinicians, patients, policy makers, payers, public health practitioners and medical associations. link
Data Infrastructure NIH CONTEMPORARY TREATMENT AND OUTCOMES FOR ATRIAL FIBRILLATION IN CLINICAL PRACTICE KAISER FOUNDATION RESEARCH INSTITUTE $40,390 Aim 1: Develop and test novel risk stratification schemes for thromboembolism (ischemic stroke and systemic thromboembolism) in patients with atrial fibrillation from a large-scale community-based cohort and additionally validate the resulting risk models against rich datasets from randomized clinical trials in atrial fibrillation. Aim 2: Establish and characterize a contemporary registry of incident atrial fibrillation within very large, diverse community-based populations to provide critical insights into current outcome event rates and practice patterns, potential health disparities, and to facilitate more rapid enrollment into future effectiveness studies and clinical trials as well as development of improved risk stratification models. Aim 3: Identify and validate optimal design and analytic approaches to reduce confounding and bias for comparative effectiveness analyses (e.g., different antithrombotic strategies) in observational studies of patients with atrial fibrillation. PUBLIC HEALTH RELEVANCE: Atrial fibrillation is the most common clinically significant arrhythmia in adults and one of the most potent risk factors for ischemic stroke and other systemic throm-boembolism. It currently affects millions of Americans and its prevalence is expected to increase substantially during the next several decades. While multiple strategies have been developed to reduce the risks of atrial fibrillation-related adverse events, existing risk stratification schemes are of limited clinical utility in guiding treatment decisions. Furthermore, few data exist about the comparative effectiveness of different therapies in clinical practice. The proposed study will provide a critical set of research resources to improve risk prediction, facilitate more valid comparative effectiveness analyses, and streamline the planning and conduct of future randomized clinical trials in atrial fibrillation. link
Data Infrastructure NIH HIGH-THROUGHPUT GENETIC ANALYZER UPGRADE FOR COMPARATIVE POPULATION GENOMICS YALE UNIVERSITY $92,429 Upgrading our equipment will allow us to effectively serve increasing demands from several research laboratories with NIH funded projects. This group of scientists' works within a diverse array of health related fields with well-established track records using DNA based approaches. Although there is a larger DNA Sequencing core facility on campus, DAFSH provides services, such as microsatellite analysis, which are not available in any other core facility at Yale or in the surrounding area, catering to small and medium sized laboratories. The infrastructure for successfully managing current equipment is well established with experienced personnel dedicated to its operation and maintenance ensuring its longevity. The facility is directed by an NIH sponsored investigator and it is located within her laboratory, which serves also as a research and training facility sponsored by the Yale Institute for Biospheric Studies (YIBS). This ensures on-site experienced help that provides troubleshooting and training of new users, if needed. 05/02/2010 link
Data Infrastructure NIH SEVERITY SCALE AND QUALITY OF LIFE INSTRUMENT FOR INFANTILE HEMANGIOMAS Indiana University-Purdue University at Indianapolis $268,981 This application addresses broad Challenge Area (05) Comparative Effectiveness Research and specific Challenge Topic, 05-AR-102: Comparative Effectiveness (CE) of Treatments for Chronic Childhood Arthritis and Musculoskeletal (MSK) and Skin Disease. Infantile hemangiomas (IH) are the most common tumor of infancy, occurring in 1-5% of the children, yet no FDA approved treatments exist. The primary objective of this proposal is to develop a research platform to develop (1) standardized nomenclature for disease severity and (2) instruments to measure response to therapy to guide the design of studies. This objective will be achieved by first creating a research infrastructure, the Hemangioma Investigator Group Research Core (HIG-RC), to provide support in the areas of research design, implementation, and data interpretation. 09/02/2010 link
Data Infrastructure CMS Research Data Assistance Center: Develop Enhanced Chronic Condition Warehouse Customer Service Training University of Minnesota $1,999,881 This effort will allow the contractor to enhance customer service and training to the research community. This modification will require the contractor to provide the same quality and level of services to other federal agencies who want to learn how to use CMS data for projects relating to Comparative Effectiveness Research (CER). In summary, this modification will enhance ResDAC's help desk, training, and outreach functions designed to familiarize researchers in how to obtain and use CMS data for CER. It will encompass the provision of technical assistance and education to all other federal agency employees via a ResDAC maintained website, a knowledgeable Assistance Desk team, and academic faculty and staff who will provide outreach to the research community at national conferences. link
Data Infrastructure AHRQ Clinically Enhanced State Data Social & Scientific Services, Inc. $932,366 Modification to an existing Contract with Social and Scientific Services using ARRA funding. This Modification is for Technical Assistance to Enhance State Data. This opportunity is available to the current contractor under the HHSA290-2009-0010C Contract, which was previously competed and awarded in 2009. link
Data Infrastructure AHRQ COMPARATIVE EFFECTIVENESS OF PREHOSPITAL AND HOSPITAL EMERGENCY CARE RUTGERS THE ST UNIV OF NJ NEW BRUNSWICK $0 Patients with critical conditions such as cardiac arrest or major trauma often depend on prehospital emergency medical services (EMS) for life-saving care. Nevertheless, the evidence base for that care, particularly as it relates to transitions between prehospital and hospital settings, is extremely limited. These transitions are poorly understood because data linking prehospital and hospital services are lacking. Without linked data, many important questions about the effectiveness of emergency care systems and protocols cannot be answered. This project will create a data infrastructure for comparative effectiveness research (CER) that bridges prehospital and hospital care using newly available electronic patient care records for prehospital EMS transports in New Jersey (Specific Aim 1). These data will be linked to all-payer hospital discharge abstract data and death certificates to support a wide range of comparative effectiveness studies on patient- and system-level interventions where prehospital and hospital services are tightly connected. 10/01/2013 link
Data Infrastructure AHRQ Hawaii Hospital Information Content Queen»s Medical Center $0 The interest in comparative effectiveness research (CER) is based on the belief that more informed decisions about the use of health care resources could improve the public's health and reduce the costs of care. Although CER encompasses a broad range of methodologic approaches and data sources, the goal of this proposal is to develop the capacity to perform CER by enhancing the breadth and scope of data contained within a statewide, all-payer Hospital discharge and emergency department data set in Hawaii - the state that has the nation's most racially diverse population, the longest life expectancy, the longest experience with employer-mandated health care benefits (over 35 years), and one of the lowest Medicare costs per beneficiary. 10/02/2010 link
Data Infrastructure AHRQ Improving Data & Enhancing Access (IDEA) Northwest Portland Area Indian Health Board $0 Correctly assessing the health status of American Indians/Alaska Natives (AI/AN) and other minority populations is complicated by the fact that public health data sources often fail to capture accurate race information. Using the most complete roster of Northwest AI/AN available, the improving data & enhancing access-Northwest (IDEA-NW) Project will complete probabilistic record linkages with external datasets in a three-state region to identify and correct inaccurate race data for AI/AN. Repeating these linkages at regular intervals will allow for an evaluation of the extent of racial misclassification in these data systems over time, and provide measures of the project's success in these mitigating errors. The result will be improved ascertainment of true rates and trends in specific health conditions affecting Northwest AI/AN, informing local and regional efforts to eliminate health disparities. 10/02/2010 link
Data Infrastructure FDA Building FDA CER Clinical Data and Standards Infrastructure, Tools, Skills, and Capacity: Legacy Data Conversion SCENPRO, Inc. $5,947,450 The Food and Drug Administration (FDA) intends to solicit proposals under solicitation number RECOVERY- ARRAOS: 10-223-SOL-00105 for an initiative called “Legacy Data Conversion Services.” Certain legacy study data that currently resides at FDA in a myriad of different formats must be converted into an electronic uniform standard structure to facilitate answering important scientific and regulatory questions of interest to promote the public health. The requirement will provide services to convert legacy study data to a standard format identified by FDA {format to be identified on a case by case basis and may include Clinical Data Interchange Standards Consortium (CDISC; www.CDISC.org) Study Data Tabulation Model (SDTM), Standard for Exchange of Nonclinical Data (SEND), Analysis Dataset Model (ADaM), and the CDISC-HL7 (Health Level 7; www.HL7.org) standards}. The contractor shall work with FDA to harmonize variable names and terminology as needed to allow analysis across multiple studies. The requirement will also support the advancement of current standards and support the development of new standardized values for domain data by ensuring alignment to the appropriate standard development organization (SDO; e.g. CDISC, HL7). 09/17/2010 link
Data Infrastructure AHRQ New Mexico Race and Ethnicity Data New Mexico State Department of Health $0 New Mexico Department of Health and the Health Policy Commission will improve the quality of Race and Ethnicity Data in hospital discharge and emergency department Databases in New Mexico. In addition, the project will collect tribal identifier Data and establish methods and procedures for tribal identifiers as a model for other states. The New Mexico administrative code will be revised to require that hospitals report Race and Ethnicity Data, consistent with the 1997 Office of Management and Budget standard, and tribal identifier Data to the State. Under the guidance of a state advisory committee, 5 10 pilot hospitals will field test the training materials that will be developed for the project. These will include hospital procedure, Data collection, patient education and train-the-trainer materials. Once the pilot hospitals have begun reporting Race and Ethnicity Data from hospitalizations successfully using these New methods, reporting will be expanded to all other non-federal hospitals. And once hospitalization Race, Ethnicity and tribal identifier reporting is well underway, reporting of Race, Ethnicity and tribal identifier will commence from emergency departments. Hospital specific compliance plans will be developed and modified to assure improvements in each hospital's Data. Evaluation of this New approach in New Mexico will be focused on several complementary methods. Chart reviews at pilot hospitals will help determine if the New approach to Race, Ethnicity, and tribal identifier reporting has been adequately implemented. If not, procedures will be revised as necessary. Linkage of electronic hospital discharge records with birth certificate records and Indian Health Service records periodically will track improvements in the reliability of Race, Ethnicity and tribal identifier Data. And phone calls to hospitalized persons following discharge to compare their Race, Ethnicity and tribal identifier by self-report with hospital records will track improvements in the validity of these Data. Dissemination of these New methods to other states will be critical to the success of the project. New Mexico expects to have established a model for the collection, reporting and appropriate dissemination of tribal identifier Data included in hospital Data which will be disseminated to other states informally and through a published manuscript. The field tested Data collection materials, patient education materials and training modules developed by the project will also be disseminated to other states. 10/02/2010 link
Data Infrastructure AHRQ Using Clinically-Enhanced Claims Data to Guide Selection of Coronary Procedures New York State Department of Health $0 The goal of this research program is to examine the comparative effectiveness of Coronary artery bypass graft (CABG) Procedures and percutaneous Coronary artery interventions (PCI). This will be done by clinical enhancement of the New York State's Statewide Planning and Research Cooperative System (SPARCS) acute care hospital discharge Database with hospital numerical laboratory Data. Laboratory Data will permit refinement of patient risk adjustment, provide full accountability of complications, and validate the accuracy of present-on-admission coding. Complete Data sets from hospitals recruited into the project will allow analyses of 1) factors that influence whether Coronary artery revascularization is performed by open surgical intervention or percutaneously, 2) short-term and long-term clinical outcomes of each chosen intervention by subsets of patients and subsets of hospitals, and 3) how alterations in Selection of patients, Procedures, and sites can improve short-term and long-term clinical outcomes of patients undergoing the different treatment options. Clinical outcomes will employ risk adjusted mortality rates, risk-adjusted length of stay in acute hospital facilities, and readmission/emergency department visits within 30 days of the index procedure. Precise risk adjustment will allow patient-level propensity matching models to be used, and clinical outcomes assessment can then be used for evaluation of hospital effectiveness. Year 1 will be invested in recruitment of participating hospitals and laboratory Data enhancement of the SPARCS Database, Year 2 will be used for refinement of protocols and initial analyses of Data, and Year 3 will be devoted to final analyses with published reports and presentations. Results of these analytical evaluations can then be employed to provide feedback to providers so that optimum treatment strategies can be adopted for improved patient care using the comparative effectiveness paradigm. 10/02/2010 link
Research Methods AHRQ Comparing the Effectiveness of Diabetes Care Interventions in Safety Net Clinics UNIVERSITY OF CALIFORNIA LOS ANGELES $0 Despite the large disease burden of diabetes, very little is known about the comparative effectiveness of interventions aimed at improving the quality of diabetes care in community clinics and health centers (CCHCs) that serve vulnerable patient populations. The effectiveness of interventions like pharmacist-led medication management and nurse case management has been demonstrated, but the broad uptake of these approaches for improving diabetes care quality is not financially feasible for most CCHCs. The proposed project aims to compare the effectiveness of medical assistant panel managers and community health outreach workers- two relatively low cost interventions aimed at improving the quality of diabetes care in CCHCs, and to examine the organizational facilitators of intervention effectiveness. 10/02/2010 link
Research Methods AHRQ A Comparison of Provider Versus Health Plan Delivered Care Management in Michigan Michigan State University $0 Nearly one out of every two American adults has at least one chronic illness. Research has shown that care management services can improve chronic disease patient outcomes; however, it is unclear which health care entity is best positioned to provide the most cost-effective patient benefits. This study will compare provider- delivered care management (PDCM) to health plan-delivered care management (HPDCM); seeking to determine the comparative effectiveness of these two approaches on patient participation in care management, clinically relevant health indicators, and healthcare utilization. 10/02/2010 link
Data Infrastructure CMS-ASPE Strategic Design of Creation of an All-Payer, All-Claims Database Avalere Health LLC $1,013,374 The American Recovery and Reinvestment Act (ARRA) created a Federal Coordinating Council (FCC) for Comparative Effectiveness Research (CER) and charged it with developing recommendations on how t invest funding appropriated to the Secretary for comaprative effectiveness research. The Council recommended, and the Secretary agreed, that a robust longitudinal claims infrastructure to support CER was critical. There exist a number of databases with longitudinal claims data that could facilitate analysis of such data for CER purposes. Each, however, has limitations in its application to CER. The Centers for Medicare and Medicaid Services (CMS) Integrated Data Repository (IDR), Chronic Conditions Warehouse (CCW), and Medicaid cliaims files (MAX) databases include data only on the Medicare and Medicaid populations; state-based all-payor, all-claims databases are limited geographically in scope and by variability in infrastructure design and state capabiliity; private databases may include information on a more demographically diverse population, but are still fragmented and often accessible to researchers due to cost. An all-payor, all-claims database would allow for greater power in analysis, ensuring taht the data infrastructure the Secretary supports will be able to produce robust analysis. If developed well, this database would be a representative sample of the population and could be built upon over time. The public commentary at FCC listening sessions affirmed the value of an all-payor, all-claims database. Claims data, especially if established in a manner where it can be linked to other data over time, can be a powerful tool for CEr and ultimately improve care for all Americans. Given the breadth of potential options for building an all-payor, all-claims database and the significant investment required to do so successfully, the awarded contract is for a targeted design study to inform the creation of such a database and supporting services, methods, and skills. Additionally, the awardee may be involved in supporting tranistion to an implementation of such a database under the contract. 01/23/2010 link
Data Infrastructure CMS-ASPE Leveraging Health Data for Rapid Comparative Effectiveness Analysis Pilot Test Thomson Reuters (Healthcare) $776,609 The Office of the Assistant Secretary for Planning and Evaluation intends to issue two competitive task order contracts, entitled “Leveraging Health Data for Rapid Comparative Effectiveness Analysis Pilot Test”, using the GSA Mission Oriented Business Integrated Services Contracts, Group 70. These two contracts are part of the Office of the Secretary comparative effectiveness research (CER) portfolio from the American Recovery and Reinvestment Act. The purpose of these two contracts is to pilot test the ability to link healthcare data and utilize next generation analytical applications to query the data. This pilot test, if successful, would substantially increase the yield of database investments and other Federal data resources. The Federal government seeks to establish a rapid-prototyping environment to pilot test the potential to link health care data. It also seeks to utilize next generation analytical applications to answer specific CER questions. 06/04/2010 link
Data Infrastructure CMS-ASPE Leveraging Health Data for Rapid Comparative Effectiveness Analysis Pilot Test Vexcel Corporation $398,289 The Office of the Assistant Secretary for Planning and Evaluation intends to issue two competitive task order contracts, entitled “Leveraging Health Data for Rapid Comparative Effectiveness Analysis Pilot Test”, using the GSA Mission Oriented Business Integrated Services Contracts, Group 70. These two contracts are part of the Office of the Secretary comparative effectiveness research (CER) portfolio from the American Recovery and Reinvestment Act. The purpose of these two contracts is to pilot test the ability to link healthcare data and utilize next generation analytical applications to query the data. This pilot test, if successful, would substantially increase the yield of database investments and other Federal data resources. The Federal government seeks to establish a rapid-prototyping environment to pilot test the potential to link health care data. It also seeks to utilize next generation analytical applications to answer specific CER questions. 06/04/2010 link
Data Infrastructure CMS-ASPE Implementation of an All-Payer, All-Claims Database Ingenix Public Sector Solutions $16,436,482 The overall purpose of this project is to build and operate a multi-payor claims database (MPCD) to support Comparative Effectiveness Research (CER) using Medicare, Medicaid and private payor claims data and to enable access to the database for researchers who seek to use it to improve the public's health. 09/16/2010 link
Data Infrastructure FDA Building FDA CER Clinical Data and Standards Infrastructure, Tools, Skills, and Capacity: Modern Analytic Tools Implementation (Servers) Red River Computer Company $707,077 Pursuant to FAR 5.7, the United States Food and Drug Administration (FDA) is posting this notice for informational purposes only. The FDA intends to use AMERICAN RECOVERY AND REINVESTMENT ACT funds to purchase four (4) servers. The purchase will include the components integrated into the servers, the software that runs the servers, and related hardware and software support/maintenance agreement. FDA is buying this equipment to support its Comparative Effectiveness Research (CER) initiative. FDA plans to procure these goods under the NASA SEWP GWAC. 06/19/2010 link
Data Infrastructure FDA Building FDA CER Clinical Data and Standards Infrastructure, Tools, Skills, and Capacity: Modern Analytic Tools Implementation (Servers) CNI Information Technology, LLC $180,539 Pursuant to FAR 5.7, the United States Food and Drug Administration (FDA) is posting this notice for informational purposes only. The FDA intends to use AMERICAN RECOVERY AND REINVESTMENT ACT funds to purchase security infrastructure needed to provide a secure enclave for its modern analytical tools environment. FDA is buying this equipment to support its Comparative Effectiveness Research (CER) initiative. The purchase will include 1 year warranty and maintenance package for the hardware and associated software. FDA plans to procure these goods under the CNI Information Technology, LLC IDIQ base contract to ensure compatibility with existing security FDA security infrastructure. 09/12/2010 link
Data Infrastructure AHRQ Surgical Care and Outcomes Assessment Program Comparative Effectiveness Research UNIVERSITY OF WASHINGTON $0 The Surgical Care and Outcomes Assessment Program (SCOAP) is a voluntary, performance surveillance, sharing and feedback platform derived from clinical records. SCOAP improves quality by increasing adoption of evidence-based process of care measures and performing "real world" comparative effectiveness research (CER). In just four years, SCOAP was deployed across nearly all statewide hospitals. Versions of SCOAP exist for cardiac care, general surgical care, pediatric surgical care, and now vascular interventions (VI- SCOAP) for peripheral vascular disease. As a platform for both CER and improved adoption of CER-informed process of care measures for clinical quality improvement (QI), SCOAP is currently limited in scale by a lack of automated data gathering, linkage between data streams and connections to post-discharge and patient reported outcomes. Drawing information out of these different systems and linking them to other data sources for CER or QI requires an information technology solution that can interact with all available data systems and all types of data. We propose to deploy Amalga UIS" across the SCOAP Network to address the problem of inter-system connectivity by linking data systems in a common, framework. Amalga UIS" deployment within SCOAP will create automated data retrieval from each participating hospitals' varied electronic sources, doctor's offices and outpatient data streams. We will link automated clinical data with to administrative claims to track for all subsequent hospitalizations, vital status records for survival outcomes, healthcare payer claims datasets for outpatient encounters and medication utilization data, and point-of-care, longitudinal patient reported outcomes. The resulting SCOAP CER Translation Network (CERTN) will facilitate efficient CER as well as support SCOAP's QI initiatives around CER-driven process of care metrics. We will demonstrate the usability of the SCOAP CERTN Project for research and improved adoption of CER-informed process of care by using VI-SCOAP and comparing the treatment strategies of peripheral arterial disease and addressing procedural safety. Leveraging existing strengths of the SCOAP network and the VI-SCOAP registry with Microsoft's partnership, we propose several enhancements to improve our capability and scalability for longitudinal clinical and patient reported outcomes data collection. The SCOAP CERTN project will be a large-scale, real-world resource for CER based on clinical data using an automated data retrieval stream from diverse healthcare settings. This will greatly enhance existing SCOAP QI by delivering more comprehensive and timely data, and in relieving manual staff and resource burden to participating hospitals. SCOAP CERTN's initial CER focus will be in vascular surgery and interventions, but the project will be a gateway for investigators from all clinical disciplines to evaluate clinical outcomes, cost-impact, PROs and to translate evidence into QI. Importantly, surgical and interventional services span the continuum of healthcare conditions and SCOAP CERTN will have immediate capacity for investigators interested in almost any of AHRQ's priority conditions. 10/02/2010 link
Data Infrastructure CDC Enhancing Cancer Registry Data Systems for Comparative Effectiveness Research Macro International, Inc. $18,961,389 The purpose of this task order is to conduct activities to establish Specialized Cancer Registries to enhance data collected through a subset of population based central cancer registries for comparative effectiveness research. Activities include data collection, methodological development and pilot testing activities with the goal of enhancing cancer registry data for clinical follow-up. Outcomes will include a data set to be used for comparative effectiveness and other research. This data set will provide a unique set of data items in a single data set. Data from these funded activities will be made available for researchers through an established National Center for Health Statistics Research Data Center (RDC). The use of the RDC will allow CDC to protect the data as required by state laws authorizing the collection of cancer diagnoses and treatment data and CDC's Assurance of Confidentiality; and protect the confidentiality of patients whose data are included in the data set. It is anticipated that updates to the data will also be available through the RDC. American Recovery and Reinvestment Act (ARRA) terms, conditions and reporting will be applicable to the work under this project. 05/05/2010 link
Data Infrastructure AHRQ Registry of Registries Outcome Sciences $4,997,998 The Agency for Healthcare Research and Quality (AHRQ) intends to issue a competitive task order against an Indefinite Delivery Indefinite Quantity with the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Network. It is anticipated that AHRQ will award 1 task order. The major objective under this request for task order is to define and develop a Web-accessible Registry of Patient Registries (RoPR) system that links various data components for various stakeholders. The task order is funded through the American Recovery and Reinvestment Act of 2009. 10/02/2010 link
Data Infrastructure FDA Quality Assurance Support for the Janus Software Development Project and the Janus Phase 3 Infrastructure Development and Implementation for FDA SAIC-Frederick, Inc. $6,646,000 The scope of this project is to acquire Subcontractor support to provide Quality Assurance (QA) support for the Janus software development project; Janus Infrastructure Development and Implementation for FDA ARRAOS (Janus Phase III) and whose main scope and objectives are described below for context. The work includes comprehensive testing and QA support for all aspects and phases of the Janus Phase III project. Application functionality testing and testing of interfaces to other systems, as well as, relevant Enterprise Services in the caBIG Service Portfolio. A more specific project service list will grow throughout the project lifecycle, and is being added to project documentation and deliverables accessible at https://gforge.nci.nih.gov/projects/janus-iii/, and is within scope of this request. 07/15/2010 link
Data Infrastructure AHRQ Scalable PArtnering Network for CER: Across Lifespan, Conditions, and Settings KAISER FOUNDATION RESEARCH INSTITUTE $0 The Scalable PArtnering Network for CER: Across Lifespan, Conditions, and Settings, or SPAN, will develop a distributed research network that is interoperable across a range of health care systems and sites, incorporating large and diverse patient populations. The network infrastructure will have the capability to conduct large comparative effectiveness research (CER) studies using data collected on patient-reported outcomes collected at the point of care and real-time data collection. Furthermore, we address the important issue of governance to oversee all aspects of managing and conducting research with confidential health information. SPAN will leverage previous AHRQ support of the development of the DEcIDE Distributed Research Network to create the expanded and enhanced network suitable for conducting comparative effectiveness research (CER), compatible with AHRQ's mission to improve the quality and effectiveness of health care. One particularly unique feature of the SPAN network is the incorporation of integrated and less-integrated (community) health systems-an addition that poses potential data management challenges that are vastly outweighed by the benefits of adding diverse patient populations to distributed research networks. If this pilot effort on expanding across types of health systems is successful, we would propose future expansion of this feature. We selected initial cohorts for development that not only present opportunities for comparative effectiveness studies of treatments and processes of care, but that lend themselves to expansion for further cohort development-across AHRQ priority conditions and populations, different sites, and increased complexity of descriptive and treatment variables. Thus, the current proposal sets the stage for significant future CER by developing a network with the capacity to extract diagnostic, treatment, descriptive, and process of care data on more than 7.3 million individuals, the ability to grow and diversify, and the governance infrastructure to proactively address the complex issues that inevitably accompany investigations dependent on healthcare data. Results from research conducted with cohorts derived from this network will inform care delivery on individual levels as well as policy- level decisions on healthcare funding and reform. 10/02/2010 link
Data Infrastructure AHRQ SCANNER: Scalable National Network for Effectiveness Research University of California, San Diego $0 We will develop a distributed network infrastructure for comparative effectiveness research that provides flexibility to participant sites in the means for data sharing. This flexibility will be implemented by allowing codification of data sharing policies - each institution will specify its own policies. The SCAlable National Network for Effectiveness Research (SCANNER) will connect diverse healthcare delivery settings with secure infrastructure that utilizes data collected at the point of care. Policies for data sharing will range from sharing of de-identified records to sharing aggregate results. Within this broad range, policies can be fine-tuned (for example, different levels of sharing for those with whom there is a DUA). When the policy specifies that data must remain at an institution, the network still could allow users outside that institution to execute queries that return summary results from simple patient counts or complex statistical procedures. The network will have a main node that manages policies, distributes queries, aggregate results, and maintains trust and security (authentication, authorization, auditing, etc). Each site will maintain a node that contains data from that site. The network will support (1) retrospective analyses, (b) prospective observational studies, (c) clinical trials, and (d) feedback to point-of- care users. Near real-time collection, analysis, dissemination of results, and feedback to the clinician will be enabled by an infrastructure that allows data to be exchanged according to policies specified by individuals and institutions. The network can scale because it is not dependent on a single trust management provider or data model, but is managed instead by a broker that assigns defined roles to selected entities. The specific aims of this project are to (1) develop and encode policy models based on multiple stakeholders, (2) implement a scalable and secure network and analytical tools that operates across multiple settings and different IT vendors, and (3) demonstrate the use of this network by collecting data on 4 pairs of cohorts. The particular Comparative Effectiveness Research studies that will be demonstrated relate to (1) the effectiveness of co-management by pharmacists-clinicians for patients with (a) diabetes, and (b) hypertension, and (2) the effectiveness of new antiplatelet (prasugrel) and antithrombotic agents (dabigatran) as compared to their standard counterparts clopidogrel and warfarin, respectively. 10/02/2010 link
Data Infrastructure HRSA ARRA-CHARN Central Data Management Coordination Center: Building Effectiveness Research Capacity through a Health Center Network Association of Asian/Pacific Community Health Organizations $0 The Community Health Applied Research Network (CHARN) is being established in response to the funding opportunities made available under the Recovery Act for Comparative Effectiveness Research (CER) Data Infrastructure. The CHARN will be comprised of four Research Nodes and a Central Data Management Coordinating Center (CDMCC). Research Nodes are health center-led consortia of safety net providers in partnership with one or more academic institutions and will be funded through four separate cooperative agreements. This funding announcement is for four Research Node Centers to support the four Research Nodes. Each Research Node Center will serve as the coordinating arm of the Research Node and will maintain a research partnership with the other affiliate organizations within the Research Node. Support for the Research Node will include arranging and managing the participation of at least 3 affiliates, maintaining scientific and technical personnel for research protocol development and implementation, coordinating intra-node activities, and providing resources for intra-node activities. 08/27/2010 link
Communication of Research Results AHRQ Implementation Strategies in AHRQ Networks James Bell Associates, Inc. $2,209,935 The Agency for Healthcare Research and Quality (AHRQ) awarded a task order against an Indefinite Delivery Indefinite Quantity Contract entitled AHRQ Planning Evaluation and Analysis. The successful offeror of this task order award was James Bell Associates, Inc. This task order was awarded in the amount of $2,209,935. This task order is to conduct a formative evaluation of grantee projects to accelerate the spread and use of CER findings to improve care quality, including providing timely, ongoing feedback to grantees in order to maximize their likelihood of success; conduct a summative evaluation to assess the level of success of individual grantee projects and to develop and implement a strategy to generate and spread actionable information to others in the nationwide health care community who are interested in promoting the spread of comparative effectiveness research (CER) findings and other evidence-based practices to improve the quality of care. 09/25/2010 link
Data Infrastructure HHS - ASPE Strategic Design for an All-Payor, All-Claims Database to Support Comparative Effectiveness Research Avalere Health $1,000,000 An all-payor, all-claims database would allow for greater power in analysis, ensuring that the data infrastructure the Secretary supports will be able to produce robust analysis. Claims data, especially if established in a manner where it can be linked to other data over time, can be powerful a tool for CER and ultimately improve care for all Americans. link
Communication of Research Results ASPE Implementation and Evaluation of Imaging Decision Support Incorporating CER MASSACHUSETTS GENERAL HOSPITAL $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH under the American Recovery & Reinvestment Act of 2009 (“Recovery Act” or “ARRA”), Public Law 111-5, invites Research Project Cooperative Agreement (UC4) applications from organizations that propose to study the impact of clinical decision support systems in disseminating and increasing the consideration of comparative effectiveness research findings. The purpose of this FOA is to implement and assess real-time decision support systems, which if effective, could be broadly adopted. 09/27/2010 link
Communication of Research Results ASPE Impact of Decision Support and Accountability Tools on Adoption of Evidence BRIGHAM AND WOMEN»S HOSPITAL $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH under the American Recovery & Reinvestment Act of 2009 (“Recovery Act” or “ARRA”), Public Law 111-5, invites Research Project Cooperative Agreement (UC4) applications from organizations that propose to study the impact of clinical decision support systems in disseminating and increasing the consideration of comparative effectiveness research findings. The purpose of this FOA is to implement and assess real-time decision support systems, which if effective, could be broadly adopted. 09/27/2010 link
Communication of Research Results ASPE Accelerating Adoption of Assistive Technologies to Reduce Physical Strain Among Family Caregivers of the Chronically Disabled Living at Home The Lewin Group $328,620 The Office of the Assistant Secretary for Planning and Evaluation intends to issue one task order under the PSC Task Order’s. The main objective of this project is to accelerate adoption of assistive technologies to mitigate high family caregiver stress associated physical strain of providing personal assistance with daily living tasks (e.g. help with bathing, toileting, transferring) to chronically disabled elders living at home. There are two components to the project: The research component involves a systematic review of the evidence-base related to the role of assistive technologies in preventing overexertion and injuries among paid long-term care workers and the implications for unpaid family caregivers. The adoption component involves (1) consultation with experts on assistive technology and experts on family caregiving for the elderly as well as (2) site visits (in person and/or telephonic) to the local programs that operate under the umbrella of the Older Americans Act-funded National Family Caregiver Support Program. The purpose is to gain a better understanding of what these programs currently do or could do to facilitate family caregivers’ access to appropriate assistive technologies (those identified by the research component). The end product is to be a report including recommendations how to maximize the potential of the NFCSP as a vehicle for accelerating adoption of assistive technologies to reduce the physical strain experienced by family caregivers of the non-institutionalized frail elderly. 07/17/2010 link
Communication of Research Results ASPE Dissemination of Comparative Effectiveness Research Findings When Findings Challenge Current Practices RAND CORPORATION $0 The purpose of this task order is for the Contractor to use case studies to analyze six examples of CER dissemination and adoption of findings that propose actions contrary to current practice. The analysis of how the dissemination was conducted in the case studies and the extent to which CER findings are adopted will contribute to a report with specific, step-by-step lessons learned, including suggestions for the methods to explain findings to health professionals and the public, dissemination approaches, and strategies that promote adoption. 08/11/2010 link
Communication of Research Results ASPE Peer-led and Telehealth CER Adoption for Diabetes Prevention and Management UNIVERSITY OF MIAMI SCHOOL OF MEDICINE $0 09/15/2010 link
Communication of Research Results ASPE Accelerating Adoption of Childhood Obesity Comparative Effectiveness Research Harvard Pilgrim Health Care $0 09/22/2010 link
Communication of Research Results ASPE An Evaluation of a Multi-Modal Network to Spread an Enhanced Surgical Site Infection Institute for Healthcare Improvement $0 09/22/2010 link
Communication of Research Results ASPE Bundling Effective Resident Hand Off Practices to Improve Patient Safety CHILDREN»S HOSPITAL BOSTON $0 09/22/2010 link
Communication of Research Results ASPE Accelerating Adoption of Comparative Effectiveness Research in Premature Infants DUKE UNIVERSITY $0 09/22/2010 link
Communication of Research Results ASPE Developing Quality Measures for Schizophrenia in Medicaid Mathematica Policy Research, Inc. $299,309 The purpose of this project is to develop a set of at least three validated quality measures for schizophrenia for use in Medicaid (including Medicaid managed care plans) for accountability, quality assessment and improvement, and potentially other policy purposes. These measures will specifically focus on ambulatory care provided to adult schizophrenia patients and paid for by state Medicaid programs. Since the Department will submit these measures to the National Quality Forum (NQF) for their endorsement, the measures will be in full compliance with the NQF measure evaluation criteria. 08/01/2010 link
Communication of Research Results AHRQ Adaptation, Education and Motivation: Improving Evidence-Based Medication Adhere Morehouse School of Medicine $0 The proposed adaptation research and dissemination project will adapt, customize, and deliver the content of CERSGs for oral and insulin medications, aimed at enhancing prescribed medication adherence among a vulnerable population of low-income, urban African American adults with type 2 diabetes. The primary goal of the project is to prevent or delay microvascular complications of diabetes, an increasing prevalent disease burden. 09/03/2010 link
Data Infrastructure NIH NCI CLINICAL TRIALS DATABASE ; DATABASE AND INTEROPERABLE PLATFORM SCIENCE APPLICATIONS INTERNATIONAL CORP $6,700,000 Over the two years of proposed funding, the database will be further developed to allow entry of outcomes and adverse events as well as move clinical trial accrual data entry to shared services. link
Data Infrastructure NIH CABIG CANCER KNOWLEDGE CLOUD: ONCOLOGY EXTENDED EHRS SCIENCE APPLICATIONS INTERNATIONAL CORP $103,000,000 This effort prototypes a new 21st century biomedical "ecosystem" in the cancer community. The information technology platform underpinning this effort is the caBIG (ca for cancer and BIG for the Biomedical Informatics Grid). caBIG flexibly connects local data and applications with software, data, and infrastructure services offered through the internet "cloud", using a semantically constrained Services Oriented Architecture (SOA). link
Data Infrastructure NIH CONCEPT-LEVEL METHODS FOR COMPARATIVE EFFECTIVENESS RESEARCH UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER HOUSTON $471,398 Many organizations are building clinical data warehouses to enable comparative effectiveness research. However, simply loading data from electronic medical records into clinical data warehouses is not enough. To enable reuse of healthcare data for research, we will develop new ways to access and visualize clinical data within data warehouses. Specifically, we will develop new ways to extract concepts from unstructured text, visualize large data sets to quickly see patterns and determine the privacy implications of our methods. 09/02/2010 link
Data Infrastructure NIH DEVELOPING A COMMUNITY-BASED ASD RESEARCH REGISTRY CHILDREN»S HOSPITAL OF PHILADELPHIA $500,000 Developing a Community-Based ASD Research Registry The difficulty of enrolling large samples in research studies is perhaps the most significant barrier to better understanding the causes and treatment of Autism Spectrum Disorder, or ASD. We propose a new approach to quickly and efficiently create an ASD research registry that in- cludes at least 7500 individuals with ASD within the state of Pennsylvania interested in partici- pating in research. We will establish that members of the registry are as diverse as the broader population from which they are drawn, test a cost-effective way of verifying their diagnosis, and demonstrate how to build effective partnerships between universities and local and state agen- cies to advance research. 09/02/2010 link
Data Infrastructure NIH DEVELOPING INFORMATION INFRASTRUCTURE FOCUSED ON CANCER COMPARATIVE EFFECTIVENESS H. LEE MOFFITT CANCER CTR & RES INST $2,005,467 In collaboration with the Institute for Human and Machine Cognition (IHMC), the MCC will integrate the TRIPS natural language processing technology to capture discrete data elements from unstructured data currently only available through chart abstraction. These data will be added to existing elements within the MCC data warehouse. A CER data mart will be constructed from the MCC data warehouse and end-user interfaces will provide access to heterogeneous data for research and clinicians. 09/02/2010 link
Data Infrastructure NIH PROGRAMS IN CLINICAL EFFECTIVENESS OF CANCER PHARMACOGENOMICS DUKE UNIVERSITY $1,996,931 Aim 1 - To develop a comprehensive registry of biological samples and health and economic data to support evidence generation and clinical effectiveness research for evaluating cancer pharmacogenomic markers in lung and breast cancer. Aim 2 - To develop guidelines for the systematic evaluation and integration of genomic and clinical data, using literature databases, a longitudinal registry of breast and lung cancers and ongoing prospective genomeguided trials. 09/02/2010 link
Data Infrastructure NIH DEVELOPMENT OF A REGIONAL HEALTH IMAGE EXCHANGE SERVICE UNIVERSITY OF ALABAMA AT BIRMINGHAM $912,881 The goal of this proposal is to establish in a regional Health Image Exchange system that services several large hospitals in the Vicinity of Birmingham, AL. The objectives are straightforward: bring the participating hospitals up to a network/information transaction capability to support the exchange process, employ the expertise of the University of Alabama Birmingham to develop an image exchange service compatible with the national Health Information networks 2007 prototype, deploy the developed technology incrementally to the participating hospitals and design a web accessible access point to allow patients and physicians to view information about appropriate medical images. 09/02/2010 link
Data Infrastructure NIH DATA INFRASTRUCTURE FOR POST-MARKETING COMPARATIVE EFFECTIVENESS STUDIES UNIVERSITY OF PENNSYLVANIA $500,000 By compiling a very large, longitudinal, and current data resource of Medicaid and Medicare health insurance claims (including Part D), this project will create an important, permanent, national data infrastructure for conducting post-marketing comparative effectiveness studies, thereby providing clinicians and patients with an evidence base for selecting among alternative therapies or approaches. To demonstrate the utility of this infrastructure, this project will examine drug utilization in Medicaid enrollees, including those also enrolled in Medicare, and evaluate differing strategies for supplementation and monitoring of potassium among diuretic users in preventing 1) all-cause death and 2) sudden cardiac death and ventricular arrhythmia, which are both serious outcomes of importance to patients, clinicians, and policy makers. 09/02/2010 link
Data Infrastructure NIH KAISER PERMANENTE AUTOIMMUNE DISEASE REGISTRY KAISER FOUNDATION RESEARCH INSTITUTE $499,724 Propose to establish the Kaiser Permanente (KP) Autoimmune Disease Registry, containing comprehensive clinical information for a large, diverse population with access to DNA for future genotyping and functional assays 09/02/2010 link
Data Infrastructure AHRQ-Indian Health Service Building Infrastructure for Comparative Effectiveness Protocols (BICEP) Connecticut Center for Primary Care $0 The primary aim of this application is to build an analytic database infrastructure that will expand the capability of the Connecticut Center for Primary Care (CCPC) to conduct comparative effectiveness research (CER) on complex patients who are seen by the primary care clinicians in the CCPC Practice-Based Research Network (PBRN). The project is titled Building Infrastructure for Comparative Effectiveness Protocols (BICEP). The primary aim will be accomplished by combining Allscripts Electronic Health Record (EHR) data and electronic data from various ancillary data sources into a single analytic database that (1) links information from all sources by unique patient identifier, and (2) standardizes the meaning, coding, and location of data elements from all of these sources. Allscripts is a leading EHR system that has been implemented by ProHealth Physicians, whose 75 clinical practices with over 340,000 patients are part of the CCPC PBRN. Other data sources include ProHealth laboratory data, pharmacy claims data, pay for performance data, and historical patient records. The analytic database will group data in five primary categories: (1) patient characteristics; (2) diagnoses; (3) interventions and processes; (4) patient outcomes; and (5) system. This will result in a data infrastructure that provides an analytic database that can be used for CER with complex patients. A secondary aim of this application is to conduct a pilot study to demonstrate the feasibility and value of using the analytic database for conducting CER among complex patients. The study will be of complex patients with both hypertension and diabetes and will examine the combinations of processes that yield the best control of both conditions. The study will include development of novel statistical methods for assigning disease control scores to complex patients, identifying clinicians who set the "benchmark" for success in controlling multiple diseases in complex patients, and identifying clinical interventions and processes that contribute to such clinicians' success. 08/18/2010 link
Data Infrastructure AHRQ-HIS Clinical Database to Support Comparative Effectiveness Studies of Complex Patient University of Michigan, Ann Arbor $0 This project will use an objective and standardized Physician Office Appraisal Tool to identify potential risks to patient safety and to increase compliance with HEDIS and regional insurer quality guidelines in primary care office practices in the Caritas Christi Healthcare Network. Through joint collaboration between Caritas Christi Healthcare and its associated medical professional liability companies, the Physician Office Appraisal Tool will be used as an intervention to educate physicians, health care providers, and staff. The appraisal tool will evaluate individual primary care practices with regard to practice operations that directly impact patient safety and quality. Patient safety and quality metrics can be obtained before and after the intervention and subsequently benchmarked against known controls that are currently available for peers, specialty, healthcare systems and best practices. The impact of the changes anticipated through this intervention can then be prospectively analyzed in the healthcare network and the medical malpractice insurers' databases for claims analysis for outpatient ambulatory practices. This effect prospectively may translate into improved patient safety and care, and may be accompanied by decreased liability claims, and ultimately premium costs. 08/14/2010 link
Data Infrastructure AHRQ-Indian Health Service Collaborative National Network Examining Comparative Effectiveness Trials American Academy of Family Physicians $0 This project is the creation of the Collaborative National Network Examining Comparative effectiveness Trials or CoNNECT by combining two existing national networks devoted to studying primary care. The Collaborative Care Research Network (CCRN) is a national network that seeks to advance effectiveness research on collaborative care, defined as the integration of mental health, substance abuse, and behavioral health services into primary care. The CCRN is affiliated with an electronic practice-based research network, the Distributed Ambulatory Research and Therapeutics Network (DARTNet), which was created with funding from the Agency for Healthcare Research and Quality's Developing Evidence to Inform Decisions about Effectiveness Network. DARTNet enables comparative effectiveness research by extracting and standardizing clinical data from multiple electronic health record systems across numerous institutions. This proposal harnesses the power of DARTNet and formalizes the relationship between DARTNet and the CCRN to enhance the CCRN's capabilities to conduct comparative effectiveness research on mental health, behavioral health, and substance use in primary care. The resulting structure-the intersection between DARTNet and the CCRN-creates the Collaborative National Network Examining Comparative effectiveness Trials (CoNNECT). There are three aims associated with this project: Aim 1: Establish and test CoNNECT; Aim 2: Demonstrate the effectiveness of the infrastructure and its capacity by conducting a research project to evaluate the care of people with expensive chronic diseases complicated by comorbid mental health, behavioral health, and substance use problems; Aim 3: Evaluate CoNNECT to determine it strengths, weaknesses and potential for extensive comparative effectiveness research, with patients from underrepresented groups, with both depression or other mental conditions AND other priority chronic medical conditions. 08/03/2010 link
Research Methods AHRQ Horizon Scanning--Establish and Entity for Identification of New and Emerging Issues for Comparative Effectiveness Review ECRI $9,499,986 This project will provide AHRQ with a systematic process to identify and monitor healthcare technologies that are likely to have a high clinical, system and cost impact in the US. 09/01/2013 link
Research Methods AHRQ DESCRIBING AND UNDERSTANDING RACIAL DISPARITIES CHILDREN»S HOSPITAL OF PHILADELPHIA $0 This proposal explores a new method for describing and understanding racial disparities through the use of "Tapered Multivariate Matching" (TMM). TMM represents a new theory and conceptual framework for examining racial disparities that will aid in better measuring and more clearly describing racial disparities as well as better isolating and identifying specific features of the healthcare system that lead to differences in quality of care across racial groups. Presently, the size of a disparity is typically measured by reporting a regression model coefficient on race. However: (1) Minorities are, by definition, underrepresented in these models because whites generally outweigh blacks in most analyses, which can tend to weight model coefficients from a white perspective. At the same time, minorities often present with very different covariate distributions; therefore, (2) the interactions needed to properly define the relationships between race and explanatory covariates are usually not analyzed, or if analyzed, not reported. I 08/02/2010 link
Data Infrastructure AHRQ-HIS Development of the Post Acute Care Supplement (PACS) Research Files Sphere Institute $0 The SPHERE Institute, in partnership with the Acumen LLC DEclDE Center, proposes to build data capacity that will support comparative effectiveness research (CER) on complex patients in Medicare and Medicaid-funded post-acute care. The project will create Post Acute Care Supplement (PACS) files that will substantially enhance the information available on outcomes such as functional status and psychosocial well-being, confounders such as cognitive impairment and communication difficulties, and vital care processes including medication management. The PACS files will be developed from two administrative data sets that capture assessments at multiple points in post-acute care, the Minimum Data Set (MDS), which covers nursing homes, and the Outcome and Assessment Information Set (OASIS), which covers home health care. For the period 1999-2010, we will develop annual files that summarize health conditions, functional status, and care patterns into one observation per beneficiary per year. We will also develop more detailed files that provide comparable information for shorter time periods. The SPHERE Institute aims to: (1) establish Data Use Agreements with the Centers for Medicare and Medicaid Services (CMS) to obtain individually identifiable data from post-acute settings; (2) develop "standardized" research data structures process from the raw data, designed to meet most of the needs of researchers and policy analysts and to be readily linkable to Medicare and Medicaid claims datas; (3) establish protocols for data distribution consistent with existing protocols for confidential CMS data; (4) create extensive data documentation to make specific data elements easily understood and easily retrievable by potential users; and (5) develop a plan for updating the research files in the future. 10/02/2010 link
Data Infrastructure AHRQ-Indian Health Service Enhancing Comparative Effectiveness Research Capabilites in PPRNet MEDICAL UNIVERSITY OF SOUTH CAROLINA $0 High quality epidemiologic and comparative effectiveness research is needed to inform the health system about how to best care for people with multiple chronic illnesses since approximately one quarter of Americans fit this designation. The intent of the proposed work is to greatly enhance the capability of an existing, successful primary care practice-based research network (PBRN) to conduct these kinds of research. The work will be done in Practice Partner Research Network (PPRNet), a national PBRN among 156 primary care practices in 40 States who use a common electronic medical record (EMR) and pool nonidentifiable data for quality improvement and research. PPRNet researchers, located at the Medical University of South Carolina, will conduct the work, which will comprise of both infrastructure development and conduct of a primary research project designed to test the capability of the new infrastructure. Infrastructure development planned includes a set of activities intended to expand PPRNet to at least 250 practices and development of sophisticated computer algorithms to enhance the ability of researchers to identify patients with any of 20 chronic medical conditions. The primary research project will be a cross-sectional epidemiologic study, comparing the delivery of recommended preventive services among patients with no chronic illness, one chronic illness, and multiple chronic illnesses. To date there is inadequate information about the relationship between chronic illness and receipt of preventive services. The proposed research will address this issue and findings will likely lead to a variety of investigations designed to improve preventive services delivery to patients with multiple chronic illnesses. 08/01/2010 link
Data Infrastructure AHRQ-Indian Health Service Enhanced Data to Accelerate Complex Patient Comparative Effectiveness Research UNIVERSITY OF IOWA $0 It is our premise that easy to use data products will accelerate meaningful comparative effectiveness research (CER). Claims data are extremely difficult to use, requiring extensive experience to most appropriately aggregate these data to the patient level. Specialized expertise is also required to create meaningful variables such as treatments, covariates, and endpoints from claims data. We propose to develop and disseminate a large easy to use suite of analytical files and pre-coded algorithms to study comparative effectiveness of secondary prevention strategies among complex patients with cardiovascular disease (CVD). Adherence to CVD practice guidelines declines with age and this may be explained by uncertainty over the effectiveness of various secondary prevention strategies for the oldest old and those with multiple comorbidities. This collaboration of the University of lowa Older Adults Center for Education and Research on Therapeutics (lowa CERT) and Buccaneer Computing Systems & Services, Inc (Buccaneer) proposes to use the Medicare Chronic Condition Warehouse (CCW) as our major input source to create a longitudinal cohort of 1.8 million Medicare beneficiaries admitted with AMI or stroke/TIA in 2007 and followed through 2008 for recurrent events, complications and death. The large sample ensures power to test comparative effectiveness of secondary prevention strategies in priority subgroups with complex conditions, e.g. people over 80 years old with diabetes. At least 2 SAS(r) analytic data files will contain different levels of detail and aggregation for the same CVD cohort. From the more than fifty raw claims, drug event, and demographic (enrollment) data files in CCW, we will process the files to join the information for each beneficiary in our cohort over time and across all care settings. The analytical files will consist of: 1) patient-level aggregated data file(s) that summarize across care settings the care received by each beneficiary, and from this file we will create 2) summary treatment and outcome data files, to allow for rapid querying and reporting (e.g., for feasibility analyses and preliminary data analysis).The code and algorithms to create the data product are expected to streamline the development of future data products in new clinical populations for future CER studies. The federal CERT and CTSA networks are natural communication assets to disseminate information about the data product. We will test the data product in a research project focused on the uncertainty around statin effectiveness and safety in the aging patient with multiple comorbidities. 08/03/2010 link
Data Infrastructure NIH DEVELOPMENT OF A CARDIOVASCULAR SURVEILLANCE SYSTEM IN THE CVRN KAISER FOUNDATION RESEARCH INSTITUTE $3,463,723 The broad goals of this project are to: 1. Establish a surveillance system for coronary heart disease (CHD), heart failure (HF) and stroke in the 15 centers of the National Heart Lung and Blood Institute (NHLBI) funded Cardiovascular Disease Research Network including therapeutic interventions, post-event outcomes and important risk factors and confounders. 2. Work collaboratively to establish and implement an aggregate database incorporating coronary heart disease CHD, HF, and stroke data from all 15 CVRN sites that can be used by CVRN investigators and other qualified research scientists to conduct studies related to comparative effectiveness and health disparities. 3. Identify standard criteria for coronary heart disease, heart failure and stroke clinical outcomes, as well as all components noted in goal #1 to enable data aggregation 4. Determine the most recent 10-year trends in the rates of acute myocardial infarction and stroke hospitalization and their relationship to trends in risk factors, co-morbidities, therapeutic interventions, medications, and diagnostic modalities. 5. Demonstrate that the data can be used to address research questions regarding comparative effectiveness and novel methods of monitoring health disparities, areas that have been identified as RC2 topics by NHLBI. 08/02/2010 link
Data Infrastructure NIH THE KAISER PERMANENTE NATIONAL RESEARCH DATABASE KAISER FOUNDATION RESEARCH INSTITUTE $1,740,459 Kaiser Permanente (KP) has electronic health records (EHRs) on almost 30 million current and past members in 8 regions of the country. For the past 3 years we have been engaged in the creation of a pilot research database for KP Northern California, which constitutes about 1/3 of the health plan membership. The aim of this proposal is to enhance the pilot database, and expand it into a national research database (NRDB) that includes data extracted from the EHRs for all regions. 10/01/2010 link
Data Infrastructure NIH COMPARATIVE EFFECTIVENESS OF ADVANCED IMAGING IN CANCER DARTMOUTH COLLEGE $1,999,273 This project will provide a national infrastructure for CER initiatives for advanced imaging in cancer. 09/02/2010 link
Data Infrastructure NIH DEVELOPING INTERACTIVE TECHNOLOGIES TO IMPROVE RESEARCH AND HEALTH BEHAVIOR UNIVERSITY OF PENNSYLVANIA $2,700,777 The proposed IT infrastructure will provide a state-of-the-art platform on which to build, test, and deploy large- scale behavioral intervention studies and advance the science at the intersection of behavioral economics and health. 09/02/2010 link
Data Infrastructure NIH COMPARATIVE EFFECTIVENESS RESEARCH IN PEDIATRIC RHEUMATIC DISEASES: LEVERAGING CA SEATTLE CHILDREN»S HOSPITAL $497,649 In this application we propose to 1) to develop the platform for studies of comparative effectiveness utilizing data collected from existing registries, ongoing clinical trials and newly developed treatment protocols and 2) develop best care protocols based on currently available literature, experience of CARRA practitioners and consensus techniques. With completion of the project CARRA will be able to: 1) Perform comparative effectiveness research to define optimal care in Pediatric Rheumatic Diseases (PRD), 2) Conduct research that will translate to prevention, better treatment, and cure of PRD, 3) Investigate methods to improve quality of life in children with PRD, 4) Promote a culture where ultimately all children with PRD will be able to participate in research protocols. 09/02/2010 link
Data Infrastructure NIH BUILDING CER CAPACITY: ALIGNING CRN, CMS, AND STATE RESOURCES TO MAP CANCER CARE DANA-FARBER CANCER INSTITUTE $1,999,936 Through a partnership between investigators in the Cancer Research Network (CRN) and Dana-Farber/Harvard Cancer Center, we propose to develop a resource with sufficient depth and breadth to support high quality cancer comparative effectiveness research (CER) addressing two key knowledge gaps. First, we will focus on treatment of advanced disease. Advanced cancer results in the bulk of deaths, morbidity, and expenditures. Moreover, the evidence base for treatment of advanced disease is often thin and based on expert consensus achieved through extrapolation from small efficacy studies in highly selected cohorts. The second key gap we will address is the relative dearth of population-based research on patterns and outcomes of cancer care for patients who aren't represented in SEER-Medicare. 09/02/2010 link
Data Infrastructure CMS Comparative Effectiveness Research (CER) Data Infrastructure Medicaid Analytic eXtract (MAX) Long-Term Care- Assessment (LTC-A) File Actuarial Research Corporation $528,288 This Medicaid Analytic eXtract file (MAX) comparative effectiveness research (CER) task order funded per the American Recovery and Reinvestment Act of 2009 will develop a research file that incorporates key administrative assessment data from the Minimum Data Set (MDS) for nursing facilities, data from the Outcome and Assessment Information Set (OASIS) for home health agencies, and selected On-line Survey and Certification Assessment Reporting (OSCAR) data and link it to Medicare and Medicaid administrative data. This file will be known as the Long-Term Care Assessment file (LTC-A). link
Data Infrastructure CMS Development of a Medicaid/CHIP Environmental Scanning and Program Characteristics (ESPC) Database IMPAQ INTERNATIONAL, LLC. $858,436 The purpose of this project is to define basic requirements for a Medicaid/CHIP Environmental Scanning and Program Characteristics (ESPC) database that will include an array of Medicaid program characteristics for each of the 50 States and the District of Columbia. link
Data Infrastructure CMS Comparative Effectiveness Research Data Infrastructure Medicaid Analytic eXtract Production, Enhancement, and Data Quality Mathematica Policy Research $7,649,725 This task order is to produce person level data files on Medicaid eligibility, service utilization and payment information to support Comparative Effectiveness Research (CER) that is funded by the American Recovery and Reinvestment Act of 2009 (ARRA). link
Data Infrastructure AHRQ-Indian Health Service Expansion Research Capability to Study Comparative Effectiveness in Complex Patients Florida State Department of Health $0 The Florida Department of Health (DOH), Bureau of Epidemiology's proposes Linking Florida Cancer Registry Data with Hospital Electronic Medical Records. Specifically, DOH will collaborate with the Florida Agency for Health Care Administration (AHCA), two hospital systems (Broward Health and Baycare Health), and the Florida Agriculture and Mechanical University (FAMU) and the University of Miami (UM) to enhance data capture to increase the scope of research to reduce the morbidity and mortality due to cancer and other co-morbidities. The Florida Cancer Data System (FCDS), statewide cancer registry, collects patient demographics, tumor diagnostics, and the initial course of treatment from hospitals and outpatient facilities as mandated by state laws. The FCDS and two hospital systems will use the AHCA planned clinical messaging service of Health Information Exchange (HIE) system as the vehicle to exchange cancer patient's clinical and laboratory data. Each participating organization (FCDS and hospital systems) will develop an interface between its own data system connection with the HIE. In addition, hospital systems will develop computer programs to identify eligible patients who are either diagnosed with cancer or treated for cancer, and to process coded and noncoded (texts and images) medical records. FCDS will develop software to link the incoming medical record data with current cancer reports using probabilistic matching algorithms. The linked data will be documented. Protection of patient's confidentiality will be enforced throughout the project. Researchers will conduct a pilot study on breast cancer patients using the enhanced data with detailed information on co-morbidity and treatment. A plan will be developed for disseminating data to other researchers. The experience and lessons learned from this project will assist AHCA with implementing its statewide HIE system. On the other hand, incorporating the data exchange between FCDS and the hospitals systems in the statewide HIE system will be an ultimate plan of sustainability. 10/02/2010 link
Data Infrastructure AHRQ-Indian Health Service Optimal & Equitable Care: Medicaid Data Research Infrastructure Morehouse School of Medicine $0 This is a Data Capacity-Building Project, to build a robust comparative effectiveness research infrastructure, agenda, and collaborative partnerships focused on eliminating health disparities. Specifically we will build a database comprised of all Medicaid enrollees and claims in the states that share in common both adverse minority health outcomes and the historical roots of racial health disparities in the South. Setting & Participants: Our CMS data request has already been approved and we have actually purchased (but not yet received) a 100% sample of four years (2004-07) of Medicaid Analytic Extract (MAX-file) data (plus Medicare-linked claims for dual-eligibles) from fourteen southern states, representing 3.8 to 5.4 million persons each year (one-third of all U.S. Medicaid enrollees, nearly half [48%] of African American and 21 % of Latino Medicaid enrollees in the U.S). This region is the epicenter of the black-white health disparities epidemic, and has also experienced a recent and rapid influx of Latino immigrants. Our HBCU-based team has previously had extensive experience training health services researchers (especially minority investigators) to use Medicaid claims data for research, but we currently lack the personnel and infrastructure support needed to efficiently organize and analyze these data to support minority investigators. Specific Alms: Using Medicaid Claims Data: 1. To build a Medicaid claims data set (including socio-economic, contextual, and geospatial analytic variables, NDC cross-walk data and therapeutic class codes, as well as certain Medicare data for dualeligibles) to support projects focused on the intersection between disparities research and comparative effectiveness research in clinically and socially complex patient populations. 2. To create an efficient process for assisting non-Morehouse investigators to develop research protocols, analysis plans, CMS data re-use requests, and analytic files for collaborative research. 3. To train, develop, cultivate, and support emerging minority investigators (especially at HBCUs and other minority-serving institutions) as independently-funded health services researchers who are increasingly proficient in multivariate analysis of Medicaid and Medicare claims data. 4. Cultivate comparative effectiveness and disparities research collaborations with Georgia Tech experts in mathematics, complexity science, simulation modeling, and interactive computing. 10/02/2010 link
Data Infrastructure AHRQ-HIS Research Capability to Study Comparative Effectiveness in Complex Patients North Carolina Community Care Networks $0 North Carolina Community Care Networks, Inc., proposes to link three separate databases maintained by the NC Department of Health and Human Resources to create an infrastructure for comparative effectiveness research with medically indigent and uninsured patients who present with complex medical and psychiatric comorbidities. The three databases include statewide Medicaid claims, state psychiatric hospital admissions (HEARTS), and state-funded outpatient mental health services (IPRS). To demonstrate the capabilities of the integrated database, we will conduct a study of medical homes in the NC Medicaid program for patients with complex medical-psychiatric problems. Several hypotheses will be tested to assess the extent to which these patients engage in medical homes as readily as their non-mentally ill counterparts, use their medical homes as mental health homes, and receive high quality care for their mental illness and for medical comorbidities. The project includes the creation of an oversight structure for managing the integrated database and making it available to the research community in NC and elsewhere. 10/02/2010 link
Research Methods AHRQ IMPROVING METHODS FOR COMPARATIVE EFFECTIVENESS RESEARCH IN CARDIOVASCULAR CARE BRIGHAM AND WOMEN»S HOSPITAL $0 Specifically, the applicant will 1) develop new databases to study CE of therapies in patients with heart failure (HF) and coronary artery disease (CAD) by linking large claims databases from Medicaid, state pharmacy assistance programs, and Medicare with large clinical registries of CAD and HF and 2) develop and evaluate models for 3 analytic techniques A) high dimensional propensity score using data mining techniques, B) instrumental variable analysis, and C) propensity score calibration to combat bias due to lack of detailed clinical information in claims data research assessing CE of therapies in HF and CAD. 07/02/2010 link
Other AHRQ We Will Not be Moved: the Black Church Health Movement, 1900-1935 UNIVERSITY OF PENNSYLVANIA $0 link
Other AHRQ ENHANCED PRESCRIPTION DRUG LABEL DESIGN TO IMPROVE PATIENT UNDERSTANDING AND USE NORTHWESTERN UNIVERSITY $0 05/02/2011 link
Other AHRQ STRATEGIES TO IDENTIFY UNDIAGNOSED HIV INFECTION IN THE EMERGENCY DEPARTMENT Denver Health and Hospital Authority $0 04/02/2011 link
Other AHRQ Enhanced Spanish drug label design to promote patient understanding and use NORTHWESTERN UNIVERSITY $0 Objective of the study is to test the effectiveness of an evidence-based, Spanish language prescription drug (Rx) labeling strategy to improve patient understanding and use. 05/02/2011 link
Other AHRQ DO PERFORMANCE INCENTIVES IMPROVE HEALTHCARE QUALITY FOR VULNERABLE POPULATIONS? CHILDREN»S HOSPITAL BOSTON $0 In this study proposal, we hypothesize that performance incentives can significantly improve incentivized components of care, but will have a null or negative effect on unincentivized components of care. To examine these questions, we will use a retrospective study design and draw independent samples at three strategically chosen cross-sections in time before and after the introduction of performance incentives at our nation's largest federally-qualified health center, ACCESS Community Health Network. 10/01/2010 link
Other NIH A PATIENT ADVOCATE AND LITERACY-BASED TREATMENT OF ASTHMA UNIVERSITY OF PENNSYLVANIA $505,555 Half of US adults have no more than basic reading and numerical skills. A consequence is inadequate health literacy, which is associated with unsatisfactory patient-provider communication and poor health outcomes in chronic diseases, including asthma. We have adapted a patient navigator intervention to address asthma in high risk communities as a practical, immediate, and sustainable method of achieving effective health literacy in patients low health literacy. 09/02/2010 link
Other NIH CATALAC: COMMUNITY-ACADEMIC TREATMENT & ASSESSMENT FOR LOW-INCOME AGED CONSUMERS UNIVERSITY OF CALIFORNIA SAN FRANCISCO $142,777 Our aims are to (1) Test and refine an assessment toolkit for mentally ill older adults that is practical and portable in English and Cantonese (2) Implement a web-based electronic clinical and research case identification and outcome monitoring system, (3) Implement and evaluate Problem Solving Therapy for older adults with depression and mild cognitive impairment and (4) Develop a research-training program in community-based clinical outcomes research. 10/01/2011 link
Other NIH NOVEL TECHNOLOGIES TO IDENTIFY PRECLINICAL CORONARY DISEASE IN HIGH RISK FAMILIES JOHNS HOPKINS UNIVERSITY $500,000 The goal of this proposed challenge grant study is to advance personalized preventive medicine using a comparative effectiveness research model to compare the relative effectiveness two methods for looking at coronary artery plaque. The purpose is to identify subjects with latent preclinical CAD who would represent appropriate targets for intensive preventive therapies. 08/02/2010 link
Other NIH PREVENTING SPIKE-WAVE EPILEPTOGENESIS: CRITICAL PERIODS & NEUROIMAGING BIOMARKERS YALE UNIVERSITY $408,183 The aims are to investigate fMRI resting functional connectivity and DTI as promising biomarker of epileptogenesis and its prevention by therapy. Will performing measurements of fMRI resting functional connectivity at different developmental stages in treated vs. untreated animals. We will also relate these measurements to connectivity evaluated through coherence analysis of electroencephalography. In addition, we will investigate DTI as another promising biomarker by again performing measurements at different ages in treated vs. untreated animals. 09/02/2010 link
Other NIH MORE R.E.S.U.L.T.S. CALIFORNIA STATE UNIVERSITY LOS ANGELES $142,093 To explore this problem and the methods generally used to address it, the research will compare and contrast the efficacy of various NIGMS Minority Opportunities in Research (MORE) programs at three universities, with appropriate control groups to determine the efficacy of individual elements of intervention within such programs. 09/02/2010 link
Other AHRQ CONFLICT OF INTEREST IN CLINICAL PRACTICE GUIDELINE DEVELOPMENT OREGON HEALTH AND SCIENCE UNIVERSITY $0 Many groups produce clinical practice guidelines to help physicians provide the best health care, based on evidence of what works well. If someone involved in preparing these guidelines has a financial relationship with companies that sell medications or equipment related to that healthcare condition, this conflict of interest may interfere with the quality of the guidelines. In this project we will look at different types of conflict of interest, and how these conflicts might affect healthcare recommendations about the control of blood sugar in diabetes. 10/01/2010 link
Other AHRQ Mentored Clinical Scientist Development Program Award (K12) UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 Creating the next generation of well trained comparative effectiveness research is of critical national importance as we seek to improve the effectiveness and efficiency of the delivery of drugs, devices and biologics. 07/03/2010 link
Other AHRQ Mentored Clinical Scientist Development Program Award (K12) UNIVERSITY OF PITTSBURGH AT PITTSBURGH $0 At a time when rapid advances and new discoveries contribute to the complexity of decision making in health care and health care delivery, the need for excellent comparative effectiveness research is clear. To ensure that the research is of high quality, it is necessary to train a new cohort of investigators in specific CER methods. 07/03/2010 link
Other AHRQ Mentored Clinical Scientist Development Program Award (K12) University of Colorado, Denver $0 The Colorado Comparative Effectiveness Research (CER) and Safety K12 Scholars Program will be a national and regional resource for research and training in health care and CER. We will develop a new K12 program in CER and Safety education, systematically assess mentorship capacity, and continuously monitor our progress as part of a longitudinal evaluation infrastructure to improve the CER workforce and leadership pools of the future. 07/03/2010 link
Other AHRQ Mentored Clinical Scientist Development Program Award (K12) UNIVERSITY OF WASHINGTON $0 We propose a Mentored Comparative Effectiveness Research Training Program (K12) at the University of Washington that will equip six Scholars with the skills to plan, conduct, and apply practical clinical and health services research. Importantly, Scholars and their Mentors will engage with local and regional stakeholders to identify gaps in knowledge and help shape research projects that will support best practices and improve the health of the public. 07/03/2010 link
Other AHRQ Mentored Clinical Scientist Development Program Award (K12) OREGON HEALTH AND SCIENCE UNIVERSITY $0 Comparative Effectiveness (CE) reviews consistently find that a minority of studies provide meaningful information to inform real-world health care, suggesting that research could be more cost-effective. The Oregon CER K12 Program will leverage the resources and success of Oregon EPC, CTSA, and OHSU's ongoing success with K12 programs to train future leaders in CER. 07/03/2010 link
Other AHRQ Mentored Clinical Scientist Development Program Award (K12) University of North Carolina, Chapel Hill $0 The UNC CER K12 Program seeks to facilitate the mentored career development of outstanding junior investigators to conduct CER. Through mentored, interdisciplinary training, CER Scholars will participate in a curriculum that uses didactic and experiential learning to provide CER Scholars with the training, experience, and mentoring required to become independent investigators who conduct CER that improves the health of our citizens. 07/03/2010 link
Other AHRQ Mentored Clinical Scientist Development Program Award (K12) NEW YORK UNIVERSITY SCHOOL OF MEDICINE $0 This proposal will fund NYU School of Medicine to train 4 post-graduate scholars for 3 years in "comparative effectiveness research" (the right treatment for the right person at the right time). The training program will focus on areas where there is a particular shortage of training opportunities right now: a patient focus on the urban underserved, a content focus on conditions for which better decisions could significantly lower morbidity and mortality, and a method focus on research that has immediate applications to decision making. 07/03/2010 link
Other AHRQ Mentored Clinical Scientist Development Program Award (K12) DUKE UNIVERSITY $0 The federal government has identified the critical importance of comparative effectiveness research to the future of health care in the country. Academic medical centers are being called upon to train additional researchers in the conduct of comparative effectiveness research to address this much-needed area of expertise. 10/02/2010 link
Other AHRQ Institutional Research Training Awards and Comparative Effectiveness Fellowship (T32) University of North Carolina, Chapel Hill $0 Recent initiatives by the lOM, the Federal Coordinating Council, ARRA legislation, and proposed health reform legislation have substantially increased the amount of comparative effectiveness research activity and its potential policy impact. As a result, the nation is experiencing a great need for more researchers to meet the demand in areas of systematic review, observational studies, effectiveness trials, and research dissemination. Skills that can be rapidly applied are especially important, and a related focus is enhancement of the methods involved in comparative effectiveness research. 07/03/2010 link
Other AHRQ Institutional Research Training Awards and Comparative Effectiveness Fellowship (T32) UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 We propose a UAB T32 program in Comparative Effectiveness Research (CER) to support four CER Trainees (2 cohorts of 2 trainees each). The T32 training will extend our very successful T32 in Health Services & Outcomes Research, with facilitation by the UAB AHRQ-funded Center for Education and Research on Therapeutics (CERTs) and our NIH-funded Center for Clinical and Translational Sciences (CCTS). 07/03/2010 link
Other AHRQ Institutional Research Training Awards and Comparative Effectiveness Fellowship (T32) CHILDREN»S HOSPITAL BOSTON $0 The Harvard Pediatric Health Services Research Fellowship Program will build on its demonstrated success to meet the national priority of developing a workforce of comparative effectiveness researchers. These individuals will provide scientific evidence to inform effective, high value care for children and families, and help to develop a "learning healthcare system" for children. 07/03/2010 link
Other AHRQ Institutional Research Training Awards and Comparative Effectiveness Fellowship (T32) UNIVERSITY OF PITTSBURGH AT PITTSBURGH $0 Researchers with the ability to effectively evaluate the benefits and harms of different interventions and strategies are needed to improve the US public health to prevent, diagnose, treat and monitor health conditions. The University of Pittsburgh and its collaborating partners are in the forefront of training leaders in comparative effectiveness research who will contribute substantially to transforming our health system. 07/03/2010 link
Other AHRQ Institutional Research Training Awards and Comparative Effectiveness Fellowship (T32) DUKE UNIVERSITY $0 The need for comparative effectiveness research (CER) is now obvious to all health care stakeholders in the United States. The idea that any form of research worth doing is worth training scientists to do it properly, holds for CER. This training grant will improve the health care of Americans by training outstanding investigators in a critical new field. 07/03/2010 link
Other AHRQ Institutional Research Training Awards and Comparative Effectiveness Fellowship (T32) BROWN UNIVERSITY $0 Comparative Effectiveness Research (CER) is an important tool for the value-based purchasing of health care needed to "bend the cost curve." To apply CER to the growing number of areas of need, it is essential to have trained investigators in the field. Brown University has been training successful post-doctoral fellows in health services research for a quarter century and is poised to extend this effort to the special needs of CER. 07/03/2010 link
Other AHRQ Institutional Research Training Awards and Comparative Effectiveness Fellowship (T32) JOHNS HOPKINS UNIVERSITY $0 In addition to having skills to understand the determinants of health outcomes and disparities, researchers need training to test possible solutions for reducing health disparities and improving outcomes. We aim to train investigators in the best research methods to test what interventions work to improve the quality of care, what approaches reduce disparities in health services delivery, what interventions improve patient-relevant outcomes, and how best to target services to those who will benefit most. 09/03/2010 link
Medical treatments, items and services NIH COMPARING ACUTE AND CONTINUOUS DRUG ABUSE TREATMENT: A RANDOMIZED CLINICAL TRIAL WRIGHT STATE UNIVERSITY $500,000 The proposed study is a clinical effectiveness trial in which 200 drug-dependent, adult outpatients from a community treatment center will be randomly assigned to Treatment as Usual or a newly developed, long-term treatment, referred to as "Long-Term Recovery Management." The results will benefit public health by adapting treatment and recovery services to the chronic nature of addiction. 09/02/2010 link
Medical treatments, items and services NIH TARGETED THERAPIES FOR SELECTED PHENOTYPES OF OBSTRUCTIVE SLEEP APNEA UNIVERSITY OF WISCONSIN MADISON $399,974 Hope to improve the breathing during sleep in patients with OSA by individualizing their treatment to the patients' specific problem(s) associated with upper airway collapsibility and/or breathing stability. 09/02/2010 link
Medical treatments, items and services NIH EVALUATING ECONOMIC SUBSIDIES TO IMPROVE DIETARY INTAKE AMONG LOW INCOME FAMILIES UNIVERSITY OF ILLINOIS AT CHICAGO $495,446 In an effort to improve dietary intake and address the high prevalence of obesity among low-income children, the Special Supplemental Nutrition Program for Women Infants and Children (WIC) plans to revise their food packages. The overall purpose of the proposed study is to examine the mechanisms by which economic incentives offered in a large food assistance program impacts dietary intake of children. If the planned economic incentives produce improved dietary intake and altered weight gain trajectory among these high-risk children, this could have profound implications for heath disparities in this population. 09/02/2010 link
Medical treatments, items and services NIH LC-MS/MS ANALYSIS OF CSF AND ANTECEDENT BIOMARKERS OF AD WASHINGTON UNIVERSITY $410,000 Hypothesize that can distinguish novel patterns in the CSF proteome that will enhance our ability to diagnose the preclinical stage of AD, and identify subjects who will soon progress to dementia. 09/02/2010 link
Medical treatments, items and services NIH EPIGENETIC CHANGES PREDICT DISEASE COURSE OF HPV-RELATED LESIONS IN WOMEN 16-24 UNIVERSITY OF WASHINGTON $660,862 Aim one: define specific promoter region CpGs and chromatin modifications central to development of ICC by mapping methylation and histone marks of DAPK1, IGSF4, PAX1, TIMP3 and TFPI2 present in stored biopsies of ICC, CIS and normal cervical tissues; Aim two: enroll 100 16-25 year old women with biopsy confirmed CIN 2-3 and define the status of the promoter region CpGs and chromatin modifications identified in Aim 1 in their biopsies and same day exfoliated cell samples. Aim 3: Follow enrolled women every 6 months (for up to 18 months) by colposcopy and collection of exfoliated cell samples for cytology and testing to determine whether changes in methylation status and/or the pattern of chromatin marks associated with TWIST1, DAPK1, IGSF4, PAX1, TIMP3 and TFPI2 occur over time, and further, whether such changes are associated with colposcopic and cytologic changes. 09/02/2010 link
Medical treatments, items and services NIH REFERRAL PATTERNS AND RISK OF EARLY REVISION AFTER PRIMARY TOTAL JOINT ARTHROPLASTY HOSPITAL FOR SPECIAL SURGERY $372,857 Revision arthroplasty is often a complex, costly procedure with worse outcomes than primary arthroplasty. Revision procedures are thought to be more commonly performed at tertiary care centers and by higher volume surgeons, but referral patterns are actually unknown. This study proposes to identify patterns for referral for revision arthroplasty in New York and California between 1996 and 2007 and to identify risk factors for early revision (within 10 years of primary surgery) and risk factors for complication following revision surgery. 09/02/2010 link
Medical treatments, items and services NIH IMPROVING CHILDHOOD IMMUNIZATION COMPLIANCE USING ELECTRONIC HEALTH RECORDS JOHNS HOPKINS UNIVERSITY $397,606 The overall goal of the proposed research is to improve the entire spectrum of school-aged childhood immunization rates among a predominantly African American, inner city population, utilizing and comparing 2 interventions: 1. an automated Electronic Health Record-derived provider-specific performance feedback report, and 2. automated Electronic Health Record-derived trigger alerts when patients in need of immunizations present to clinic. 10/01/2010 link
Medical treatments, items and services NIH DETERMINANTS OF PARTICIPATION IN AN ANAL CANCER PREVENTION TRIAL UNIVERSITY OF CALIFORNIA SAN FRANCISCO $499,999 This application will provide critical information that will support the conduct of such a study, namely determinants of participation in a randomized clinical trial in which 50 percent of participants with HGAIN will be screened and treated, and 50 percent will be observed without treatment. At the end of a 5-year period, the number of anal cancer cases will be compared in both arms. 09/02/2010 link
Medical treatments, items and services NIH COMPUTER-ASSISTED GUIDANCE FOR TOBACCO DEPENDENCE INTERVENTIONS IN DENTAL OFFICES HEALTHPARTNERS RESEARCH FOUNDATION $447,509 This project will examine whether dentists and hygienists will assess interest in quitting and deliver a tobacco intervention more frequently when provided with computer assisted guidance compared to a control group. Specifically we will measure the delivery of questions assessing willingness to change and appropriate interventions based on willingness to change by measuring the recording of these activities in the EDR and patient receipt of these recommendations through a phone survey. 09/02/2010 link
Medical treatments, items and services NIH COMPARING FOCUSED ULTRASOUND AND UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS MAYO CLINIC COLL OF MEDICINE, ROCHESTER $500,110 This study will characterize the amount of pelvic pain women with fibroids have with their menstrual periods and at other times in the month and whether pain is decreased by uterine artery embolization (UAE) and magnetic resonance guided focused ultrasound (MRgFUS), two minimally-invasive treatments for fibroids. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE BIOINFORMATICS AND TP53 EXPRESSION PURDUE UNIVERSITY WEST LAFAYETTE $69,066 This project's aims are as follows: (1) Very dense comparative alignment of the TP53/GBN5 cis-regulatory region across mammals; (2) Characterization of transcriptional responses using cell lines from a wide variety of species; (3) Molecular footprinting of this promoter region across mammals; (4) Test hypotheses of regulatory evolution using deletion/site-directed mutation constructs with reporter gene assays. As with (2) a key novel aspect of this work is the use of wildtype fibroblast cell lines from many different orders of mammals; (5) Using a novel pair-wise cell line assay, separate cis (local) from trans (non-local) effects in the evolution of transcriptional regulation; (6) Use, test, and develop bioinformatic/genomic and molecular evolutionary techniques on the dense sequence alignment of (1), plus genomes of over 14 species of mammals. 08/20/2011 link
Medical treatments, items and services NIH COMPLICATIONS OF SURGERY FOR SPINAL STENOSIS: A CLINICAL PREDICTION RULE OREGON HEALTH AND SCIENCE UNIVERSITY $169,214 (1) Determine rates and reasons for repeat spine surgery in the population and salient subgroups; (2) determine rates of life-threatening complications and 30-day mortality as a function of age, comorbidity, prior surgery, and surgical invasiveness; and (3) develop and validate prediction rules for major adverse events. These studies will enhance surgeons' ability to estimate operative risks and advise patients about the benefits and risks of spine surgery, thus improving patient safety in a high-risk context. 09/22/2011 link
Medical treatments, items and services AHRQ IMPACT OF REGIONALIZATION OF CARE IN ACUTE STROKE PATIENTS UNIVERSITY OF CALIFORNIA SAN FRANCISCO $0 To address these issues, I propose to conduct a study with the primary goal of studying comparative patient outcomes in regionalized and non-regionalized stroke systems. The secondary goals will be to assess the cost-effectiveness of regionalized care and accuracy of prehospital stroke recognition before and after regionalization of systems. 04/02/2010 link
Medical treatments, items and services AHRQ COMPARATIVE EFFECTIVENESS OF TREATMENTS FOR DEGENERATIVE SPINE DISEASE DARTMOUTH COLLEGE $0 The proposed research will provide policy-relevant evidence on the comparative clinical effectiveness, safety, and economic value of emerging devices/biologics to treat common back-pain-related degenerative spine conditions in the elderly. 08/02/2010 link
Medical treatments, items and services AHRQ QUANTITATIVE PRETEST PROBABILITY TO REDUCE CARDIOPULMONARY IMAGING IN THE EMERGENCY DEPARTMENT CAROLINAS MEDICAL CENTER $0 This study will test if the presentation of computerized, quantitative pretest probability for ACS and PE is associated with reduced radiation exposure in these patients. 08/02/2010 link
Medical treatments, items and services NIH GENETIC, GENOMIC, AND IMAGING BIOMARKERS IN DEGENERATIVE DEMENTIA UNIVERSITY OF CALIFORNIA LOS ANGELES $454,999 Identification of biomarkers enriching diagnostic, prognostic, and therapeutic capabilities is an important goal in dementia. We propose to build a molecular classifier based on peripheral blood samples and imaging data from demented patients. This would be a valuable tool for biomarker identification, improved patients classification, therapy evaluation, and to further our understanding of disease pathophysiology. 1 09/02/2010 link
Medical treatments, items and services NIH ADVANCING INNOVATIVE COMPARATIVE EFFECTIVENESS RESEARCH-CANCER DIAGNOSTICS ADVICE UNIVERSITY OF WASHINGTON $1,997,996 This project proposes to establish a consortium of researchers and health care providing organizations that will devote their expertise to understanding the strengths and weaknesses of these tests and to produce research that will result in guidelines for the use of these tests and a future program of studies to rigorously evaluate these tests. 09/02/2010 link
Medical treatments, items and services HRSA Maternal and Child Health (MCH) Pediatric Research Network Program American Academy of Pediatrics $0 The goal of the ARRA Pediatric Research Network Program is to support the infrastructure within an established pediatric applied research network to enable it to more readily conduct comparative effectiveness research in pediatric primary care sites around the United States. These funds will be used to facilitate the pediatric research network to create a subnetwork of practices that use certified electronic health reocrds(EHRs)to address critical child health issues and generate new knowledge to improve pediatric practice. 08/29/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Virginia Coordinated Care Versus the Traditional Virginia Commonwealth University $0 The primary Aim of this study is to compare the effectiveness of the VCC, particularly the primary care component, with that of a traditional safety net delivery system at reducing the frequency of emergency department utilization, hospital utilization, and adverse health outcomes among uninsured patients who used the Virginia Commonwealth University Health System (VCUHS) from January 2003- December 2009. Attention will be paid to understanding the conditions and the types of patients for which the program was most effective. The Secondary Aim of the study is to identify the successful and replicable elements of primary care case management, care coordination, and other attributes of the patient-centered primary care model that make the VCC program effective. Attention will be paid to understanding how and why these elements are critical for different patient populations. This will be achieved by qualitative analyses, consisting of key informant interviews and focus groups with four stakeholder groups: program executives/leadership, provider physicians, care coordinators, and patients, informed by results from previous work and from analyses performed under the first Aim. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service B-Blocker Effect on a Range of Health Outcomes in Older Adults with CAD and COPD YALE UNIVERSITY $0 With this analytic epidemiologic study, we begin investigating situations in which the treatment of one condition may exacerbate other conditions or adversely affect other health outcomes. Despite potential harms to the large number of older individuals with multiple co-occurring health conditions, this topic has received little research attention. We explore the capability of using large national population-based cohorts and novel analytical techniques to compare the benefits and harms of different intervention strategies, across a range of health outcome domains, in complex older adults with multi-morbidity. To develop our strategy, we begin by investigating Beta-Blocker (2-Blocker) intensity in persons with co-occurring coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD). Once we have tested the method with this important clinical question, we will extent to other sets of conditions and medications. This project builds on our ongoing research on multi-morbidity that includes mapping disease-specific outcomes onto universal health outcomes, determining tradeoffs among competing conditions, and ascertaining the contribution of multiple co-occurring conditions to death and other health outcomes. Our methodological aim is to develop an innovative method for comparing different treatment strategies in situations in which the treatment of one condition could exacerbate other conditions or affect other health outcomes. Using our novel methods, we will test the hypothesis that, among comparable older adults with co- occurring CAD and COPD, greater 2-Blocker intensity is associated with fewer CV events and lower mortality but more frequent adverse pulmonary outcomes; worse dyspnea, fatigue, and activity levels and greater disability than no or lower 2-Blocker intensity. In secondary analyses, we will explore these aims in relevant subgroups defined by age, CAD and COPD severity, gender, race, and co-morbidity burden. Two national, population-based cohorts, the Medicare Current Beneficiary Survey and the Medical Expenditure Panel Survey will be studied (study sample 35,000-40,000). Both have a wealth of longitudinal participant-reported, medication, and claims/health care utilization data. This depth and breadth of data allows us to use innovative analytical techniques to assess the effects of treatments on disease-specific and universal health outcomes (e.g. disability, symptoms burden, functional limitations, and death), accounting for propensity to receive the treatment, and other confounders. We propose a new paradigm for quantifying the harms and benefits of treatments in complex older persons with multiple conditions. Our ultimate goal is to develop a method for determining the optimal treatments for older adults with multiple conditions that maximizes benefits and minimizes harms within the outcome domain(s) of highest priority for each patient. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Determining Processes of Cardiovascular Care Relevant to Complex Patients KAISER FOUNDATION RESEARCH INSTITUTE $0 Clinicians who care for persons with complex chronic medical conditions face both competing demands and a lack of evidence regarding best processes of care for this heterogeneous population. Those clinicians facing decisions about prevention of coronary heart disease (CHD) following a new diagnosis of cancer must take into account cancer prognosis, cardiovascular risk status, overall burden of morbidity, and the patient's goals, preferences and values. To help inform such decisions, we propose to use analytic epidemiology methods to study an historical cohort of all (over 30,000) Kaiser Permanente Colorado (KPCO) adult members who received an initial diagnosis of cancer during the period 1999 to 2007. In this cohort, we will a) assess the attainment of goals for specific components of primary, secondary, and 'tertiary' prevention of CHD as a function of cancer prognosis, overall morbidity and the interaction between them, and b) assess the comparative effectiveness of these CHD prevention interventions (in relevant sub-cohorts) on receipt of, and time to, a composite of CHD events and all-cause mortality. We hypothesize that: a) Overall morbidity, cancer prognosis, and the interaction between them will affect attainment of goals of preventive interventions for CHD; and b) specific strata of morbidity and cancer prognosis will modify the effectiveness of these interventions on the CHD outcomes. In evaluating these prevention strategies on CHD outcomes, we will study the processes of care for the comorbidities of hypertension, diabetes, hyperlipidemia, and pre-existing CHD. We will use linear regression models and Cox proportional hazard models to assess the impact of the cancer prognosis and other morbidity scores (and their interactions) on the CHD prevention outcomes. A Cox proportional hazards model will be used to assess the effectiveness of the prevention measures on time to the CHD composite outcome across strata defined by prognosis/morbidity. Finally, we will describe which prevention measures most influence which components of the CHD outcomes. Information from this investigation will inform recommendations for the use of these specific preventive interventions in patients with a range of morbidities in order to make these recommendations congruent with an evidence base that acknowledges complex patients' priorities, time, and resources. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Individualized Treatment Strategies and Optimal Hematocrit Target for complex Dialysis Patient Background Medical Technology and Practice Patterns $0 Almost all renal failure patients suffer from anemia as an important co- morbid condition. Epoetin therapy, approved by the FDA in 1989, is the mainstay of treatment for anemia among this population. After almost 20 years, key questions regarding the effectiveness of epoetin therapy remain unanswered. In particular, the role of comorbid conditions highly prevalent among renal failure patients with anemia is unknown. Do patients with co-morbidities including cardiovascular disease and diabetes require a different therapeutic endpoint given several recent randomized trials and Black Box warnings by the FDA to use the lowest dose of epoetin possible. Currently, there appears to be uncertainty in the nephrology community as to the optimal target hematocrit and epoetin dosing protocols for various patient groups. Objectives. The objective of our proposed study is to address the key question: What is the optimal treatment strategy based on the presence of co-morbidities such as cardiovascular disease and diabetes? The only existing epoetin RCT for the dialysis population suggests that patients with cardiovascular disease should not be targeted to normal hematocrit levels. Dialysis patients with diabetes have more severe anemia and are more resistant to treatment. To address this research question, we will also examine how does the presence of such comorbidities affect patient responsiveness to epoetin therapy? Specifically, for complex patients who are responsive to epoetin therapy (and use lower than average dose), does targeting higher than FDA-recommended hematocrits lead to better outcomes? For patients with co-morbid conditions who are not responsive (with low hematocrits and high doses), does administering high doses to target the FDA- recommended hematocrit lead to worse outcomes? Finally, given the presence of diabetes or cardiovascular disease, what is the optimal treatment strategy further disaggregated further by patient demographics such as race, gender and age affect outcome? Methods. We propose to apply causal analytical methods (inverse probability weighting models) that, unlike standard statistical methods, appropriately adjust for time-dependent confounders that are affected by prior treatment. The proposed methods are therefore well suited to address key questions concerning anemia management and mortality of dialysis patients. Significance. To date, limited RCTs and observational studies have been disaggregated by patient co-morbidities when evaluating patient outcomes in the renal failure population. The continuing use of a single hematocrit target range and dosing protocols for all dialysis patients ignores individual patient needs of those with comorbid diabetes or cardiovascular disease. Causal inference techniques have been developed and validated using randomized clinical trial data in other treatment areas. In this grant, we propose to apply these innovative techniques using Medicare administrative data to provide a basis for improved patient outcomes using 'individualized' guidelines based on common patient comorbid characteristics. Study findings might provide the basis for improved clinical guidelines and more cost-effective payer policies. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Outpatient Versus Residential Treatment Comparison for Pregnant Substance Abusers OREGON HEALTH AND SCIENCE UNIVERSITY $0 Addictive disorders are chronic conditions for many women. Substance use during pregnancy is especially worrisome. Moreover, major depressive disorder often co-occurs with substance abuse among women. Therefore, pregnant women with substance abuse are complex patients. Priority populations (e.g., minority group members) are greatly over-represented among pregnant substance abusers. Treatment can be effective for female substance abusers but few (if any) data are available regarding comparative effectiveness of residential versus outpatient treatment for pregnant women with addictions. Residential treatment, by definition, provides shelter and reduces availability of substances in addition to delivering care for chemical dependency. However, residential treatment removes patients from their usual home and work environments and is more expensive than outpatient care. Although not focusing on pregnant substance abusers, studies have generally found little difference in outcomes for residential versus outpatient chemical dependency treatment. On the other hand, research has also suggested patient factors (such as addiction severity) may moderate treatment impact so that sub-groups of substance abusers differentially benefit from residential (versus outpatient) care. To address these issues, the proposed project responds to RFA-HS-10-009: Recovery Act 2009 Limited Competition OS ARRA: Comparative Effectiveness Research to Optimize Prevention and Healthcare Management for the Complex Patient (R21). The work will be an analytic epidemiologic study addressing "the benefits and harms of preventive or therapeutic interventions in 'real world' settings for patients who have multiple chronic co-morbid conditions." The chief focus will be pregnant women (many of whom also have major depressive disorder) obtaining treatment for chemical dependency. Two of the co- occurring conditions are substance abuse and pregnancy (both are in the current list of conditions given in the Request for Applications). As required by the Request for Applications, a physical condition (pregnancy) will be addressed. Many participants will have (as a third co-existing condition) major depressive disorder (which is also listed in the Request for Applications). In compliance with the Request for Applications, the study population will include (as a comparison group) female substance abuse treatment patients who are not pregnant. The intervention will be specialty sector substance abuse treatment. The "real world" settings will be publicly financed substance abuse treatment programs. Among several data sets, the project will employ newly available information from the nation-wide Treatment Episode Data Set discharge database. Innovative statistical techniques (including non-linear instrumental variables approaches) will be employed. Comparative effectiveness of outpatient versus residential substance abuse treatment will be examined. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Should High-Risk Statin Utilization Rates Be Increased for Complex AMI Patients? UNIVERSITY OF IOWA $0 Filling the evidence gaps within cardiovascular disease (CVD) has been identified as a priority by the Agency for Healthcare Policy and Research (AHRQ), and, as emphasized by a report from the AHRQ Effective Healthcare Program, important questions remain regarding the effectiveness of high-dose statins for the secondary prevention of CVD in complex patient subgroups. Randomized controlled trials have shown that aggressively lowering low density lipoprotein cholesterol (LDL-C) with high-dose statins can result in an additional 16% reduction in CVD events compared to moderate-dose statins. Subgroup analyses of trial data also suggest that the benefits of high-dose statins may be even greater for complex CVD patients. Current US guidelines recommend at least a 50% reduction in LDL-C as desirable for cardiovascular prevention and that a more aggressive LDL-C goal <70 mg/dl be considered for very high risk patients. Although most patients require a high-dose statin to achieve guideline recommendations, only <25% of high risk patients in practice receive one. Wide prescribing variation, use of lower potency generic statins due to cost concerns, concerns about safety, and the existence of a "treatment risk paradox" in which complex patients are less likely treated, suggest that providers remain uncertain as to the benefits and harms of treatments for many complex CVD patients. Providers may believe that the benefits and harms of high-dose statins are heterogeneous across patients and in practice they are sorting patients based on these beliefs. Are providers missing benefit opportunities by not expanding high-dose statin prescribing rates among complex CVD patients or do current high-dose statin prescribing rates represent a correct balancing by providers of the benefits and harms across patients? As stated many years ago by John Wennberg, the real question is "Which rate is right?" This proposal is responding to the analytical epidemiological studies component of RFA-HS- 10-009. In this study we will conduct a retrospective cohort study assessing the comparative effectiveness of high-dose statins for complex patients post acute myocardial infarction (AMI) since those with AMI have a clear indication for high-dose statin therapy. We will take advantage of the large number of Medicare patients with AMI that have Medicare "Part D" prescription drug coverage in the Centers for Medicare & Medicaid Services (CMS) Chronic Condition Data Warehouse (CCW) to analyze the effectiveness of high-dose statins within subsets of complex AMI patients. Complex AMI patients will be defined by the presence of diabetes, congestive heart failure (CHF), and chronic kidney disease (CKD), conditions that place AMI patients at very high cardiovascular risk.3, 39, 40 Our analytical framework includes using both risk adjustment (RA) estimators (including propensity score methods) and moment-based instrumental variable (IV) estimators and interprets their estimates in terms of the distinct treatment effect concept produced by each estimator. Because it appears that high- dose statin utilization rates have lagged behind guideline recommendations, we hypothesize that (1) the patients that received high-dose statins had cardiovascular event-free survival gains sufficient to justify side-effect risks and healthcare costs; and (2) that higher high-dose statin treatment rates would increase cardiovascular event-free survival rates enough to justify increased side-effect rates and healthcare costs. The aims of this research are consistent with both the clinical and methodological goals of the AHRQ Comparative Effectiveness Portfolio. Our methodological approach is innovative because we will (1) assess the comparative effectiveness of high-dose statins using both RA and IV approaches in light of the correct interpretations of estimates from these methods; and (2) exploit the large number of AMI Medicare patients from the CCW to estimate the comparative effectiveness of high-dose statins complex subsets of AMI patients The research team has the unique combination of clinical, methodological, and empirical expertise that is necessary to perform the proposed research. 10/02/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Diabetes Prevention Strategies in Women with Gestational Diabetes KAISER FOUNDATION RESEARCH INSTITUTE $0 Type 2 diabetes (T2DM) develops in 50 percent of women with gestational diabetes (GDM) within 5 years after delivery. So far, no lifestyle interventions have been translated for women with GDM in the postpartum period. The main goal of this study is to examine the effect of diabetes prevention strategies in women with gestational diabetes (GDM) for improving the following: obesity, hyperglycemia, hypertension and depression in a real-world clinical setting. It is a cluster randomized lifestyle intervention trial that assesses the effect of an organizational-level intervention on weight management in GDM patients. Randomization will occur at the medical center level; 44 medical centers of Kaiser Permanente Northern California (KP) will participate and data will be collected for more than 2,400 pregnant women with GDM (36% Asian, 31% Hispanic, 25% white, 4% African American and 5% other ethnic groups). The intervention will be compared to usual care. The intervention will extend an existing KP case-management program offered by the KP Perinatal Center to patients with GDM during pregnancy. Intervention patients will be offered a postpartum lifestyle curriculum of individual telephone counseling augmented with e-mails and an interactive study website. The primary aim is to implement and evaluate an intervention of diet and physical activity (PA) with the primary goals of: (a) reaching pre-pregnancy weight for women with a normal weight prior to pregnancy; or (b) reaching a 5 percent reduction of their pre-pregnancy body weight if the women were overweight or obese prior to pregnancy. Targets for the intervention during pregnancy (Prenatal Phase I) are to help GDM patients comply with IOM guidelines for gestational weight gain. Finding that this intervention is cost-effective in this setting should motivate its adoption at KP as well as in other health care systems. 09/03/2010 link
Medical treatments, items and services AHRQ Impact of Medicaid Policy on Cardiovascular Drug Use and Clinical Outcomes BRIGHAM & WOMEN»S HOSPITAL $0 Policies to control the use of cardiovascular medications are commonly used in public and private programs despite a lack of comparative evidence on whether they achieve savings and how such savings might balance against changes in clinical events. Drawing on years of experience in studying Medicaid policy and using large patient-level Medicaid data sets, we will measure the comparative effectiveness of Medicaid policies on cardiovascular drug spending and assess whether reduced drug use is associated with adverse clinical outcomes, providing critical information for policy-makers and health system design decision makers. 09/03/2010 link
Medical treatments, items and services AHRQ Informing Sound Policy: Linking Medical Home Measures and Child Health Outcomes Indiana University-Purdue University at Indianapolis $0 The proposed research is relevant to public health because it will help practices, payers and policymakers identify which features of pediatric primary care medical home practices optimize outcomes for children so that they may make targeted investment and intervention decisions. 10/02/2010 link
Medical treatments, items and services AHRQ Physician Quality Reporting and Patient Outcomes in Medicare UNIVERSITY OF MINNESOTA TWIN CITIES $0 One of the most important developments in the U.S. health care system has been the collection of data on quality of care. Medicare's Physician Quality Reporting Initiative (PQRI) is the nation's largest data collection effort on health care quality from individual providers. To understand if this quality reporting makes a difference, this study will analyze relationships among physician reporting, quality outcomes, and expenditures, with special attention to whether results vary according to the race, ethnicity, or sex of the patient, or by type of chronic disease diagnosis. 10/02/2010 link
Medical treatments, items and services ASPE NIH/NIDDK--Increasing Adoption of Early Intervention to Prevent Diabetes After Gestational DM Social & Scientific Systems $1,999,917 This project is funded by the American Recovery and Reinvestment Act of 2009 (ARRA). Gestational diabetes mellitus (GDM) is a form of diabetes that is first diagnosed during pregnancy. About 7 percent of all US pregnancies - about 200,000 each year - are complicated by gestational diabetes. Women who have been diagnosed with GDM are at a markedly increased risk of having it again during future pregnancies or developing type 2 diabetes later in life. The purpose of this task order is to provide Recovery Act funding for a study focusing on this population that is at the highest risk for developing type 2 diabetes, that will identify effective ways to bring proven interventions into clinical practice, and engage women with a history of GDM and their health care providers in lifestyle behavior changes and/or medical therapy to prevent or delay type 2 diabetes. 08/20/2010 link
Medical treatments, items and services AHRQ Back Pain Outcomes Using Longitudinal Data (BOLD) UNIVERSITY OF WASHINGTON $0 Low back pain is one of the most important causes of functional limitation and disability, an Institute of Medicine priority condition, and it remains a particularly important problem for the elderly, an AHRQ priority population. The overall goal of this project is to establish a sustainable and rich registry to evaluate prospectively the effectiveness, safety, and cost-effectiveness of interventions for patients over age 65 with low back pain. We propose 3 specific aims: 1) To establish the Back pain Outcomes using Longitudinal Data (BOLD) registry; 2) To conduct a randomized controlled trial (RCT) in elderly patients (an AHRQ priority population) with spinal stenosis to test if the effectiveness of epidural steroid injections (ESI) plus local anesthetics (LA) is greater than LA alone; 3) To conduct a prospective, observational cohort study to compare the effectiveness of early (within 6 weeks of presentation) advanced imaging (MRI and CT) to no advanced imaging in elderly patients with new episodes of low back pain without radiculopathy with respect to pain, function and subsequent resource utilization. 10/02/2010 link
Medical treatments, items and services AHRQ BELT: Blacks & Exacerbations on LABA vs. Tiotropium Harvard Clinical Research Institute $0 The results of this study will provide the information necessary to make evidence-based, individualized, recommendations concerning treatment algorithms and potential alternative treatment recommendations for the 3.5 million Blacks with asthma. The performance of this study in real life primary care settings will hasten the translation of these findings into day to day practice for this minority population that experiences a disproportionate burden of asthma and has been underrepresented in previous asthma studies. 10/02/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Environmental Intervention and Standard Care COLUMBIA UNIVERSITY HEALTH SCIENCES $0 DiMango, Emily/Kattan, Meyer Exposure to allergens within the household is a major public health concern in asthma, one that is critical for the entire asthma population, but is most salient for residents of inner cities. The proposed study rigorously tests national guidelines in asthma care and fills a gap in understanding the importance of environmental remediation as it compares with need for pharmacological therapy for asthma control. Results of the study have the potential to affect public health policy as well as reimbursement from third party health care insurance companies. PHS 398/2590 (Rev. 11/07) Page Continuation Format Page 09/03/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness Study for Bipolar Disorder Massachusetts General Hospital $0 This study will compare two treatments over 6 months for participants with bipolar disorder who present with at least mild symptoms and who require a change in treatment. The two treatments will be the second generation antipsychotic mood stabilizer quetiapine and the classic mood stabilizer lithium. In addition to quetiapine or lithium, participants can be treated with other medications as needed. 10/02/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Treatments of Localized Prostate Cancer Vanderbilt University Medical Center $0 This study will compare the effectiveness of surgery and radiation for localized prostate cancer, the most common male cancer. It will focus on modern technologies and control for differences in patients and treatments that may affect outcomes. By figuring out what treatments "work best, in which patients and in whose hands", we will help men with prostate cancer make better decisions regarding their care. 08/14/2010 link
Medical treatments, items and services AHRQ Project CLEAR--Changing Lives by Eradicating Antibiotic Resistance University of California Irvine $0 This randomized controlled trial will compare strategies to reduce the risk of methicillin-resistant Staphylococcus aureus (MRSA) infection and re-hospitalization in MRSA carriers. This trial will provide critical answers about the role of decolonization versus standard-of-care education in preventing MRSA infections in the large group of high risk MRSA+ patients being discharged from hospitals. Findings could potentially impact best practice for the 1.8 million MRSA carriers who are discharged from U.S. hospitals each year. 10/02/2010 link
Medical treatments, items and services AHRQ Promoting Adherence to Improve Effectiveness of Cardiovascular Disease Therapies KAISER FOUNDATION RESEARCH INSTITUTE $0 The primary goal of the PATIENT study is to increase both initial use and ongoing adherence to three classes of medications used to treat diabetes or cardiovascular disease. The PATIENT interventions use interactive voice recognition, with and without supplemental personalized mailings to patients and messages to providers, to deliver medication refill reminders, educate members about their conditions, and connect members with pharmacists and their doctors. If PATIENT's methods are successful, this research should lead to reduced hospitalizations and deaths, and to increased quality of life for people with diabetes or cardiovascular disease. This research should also be broadly applicable to other diseases and treatments. 09/03/2010 link
Medical treatments, items and services AHRQ RESCUE: Randomized Evaluation of Patients with Stable Angina Comparing Utilization American College of Radiology $0 RESCUE is a multi-center randomized, controlled trial comparing coronary CT angiography (CCTA) and single photon emission tomography myocardial perfusion imaging (SPECT-MPI) integrated into a stable angina care paradigm featuring optimized medical therapy for patients diagnosed with CAD without significant disease in the left main coronary artery. Patients will be followed for a composite endpoint of major adverse cardiac events (MACE) and cross-over to revascularization over a 12-24 month period. Several comparative effectiveness analyses will be performed. The investigators hypothesize that the CCTA arm will be associated with no increase in major coronary events (MACE) or revascularization, decreased cost and increased cost-effectiveness in comparison to SPECT-MPI. Findings are expected to result in validation of an evolving new standard of care for patients with stable angina that takes advantage of CCTA to more cost effectively drive appropriate care. 10/02/2010 link
Medical treatments, items and services AHRQ RCT of US versus CT for Patients in the ED with Suspected Renal Colic UNIVERSITY OF CALIFORNIA SAN FRANCISCO $0 This study compares different imaging strategies for patients seen in large emergency departments with symptoms concerning for urolithiasis (kidney stones). The study proposes a multicenter, randomized controlled trial of ultrasonography compared with computed tomography for the evaluation of patients with suspected kidney stones. The study will enroll patients at 10 large urban Emergency Departments (ED) and patients will be randomized to one of three arms: 1) ultrasonography in the ED, 2) ultrasonography in radiology, or 3) computed tomography in radiology. The study will then collect precise and unbiased data on a comprehensive range of outcomes that will allow assessment of effectiveness, safety, accuracy and cost between patients randomized to one of the three groups. Taken together, these measures are intended to provide the basis for a valid comparison of imaging of patients with suspected urolithiasis seen in the ED. The results of this trial could lead to a change in clinical practice that is associated with both improved patient outcomes and reduced cost. 10/02/2010 link
Medical treatments, items and services AHRQ Variations in Care: Comparing Heart Failure Care Transit UNIVERSITY OF CALIFORNIA LOS ANGELES $0 Heart failure is a prevalent condition among the elderly that has high rates of potentially avoidable readmissions. Readmissions can be reduced through programs to improve the transition of care from inpatient to outpatient settings, but these programs are not currently widespread due to implementation costs at the hospital level. This research compares the costs and the effectiveness of two separate adaptations of care transition interventions on reducing readmissions for elderly heart failure patients, and their effectiveness on reducing the variation between six medical centers on readmission rates for elderly heart failure patients. 09/03/2010 link
Medical treatments, items and services AHRQ Wound EMR to Decrease Limb Amputations in Persons with Diabetes NEW YORK UNIVERSITY SCHOOL OF MEDICINE $0 The goal of this project is to demonstrate that effective utilization of the Online Wound Electronic Medical Record (OWEMR) can prevent DFU progression to amputation in a variety of healthcare settings. Successful completion of this project will provide level-1 evidence for the effectiveness of the OWEMR as a clinical intervention for reducing DFU-related foot amputations. It also will close a knowledge gap in DFU treatment by defining the effectiveness of long-term glycemic control in reducing DFU-associated amputations. Primary stakeholders in diabetes care - professional associations of wound care specialists and diabetes advocates - will facilitate the translation and dissemination of revised DFU treatment guidelines resulting from this project through their web sites, publications, continuing education programs and conferences. 10/02/2010 link
Medical treatments, items and services AHRQ ARRA "Decide Methods Center (DMC) BRIGHAM & WOMEN»S HOSPITAL $3,934,148 07/21/2010 link
Medical treatments, items and services AHRQ Comparing the Long-term and Real-world Effectiveness of Initial Management Strategies for Ductal Carcinoma In Situ BRIGHAM & WOMEN»S HOSPITAL $3,040,076 07/17/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Therapies for Heart Failure DUKE UNIVERSITY $2,073,232 07/17/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness Studies to Improve Patient Outcomes in End Stage Renal Disease (ESRD) JOHNS HOPKINS UNIVERSITY $4,556,778 07/17/2010 link
Medical treatments, items and services AHRQ Comparing the Effectiveness of Treatment Strategies for Primary Open-Angle Glaucoma Outcome Sciences, Inc. $4,055,617 07/17/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Intravenous Iron Formulations in End-Stage Renal Disease University of North Carolina at Chapel Hill $2,836,647 07/17/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Management Options for Localized Prostate Cancer University of North Carolina at Chapel Hill $3,378,263 07/17/2010 link
Medical treatments, items and services NIH IMPROVING MEDICATION THERAPY FOR OLDER PATIENTS WITH COMMON CO-MORBIDITIES JEWISH HOME OF SAN FRANCISCO $414,643 The overall goal is to improve the use of medications for older people with multiple medical disorders. 09/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Comparative Effectivness Research to Enhance the Delivery of Services within the Indian Health Service Denver Health $3,070,882 The Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services (DHHS) intends to issue a Request for Task Order Proposal under the ACTION Program to support the development of data infrastructure that will accelerate comparative effectiveness research (CER) for the American Indian/Alaska Native (AI/AN) population and to support efforts to prioritize health systems delivery strategies for chronic disease management. The goal of the task order is to use electronic clinical data from the Indian Health Service (IHS) national health information system (RPMS – Resource and Patient Management System) to enhance the capacity to electronically measure quality of care consistent with national HIT standards and conduct comparative effectiveness research that will identify care delivery models with the Indian Health System that result in improved health outcomes. Advanced practice pharmacy within the Indian Health System will be the object of CER for this project. 09/29/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Fluoride Effectiveness in Prevention of Dental Caries in High Caries Risk Adults BOSTON UNIVERSITY MEDICAL CAMPUS $0 The proposed work addresses several of the Institute of Medicine's (IOM's) national priorities in clinical effectiveness research: disparities in oral health and health care. Combining extant dental data with other components of the rich VA patient databases, we will be able to examine the effectiveness of fluoride in preventing caries in patients with five of the 14 priority conditions specified by AHRQ: medically compromised veterans with dementia, depression and bipolar disorder, diabetes, HIV-Aids and persons with alcohol dependence. Recent data suggest that dental caries is as much of a problem in adults as children (Dye, et al., 2007). However, significant knowledge gaps remain in our knowledge base regarding prevention of caries in adults (Griffin et al., 2007). Using an extant, rich electronic data base from a health care system providing dental treatment to over 342,000 veterans annually, this proposed retrospective, longitudinal study takes maximum advantage of a unique opportunity to examine the following specific aims in a population of medically complex veterans. Aim 1. Examine the effectiveness of prescription-strength, self-applied fluoride and professionally applied fluoride in the prevention of caries in medically compromised veterans who are at high risk for caries. Veterans will be defined as at risk for caries if they have had two or more restorations in the previous year. Aim 2. While recent evidence suggests that fluoride is effective in preventing caries in adults, and multiple exposures to fluoride reduces caries risk in children (Weintraub, 2006), limited data exist showing that multiple exposures or modalities are more effective than a single modality in adults. Thus, we have a unique opportunity to examine whether multiple exposures to fluoride will be more effective than a single exposure. Aim 3. Over the past year, the Department of Veterans Affairs introduced a quality measure (the fluoride monitor) that examines, on a quarterly basis, the percent of veterans at high risk for caries who receive fluoride treatments. This project will examine the effectiveness of the introduction of this fluoride monitor in reducing the rate of restorations in medically compromised veterans at high risk for caries. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Impact of Mental Illness and/or Substance Abuse on Diabetes Intervention and Outcomes Maine State Department of Health and Human Services $0 Research suggests that there are significant interactions between mental illness and chronic medical conditions, with greater morbidity, cost and poorer outcomes, both for the chronic medical disorder and for the mental illness in persons with both conditions. This analytic epidemiologic study aims to further scientific knowledge about the effectiveness and outcomes of treatments for both diabetes and behavioral health disorders, including depression, serious and persistent mental illness (SPMI) and substance abuse, when these conditions co-exist in Mainers served by the publicly funded health and mental health systems. The project will provide data to clarify how co-existing mental illness and chronic medical disorders modify the utilization and comparative effectiveness of proven prevention and treatment interventions for each condition and the impact of these co-morbidities on overall health and disease specific outcomes in these complex populations. This study will lay the foundation for Maine's efforts to identify and implement more effective, integrated and person centered interventions to promote the overall health and safety of the complex individuals in the state's publicly funded health and human service system. Based on diagnoses on two years of Medicaid services claims, all 18-64 year old Medicaid members with continuous eligibility and full benefits will be assigned to one of three cohorts, a group with mental illness diagnoses, but no substance abuse; a group with both mental illness and substance abuse; and a group with neither behavioral health diagnosis. The mental illness groups will be further subdivided into subgroups with SPMI or depression. These cohorts will be further subdivided by the presence of diabetes. The index cohorts will be as follows: SPMI and diabetes, depression and diabetes and dual diagnosis depression or SPMI and diabetes. The cohorts with mental illness only, diabetes only and neither mental illness nor diabetes will be comparison groups. Utilization of prevention and treatment interventions, quality metrics and outcomes, defined in AHRQ publications, will be compared among the different cohorts. Where none exist, novel metrics will be created to categorize behavioral health interventions; by examining which of these are associated with better outcomes, the project will add to the evidence base on behavioral health quality interventions and metrics. Analyses will be bi- directional, examining the impact of mental illness on the utilization, quality, effectiveness of interventions, cost and outcome for diabetes, as well as the impact of diabetes and other medical co-morbidities on utilization, cost and outcome in the groups with mental illness. The findings of this project are expected to lay a foundation for future research on strategies that improve the health of complex individuals and promote the integration of mental and physical health in our traditionally separate mental, physical and public health systems of care. 10/02/2010 link
Medical treatments, items and services AHRQ Comparative Outcomes Management with Electronic Data Technology (COMET) Study STANFORD UNIVERSITY $0 We plan to develop an electronic network that will enable the transfer of information from various hospitals and medical centers, patients and research subjects, different types and severity of medical problems, various equipment and test types, and across several patient visits. This network will allow physicians and scientists to access comprehensive information about their patients and research subjects, and the sharing of this information across several academic institutions may ultimately lead to improvement in medical outcomes. We also plan to conduct a study evaluating two common treatments for obstructive sleep apnea (OSA), a highly prevalent sleep-related breathing disorder, and we anticipate that this study will provide comparative data for determining the effectiveness of these treatments in reducing cardiovascular risk in a population at high risk for cardiovascular disease, and will enhance clinical decision making in determining the optimal treatment strategies for patients with OSA. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Multiple Chronic Conditions in Very Low Birth Weight Infants: Epidemiology, NICU Care, and Outcome Research Institute Nationwide Children»s Hospital $0 Prematurity and its complications are the leading causes of death among children in the first year of life and causes of morbidity lasting for the entire lifespan. Premature and very low birth weight infants (PVLBW, defined as gestational age d 32 weeks and birth weight d 1500g) are 100 times more likely than a normal infant to die in the first year of life, and they are at high risk for developmental delays, functional disabilities, and often have multiple complex chronic conditions affecting the lungs, gut, brain, eyes, and other organs. Specifically, PVLBW children are at high risk for bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and intraventricular hemorrhages (IVH). We propose to conduct an epidemiologic description of the co-occurrence of these conditions, through a secondary analysis of 15470 premature children admitted to NICUs from 2006- 2010 at 33 children's hospitals in the Pediatric Health Information System (PHIS) database, looking at the effects of these chronic conditions on PVLBW infants receiving care in NICUs. The outcomes of interest include death during the NICU stay, cumulative burden of therapies received during the NICU stay, and re- hospitalization within 30 days following discharge from the NICU. We will: 1) Describe the incidence of the chronic conditions among PVLBW infants during the initial NICU admission, singly and in combination. 2) Describe the associations between the chronic conditions, singly and in combination, and three outcomes of the first NICU admission: death during the NICU stay, the cumulative burden of therapies received during the NICU stay, and re-hospitalization following discharge from the NICU. 3) We will document the consequences of one key intervention on the outcomes: the use of inhaled Nitric Oxide to prevent and treat BPD. The rates of both prematurity and VLBW are rising in the U.S. VLBW occurs at > 2.5 times the rate among blacks compared to the rest of the U.S. population and is therefore a significant vector of health disparities. In all analyses, we will look for evidence of disparate incidence, outcomes, treatment or efficacy of treatment of the chronic conditions based on race or payer status. We will also look for hospital- or region-specific variation in the incidence, outcomes, or treatment of the chronic conditions. Because PVLBW babies are often subject to multiple chronic disorders and are over-represented in an underserved community, they are a priority population for comparative effectiveness research. The proposed study will be significant because it will be the first to systematically describe, in a large sample, the incidence, outcomes, and treatment of multiple co- occurring severe chronic conditions in PVLBW infants, a population experiencing significant mortality and morbidity. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Optimizing Chronic Disease Prevention and Management in Advanced Dementia University of Massachusetts Medical School, Worcester $0 The Agency for Healthcare Research and Quality has invited grant applications for the purpose of understanding the comparative value of different strategies in the prevention and management of chronic illness in persons with multiple chronic conditions. In this application, "Optimizing Chronic Disease Prevention and Management in Advanced Dementia", we propose to study the effectiveness of medication prophylaxis for chronic illness in the medically complex population of nursing home (NH) residents with advanced dementia. Over half of the 1.6 million residents of US NHs have dementia, and those with advanced dementia have a prognosis comparable to that of metastatic breast cancer or stage IV heart failure. Our prior work shows that medications inappropriate in advanced dementia are used by almost 40% of NH residents with advanced dementia, and are continued in almost 20% of these patients in the last week of life. These agents such as lipid-lowering and osteoporosis drugs may not be consistent with goals of care, increase the risk of adverse drug events and drug-drug interactions, are costly, and contribute to polypharmacy. Efforts to improve prescribing in advanced dementia are hampered by a lack of studies examining medication effectiveness and drug withdrawal safety in this population. The goal of this R21 is to develop the infrastructure to systematically investigate the effectiveness and safety of strategies to reconsider medications for chronic non-dementia illnesses in NH residents with advanced dementia. We describe the first in a series of studies evaluating the comparative effectiveness of medications of questionable benefit in advanced dementia, in order to rationally prioritize therapy for this vulnerable and understudied population. A particular focus is on the evaluation of the prevalence, cost, and factors associated with using medications inappropriate in NH residents with advanced dementia, and in evaluating the clinical impact of the use and discontinuation of statins for cardiovascular disease in this population. Studies will utilize administrative claims data linked to federally- mandated NH resident assessment data from 2 large populations: 1) over 12,500 NH residents with dementia who received prescription services from a nationwide long term care pharmacy between 2005-2008; and 2) NH residents of 5 states (Minnesota, Massachusetts, Pennsylvania, California and Florida), including ~95,000 NH residents with dementia who used Medicare Part D drug benefits between 2006-2007. Data sources for these populations include: drug claims for all dispensed medications; resident demographics; hospitalization claims; NH facility characteristics and mortality. Analyses will adapt techniques to address selection bias in observational studies (propensity scores, comparator group restriction, and self-controlled case-series), and methods for longitudinal and clustered data to account for repeat prescriptions in the same residents within NHs. These studies advance analytic strategies for evaluating prescribing strategies and their effects on NH residents with advanced dementia and lay the foundation for efforts to optimize prescribing in this population. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Safety and Effectiveness Evaluations for Kidney Disease in Complex Patients BOSTON UNIVERSITY MEDICAL CAMPUS $0 This application addresses broad needs for comparative effectiveness research and proposes to conduct and analytic epidemiologic studies of retrospective cohort design, to assess the benefits and harms of preventive or therapeutic interventions in "real world" settings for patients who have multiple chronic co morbid conditions. It proposes research on chronic kidney disease (CKD) in diabetes patients and its progression to end stage renal disease (ESRD), conditions that are devastating and increasingly prevalent, with high mortality and high direct costs of care. Although a number of treatments are widely recommended for slowing progression of CKD and reducing risks of associated cardiovascular disease (CVD), ESRD, and mortality, there is little experimental evidence to support these recommendations and there have been few trials comparing drugs within classes in terms of effectiveness and safety. Such trials are unlikely to be done in the near future and much can be learned from careful observational studies of existing patient data to identify the most safe and effective treatments. We propose to conduct such studies in the diabetes patient population served by the Veterans Health Administration (VA), the largest sample of older adults in an integrated health care system in the U.S. with comprehensive electronic medical records. These patients have high prevalence of CKD and other morbidities, and represent those who are often excluded from clinical trials. We have shown in our previous work that large, rigorous, longitudinal studies can be done in the VA and we have developed and evaluated methodologies for such research. We now propose to study complex diabetes patients with CKD and other co-morbidities in order to evaluate comparative effectiveness and safety in slowing the progression of kidney disease (decline in estimated glomerular filtration rate (eGFR), transition in CKD stage, transition to ESRD), reducing risks of other outcomes (CVD events, mortality), and having low associated risks of medication-related adverse renal outcomes (acute kidney injury, hyperkalemia) and other adverse events (hypoglycemia, angioedema, falls). Class-to class and drug-to-drug comparisons will be made within the following classes or groups of medications recommended for treating CKD: angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, and HMGcoA reductase inhibitors (statins). Samples and exposure groups will be selected carefully to replicate common clinical decisions in treatment and up to 11 years of national data will be used with application of rigorous epidemiologic methods to reduce potential bias and provide valid and meaningful results. This research represents a real opportunity to better understand benefits and risks associated with treatments for CKD in complex diabetes patients and application of its findings should result in safer and more effective prescribing practices. 10/02/2010 link
Medical treatments, items and services NIH/AHRQ Use of Behavioral Economics to Improve Treatment of Acute Respiratory Infections University of Southern California $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery and Reinvestment Act of 2009 (Recovery Act or ARRA), Public Law 111-5, invites applications proposing clinical trials using the principles of behavioral economics to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. For this FOA, applicants must propose controlled trials that randomize units (whether individuals or clusters such as practices, hospitals, or larger units) to conditions, resulting in a randomized clinical trial (RCT) or cluster randomized trial (CRT). Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER (e.g., those that rely on manipulating a providers default options) could be more cost effective than conventional approaches including some pay for performance schemes (P4P). For the purposes of this FOA, the definition of comparative effectiveness research will adhere to that adopted by the Federal Coordinating Council given at http://www.hhs.gov/recovery/programs/cer/cerannualrpt.pdf. Behavioral economics refers to the interdisciplinary efforts involving cognitive and social psychologists, decision scientists, and other social scientists together with economists to model economic decision-making and consequent actions. The approach is inclusive, since at its heart it tries to take into account what is known about how people actually make decisions rather than relying on the assumption that economic agents are fundamentally rational in the sense of expected utility theory (see, e.g., Kahneman and Tverskys (1979) work on Prospect Theory and Kahnemans (2003) Nobel lecture). It is hoped that this line of research will lead to significantly greater consideration of CER by health care providers and therefore enhance the quality of the nations health. 09/18/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Statins and Ace Inhibitors in Adults With Diabetes and Comorbid Conditions UNIVERSITY OF WASHINGTON $0 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service A Study of Trends in Obesity Progression Among Complex Patients Palo Alto Medical Foundation Research Institute $0 Obesity accounts for up to 15% of all deaths in the U.S. In 2007-2008, the prevalence of obesity among adults was 33.8%. Obesity threatens to reverse the net benefit of declining smoking rates on the U.S. population. It contributes to untimely mortality and reduces quality of life, both of which are further influenced by the frequent co-occurrence of debilitating co-morbidities including depression and cardiovascular diseases. This translates to tremendous health and economic costs. We propose an innovative exploratory research project focusing on patients with a constellation of three chronic conditions: (1) obesity, (2) hypertension, and (3) depression. A team with complementary capacities has been assembled for an analytical epidemiological study at the Palo Alto Medical Foundation Research Institute (PAMFRI), an AHRQ ACTION network member and a component of the Palo Alto Medical Foundation (PAMF), a large non-profit multi-specialty delivery system. PAMF has implemented the EpicCare Electronic Health Record (EHR) system since 2000. Many research and quality improvement efforts related to these three conditions are ongoing at PAMF, including a study jointly funded by the NIH and the American Heart Association, entitled Evaluation of Lifestyle Interventions to Treat Elevated cardiometabolic risk (E-LITE). Underway at one PAMF clinic, E-LITE is a randomized controlled trial (RCT) of two modified forms of a highly successful lifestyle intervention to treat overweight or obese adults. The specific aims are to: (1) Follow the clinical paths of patients with obesity alone versus with the obesity-hypertension-depression constellation, using EHR data from 2000 to 2010. We will examine the interventions these patients receive, including but not limited to, shared medical appointments for obesity or mental health, bariatric surgery, behavioral interventions, and pharmacologic treatment. We will evaluate the progression of the conditions in the constellation among patients stratified by age, gender, race, and disease states and assess the impact of various interventions. (2) Leverage the prospectively collected data in E-LITE to examine the effectiveness of intensive lifestyle interventions for subsets of E-LITE patients with various combinations of the three priority conditions. We will test if the presence of hypertension and/or depression influences the effectiveness of E-LITE interventions in reducing obesity and cardiometabolic risk. (3) Assess how well the sample of patients and physicians in E-LITE represents the patients and physicians in the study clinic and other clinics in PAMF. We will compare characteristics and clinical trajectories of patient participants in E-LITE with non-participating patients who also have obesity in that clinic or elsewhere in PAMF. We will also compare practice styles of E-LITE physicians with non-E-LITE physicians at PAMF. Results of the study can inform current PAMF and national quality improvement measures and treatment guidelines for managing patients with obesity-hypertension-depression, a common and costly constellation of priority conditions. 10/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Comparative Effectiveness of Quality Improvement Efforts Among American Indian and Alaska Native Communities Westat, Inc. $1,686,484 The Agency for Healthcare Research and Quality (AHRQ) intends to issue a competitive task order against an Indefinite Delivery Indefinite Quantity Task Order with the National Resource Center Domain 2 master contract holders. It is anticipated that AHRQ will award 1 task order. The purpose of this task order is to support the development of data infrastructure that will accelerate comparative effectiveness research on the American Indian/Alaska Native (AI/AN) population and to support efforts to prioritize prevention, treatment and chronic disease management interventions for this population through comparative effectiveness research. The goal of this task order is to use electronic clinical data from the Indian Health Service (IHS) national health information system (RPMS - Resource and Patient Management System) to enhance the capacity to electronically measure quality of care consistent with national HIT standards and conduct comparative effectiveness research that will identify care delivery models within the Indian/Tribal and Urban systems that result in improved health outcomes. 09/03/2010 link
Medical treatments, items and services HRSA Implementation of the PECARN Traumatic Brain Injury Prediction Rules for Children Using Computerized Clinical Decision Support: An Interrupted Time Series Trial Columbia University $0 The grant is intended to meet HHS/OS priorities of improving the research network infrastructure for purposes of comparative effectiveness research. Applicants should address specific needs in the field of pediatric emergency care that transcend state boundaries. Objectives must meet a demonstrable need, and methodologies and strategies for achieving the objectives must be realistic, appropriate and scientifically sound. Each application must contain an evaluation plan that includes measurable outcomes and clearly defined time frames for conducting the evaluation. 07/30/2010 link
Medical treatments, items and services AHRQ Enhancing Clinical Effectiveness Research with Natural Language Processing of EMR KAISER FOUNDATION RESEARCH INSTITUTE $0 Comparative effectiveness research (CER) requires that clinical data be in standard forms allowing multiple, large databases to be efficiently combined, and requires that all of the data be coded so that automated summarization of the data is possible. However, much of the clinical data necessary for CER is in the text clinical notes written by clinicians when caring for patients. We will build a centralized website where CER researchers can build software applications that will process their electronic medical records, including both the text and coded data, creating standardized datasets permitting comparative effectiveness research. We will demonstrate the utility of this infrastructure by conducting CER studies investigating the effectiveness of interventions in asthma and smoking, across the 6 participating health systems. 10/02/2010 link
Medical treatments, items and services AHRQ Indiana PROSPECT Indiana University-Purdue University at Indianapolis $0 Project Narrative This proposal seeks to enhance the existing information technology infrastructure in Central Indiana to improve the nation's capacity to conduct comparative effectiveness research (CER) and apply these new capacities to a novel CER project evaluating treatment for Alzheimer's disease. 10/02/2010 link
Medical treatments, items and services AHRQ Multi-Institutional Consortium for CER in Diabetes Treatment and Prevention KAISER FOUNDATION RESEARCH INSTITUTE $0 A network of 32 health services and intervention scientists affiliated with the HMO Research Network propose to build a national database for conducting comparative effectiveness research on treatment and on approaches to preventing diabetes mellitus. The database will include information on more than 750,000 persons with diabetes. It will be used to generate ongoing information on the occurrence, treatments and outcomes of diabetes and to conduct 2 studies of approaches to treating and preventing this condition. 10/02/2010 link
Medical treatments, items and services AHRQ The Population-Based Effectiveness in Asthma and Lung Disease Harvard Pilgrim Health Care, Inc. $0 Project Narrative This project will create a new infrastructure to accelerate comparative effectiveness research in asthma and other lung diseases in diverse populations. We will form the Population-Based Effectiveness in Asthma and Lung Diseases (PEAL) Network, creating highly detailed, standardized, linked computerized datasets from a state Medicaid plan and four health plans. We will conduct comparative effectiveness research on asthma controller medications, evaluating adherence and other real-world factors. This project is innovative in that we will link claims, electronic medical record, patient, and provider data, and will build new linkages with a Medicaid plan to include vulnerable groups who are disproportionately burdened by asthma. 10/02/2010 link
Medical treatments, items and services AHRQ Washington Heights Initiative Community-based Comparative Effectiveness Research COLUMBIA UNIVERSITY HEALTH SCIENCES $0 This research has the potential to improve the evidence base for treatment hypertension and other clinical conditions for a medically underserved, minority, low income, immigrant patient population. Currently, the evidence base for care delivery is not strong for this population, resulting in disparities in health care and outcomes. Insights gained through working with this specific population will then be generalizable to other such communities and populations. 10/02/2010 link
Medical treatments, items and services NIH/AHRQ A Randomized Trial of Behavioral Economic Interventions to Reduce CVD Risk UNIVERSITY OF PENNSYLVANIA $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery and Reinvestment Act of 2009 (Recovery Act or ARRA), Public Law 111-5, invites applications proposing clinical trials using the principles of behavioral economics to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. For this FOA, applicants must propose controlled trials that randomize units (whether individuals or clusters such as practices, hospitals, or larger units) to conditions, resulting in a randomized clinical trial (RCT) or cluster randomized trial (CRT). Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER (e.g., those that rely on manipulating a providers default options) could be more cost effective than conventional approaches including some pay for performance schemes (P4P). For the purposes of this FOA, the definition of comparative effectiveness research will adhere to that adopted by the Federal Coordinating Council given at http://www.hhs.gov/recovery/programs/cer/cerannualrpt.pdf. Behavioral economics refers to the interdisciplinary efforts involving cognitive and social psychologists, decision scientists, and other social scientists together with economists to model economic decision-making and consequent actions. The approach is inclusive, since at its heart it tries to take into account what is known about how people actually make decisions rather than relying on the assumption that economic agents are fundamentally rational in the sense of expected utility theory (see, e.g., Kahneman and Tverskys (1979) work on Prospect Theory and Kahnemans (2003) Nobel lecture). It is hoped that this line of research will lead to significantly greater consideration of CER by health care providers and therefore enhance the quality of the nations health. 10/02/2010 link
Medical treatments, items and services NIH DENTAL AND MEDICAL OFFICE IMET TO REDUCE TEEN TOBACCO, ALCOHOL, AND DRUG USE CHILDREN»S HOSPITAL BOSTON $475,105 The purpose of this project is to improve adolescent behavioral counseling services in healthcare settings with a new Internet/Intranet-based Motivational Enhancement Therapy (iMET) intervention that targets the use of tobacco, alcohol, and other drugs. If proven effective, we will disseminate iMET to primary care dental and medical offices across the U.S. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF MEDICAL THERAPY VS. BARIATRIC SURGERY FOR OBESE T2DM BRIGHAM AND WOMEN»S HOSPITAL $500,000 Adult onset diabetes is now at epidemic proportions in the United States. Surgery for obesity often results in resolution of diabetes. This trial will compare the effectiveness of obesity surgery versus maximal medical management in resolving adult onset diabetes in a less obese population. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF BRAIN IMAGING AND BLOOD BIOMARKERS IN ALZHEIMER??S D UNIVERSITY OF ILLINOIS AT CHICAGO $409,999 Using brain imaging and gene expression analysis in brain, cerebrospinal fluid and plasma of transgenic mice, human subjects with cognitive impairments and Alzheimer's disease patients, this project will determine early biomarkers for the diagnosis of Alzheimer's disease. 09/02/2010 link
Medical treatments, items and services NIH ROLE OF ADVANCED SCREENING TECHNOLOGIES IN EARLY DETECTION OF BREAST CANCER DANA-FARBER CANCER INSTITUTE $432,434 Role of Advanced Screening Technologies for Early Detection of Breast Cancer Project Narrative Magnetic resonance imaging (MRI) may be utilized for breast cancer screening in high risk populations and digital mammography may be advantageous for screening women with dense breasts. This project will use the Lee-Zelen's (2008) mathematical model to evaluate mortality benefit as well as to find optimal screening strategies for these advanced screening modalities. 09/02/2010 link
Medical treatments, items and services NIH A RANDOMIZED TRIAL OF LETROZOLE VS CLOMIPHENE IN INFERTILE WOMEN WITH PCOS PENNSYLVANIA STATE UNIVERSITY HERSHEY MEDICAL CENTER $274,042 Propose a concept protocol, which builds on the findings and experience garnered in PPCOS, and propose a double blind randomized two armed trial of clomiphene citrate vs. letrozole in infertile women with PCOS to establish superiority in terms of the primary outcome of live birth as well as to delineate the safety profile of the two drugs. 10/01/2011 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF ECG SCREENING IN CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER TUFTS MEDICAL CENTER $495,907 Our overarching goal is to use existing data to its best advantage to clarify the comparative effectiveness of three different screening and management approaches: (1) comprehensive screening (i.e., all children receive a history, physical and ECG), (2) targeted screening (i.e., all children receive a history and physical, and ECG screening is reserved for those children with risk factors identified on the history and/or physical), and (3) no screening. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF FIT VS. COLONOSCOPY FOR COLON CANCER SCREENING UNIVERSITY OF IOWA $404,139 Compare the test characteristics of a fecal immunochemical test (FIT) with colonoscopy in 700 average risk individuals undergoing screening colonoscopy; assess patient preferences for FIT vs. colonoscopy in the study sample; and compare projected costs using these screening strategies. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF MEDICATIONS USED IN CONGENITAL HEART SURGERY DUKE UNIVERSITY $450,815 This application will focus on investigating medications in 3 therapeutic areas: anti-fibrinolytic agents used during surgery, afterload reduction in the post-operative setting, and peri-operative antibiotic prophylaxis. Our overall hypothesis is that the linking and analysis of existing large pediatric data sources can address many of these current knowledge gaps and provide robust data in 3 specific areas: 1) identifying current practice patterns and variation in peri-operative care of children undergoing congenital heart surgery; 2) performing observational comparative effectiveness studies which will provide data on efficacy and safety, as well as sample sizes, event rates, and drug effect to be used in planning subsequent trials; 4) establishing a network of sites willing to participate in subsequent studies. 09/02/2010 link
Medical treatments, items and services NIH EXERCISE VERSUS COGNITIVE INTERVENTIONS FOR ELDERS AT RISK FOR DEMENTIA UNIVERSITY OF MIAMI SCHOOL OF MEDICINE $497,820 The study will assess the impact of exercise training, cognitive training, and a combination of exercise and cognitive training on physical fitness, inflammatory and immunological biomarkers, and cognitive function among Hispanic and non-Hispanic older adults with MCI. 09/02/2010 link
Medical treatments, items and services NIH EVALUATE LONG-TERM PROGNOSIS OF LOCALIZED PROSTATE CANCER FOLLOWING INITIAL RADIATION UNIVERSITY OF MEDICINE AND DENTISTRY OF NEW JERSEY - ROBERT WOOD JOHNSON MEDICAL SCHOOL $422,740 The primary objectives of the study will be to define the prognosis of elderly patients with localized prostate cancer, in terms of overall and disease-specific survival, subsequent use of cancer therapies, and serious cancer-related complications, following radiation therapy compared to conservative management. 09/02/2010 link
Medical treatments, items and services NIH ENHANCEMENT OF MS SIGNAL PROCESSING TOWARD IMPROVED CANCER BIOMARKER DISCOVERY COLLEGE OF WILLIAM AND MARY $187,282 Will develop computational tools aimed at increasing the effectiveness of cancer biomarker discovery from label-free MALDI-TOF (matrix-assisted laser- desorption/ionization time-of-flight) mass spectra for verification and identification. The computational algorithms and tools will result in more than an order of magnitude increase in both sensitivity and selectivity For molecular biomarker screening. 09/02/2010 link
Medical treatments, items and services NIH CYTOPROTECTIVE CYTOKINE SIGNALING AND REPERFUSION INJURY WASHINGTON UNIVERSITY $392,147 The long-term goal of this research initiative is to delineate the cytoprotective role of proinflammatory cytokines in myocardial ischemia reperfusion (I/R) injury. 09/02/2010 link
Medical treatments, items and services NIH VALIDATING THE NIH TOOLBOX IN THE ACUTE NEUROREHABILITATION SETTING UNIVERSITY OF ALABAMA AT BIRMINGHAM $255,487 This 2-year Challenge Grant will conduct an initial and exploratory validation study of the NIH Toolbox in the acute neurologic inpatient rehabilitation environment. The Toolbox assesses diverse neurologic functions (cognition, emotion, sensation, and movement) in a 2-hour examination. The proposed research will determine the sensitivity and specificity of the Toolbox to acute neurological illness and its feasibility with assessing adult inpatients with a wide variety of debilitating neurological disorders. 09/02/2010 link
Medical treatments, items and services NIH COMPUTER-DELIVERY OF EFFECTIVE, PSYCHOSOCIAL INTERVENTIONS IN METHADONE TREATMENT NATIONAL DEVELOPMENT & RES INSTITUTES $183,352 To our knowledge, the proposed study is the first to use mobile phone technology to deliver an interactive, science-based psychosocial intervention targeting illicit substance use that can be easily accessed in an individual's natural environment and provide therapeutic support on-demand. This tool may greatly improve the potency of existing psychosocial interventions for substance use disorders. 10/01/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF WEB-BASED VS. TRADITIONAL ADOLESCENT HIV PREVENTION NATIONAL DEVELOPMENT & RES INSTITUTES $489,063 The computerized intervention we propose to evaluate in this project, if found effective and cost-effective, could substantially advance the adolescent substance abuse treatment system by markedly improving the availability and quality of HIV (and infectious disease) prevention interventions delivered to youth in such settings. Further, this intervention is web-based, thus enabling its use in a wide variety of settings where HIV prevention interventions for youth are typically limited (e.g., schools, health care providers' offices, online social networks). 09/02/2010 link
Medical treatments, items and services NIH MINDFULNESS BASED STRESS REDUCTION FOR PSYCHO-IMMUNE DYSREGULATION IN CANCER LOYOLA UNIVERSITY CHICAGO $306,637 Using a randomized controlled design, this study will evaluate the potential benefits of Mindfulness based stress reduction (MBSR) on psychosocial distress, neuroendocrine stress activation, immune function, and health-related quality of life (HRQOL). 08/02/2011 link
Medical treatments, items and services NIH MINDFULNESS BASED STRESS REDUCTION FOR PSYCHO-IMMUNE DYSREGULATION IN CANCER LOYOLA UNIVERSITY CHICAGO $83,388 Using a randomized controlled design, this study will evaluate the potential benefits of MBSR on psychosocial distress, neuroendocrine stress activation, immune function, and HRQOL. 09/02/2011 link
Medical treatments, items and services NIH COMPARISON OF THE EFFECTIVENESS OF CAM THERAPIES IN PEDIATRIC PATIENTS UNDERGOING SEDATION FOR IMAGING STUDIES WAYNE STATE UNIVERSITY $441,460 The primary goal of our study is to compare the effectiveness of three CAM therapies in reducing the level of stress and anxiety in pediatric patients, ages 1-12 years, undergoing sedation for imaging studies and importantly reducing the need for higher doses of sedation medicines. 10/01/2010 link
Medical treatments, items and services NIH FAS PREVENTION: A TRIAL OF THE IOM MODEL UNIVERSITY OF NEW MEXICO $252,000 This is a multi-site, efficacy trial of a comprehensive, public health model, community-wide, FAS prevention program defined by the Institute of Medicine (IOM). Utilizing lOM-recommended techniques of research and prevention applied previously in American Indian communities, this study will determine the efficacy of community-wide prevention of FAS in SA, and which specific components are most viable. 07/02/2011 link
Medical treatments, items and services NIH NOVEL VACCINE TO CMV BASED ON A DISC VIRUS UNIVERSITY OF MINNESOTA TWIN CITIES $186,710 The proposed research will define the antibody and cellular immune responses to a series of vaccine candidate Cytomegalovirus (CMV) disabled infectious single cycle (DISC) strains. 07/02/2010 link
Medical treatments, items and services NIH EFFECTIVENESS OF AN ENHANCED ADAPTIVE CONTINUING CARE MODEL FOR COCAINE DEPENDENCY UNIVERSITY OF PENNSYLVANIA $498,869 Treatment for drug use disorders generally consists of relatively brief episodes of care that do not properly address the chronic, relapsing nature of these disorders. In prior work, we have developed a telephone-based adaptive continuing care model that provides extended care and has proved efficacious in several carefully controlled studies. The proposed supplement will determine whether a new 12 month version of this adaptive continuing care protocol that incorporates stepped care algorithms, patient choice, incentives for participation, and several other improvements designed to increase sustained participation rates will be more effective than standard care and yield larger effect sizes than our prior version of the protocol. 09/02/2010 link
Medical treatments, items and services NIH VARIATION IN THE SAFETY OF BACK PAIN-RELATED SURGERY DARTMOUTH COLLEGE $496,570 Compare differences in quality of care for back surgery across different hospitals and different surgeons by seeing how often a second operation is needed 30-days, 1-year, and 4-years after the initial operation as a quality indicator. The Spine Patient Outcomes Research Trial, the largest ever back surgery study in which top surgeons and top hospitals performed surgery on carefully selected patients, sets the standard for how "safe" back surgery can be. We will see where back surgery safety falls short of the SPORT benchmarks, and which hospital factors and surgeon factors are associated with making back surgery less safe. 09/02/2010 link
Medical treatments, items and services NIH INTENSIVE OUTPATIENT V. OUTPATIENT TREATMENT WITH BUPRENORPHINE AMONG AFRICAN AMERICANS FRIENDS RESEARCH INSTITUTE, INC. $498,748 This study will examine the comparative effectiveness of two common counseling approaches offered with buprenorphine in clinics treating large numbers of African Americans, a population with significant need and limited access to this type of effective treatment which reduces drug use and HIV-risk. 09/02/2010 link
Medical treatments, items and services NIH TREATING ADDICTION AS A CHRONIC ILLNESS NATIONAL CENTER ON ADDICTION/SUB ABUSE $499,999 The proposal has two specific aims: 1) to develop a state-level model to treat addiction as a chronic illness across multiple agencies (e.g., substance abuse and criminal justice) and system components (e.g., financing, regulation, service delivery) and 2) to conduct all developmental work necessary to design a rigorous comparative effectiveness research (CER) trial to test a chronic care model for SUD offenders. 01/02/2011 link
Medical treatments, items and services NIH SURGERY, IMMUNOLOGY AND IMMUNOTHERAPY OF HUMAN CANCER JOHN WAYNE CANCER INSTITUTE $2,005,765 The CER study described in this competitive revision will establish the role of surgical versus nonsurgical approaches in patients whose melanoma has spread to distant sites. Results will help clinicians develop a standardized initial approach that prolongs survival and optimizes quality of life. Results also will indicate whether BCG postoperative immunotherapy significantly improves the outcome of patients treated with surgery. 04/02/2011 link
Medical treatments, items and services NIH ADOPTION FIDELITY AND EFFECTIVENESS OF ALCOHOL SBIRT IN DENTAL PRACTICE OLD DOMINION UNIVERSITY $474,730 The proposed project seeks to tailor existing Screening, Brief Intervention, Referral and Treatment (SBIRT) protocols for alcohol abuse to be used in dental practice settings. 09/02/2010 link
Medical treatments, items and services NIH DECOMPRESSIVE CRANIOTOMY VERSUS MEDICAL THERAPY FOR REFRACTORY INTRACRANIAL HYPERTENSION UNIVERSITY OF UTAH $499,315 This comparative effectiveness research proposal employs a propensity score analysis which creates balanced groups of patients and compares their survival according to whether or not they underwent DC. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF ART FOR HIV IN PATIENTS WITH COMORBIDITIES STANFORD UNIVERSITY $499,243 The project will compare antiretroviral strategies in HIV-infected individuals with cardiovascular risk factors or cardiovascular disease, and in patients with multi-drug resistant HIV. 09/02/2010 link
Medical treatments, items and services NIH PREVENTING OBESITY IN THE BRONX: IMPACT OF THE "MOVING SMART" INTERVENTION ON PRO MONTEFIORE MEDICAL CENTER (BRONX, NY) $656,601 This proposal will evaluate "Moving Smart", an in-classroom, education-focused physical activity intervention that may revolutionize the current school policy on physical activity and serve as a model for other obesity prevention school-based programs nationwide. 10/03/2009 link
Medical treatments, items and services NIH PREVENTING OBESITY IN THE BRONX: IMPACT OF THE "MOVING SMART" INTERVENTION ON PRO ALBERT EINSTEIN COLLEGE OF MEDICINE - YESHIVA UNIVERSITY $674,896 This proposal will evaluate "Moving Smart", an in-classroom, education-focused physical activity intervention that may revolutionize the current school policy on physical activity and serve as a model for other obesity prevention school-based programs nationwide. 09/02/2010 link
Medical treatments, items and services NIH IMPROVING ADHERENCE TO POST PCI ANTIPLATELET THERAPHY IN MINORITY POPULATIONS UNIVERSITY OF MIAMI SCHOOL OF MEDICINE $498,034 The focus of the proposed study is to examine a non-traditional care- management approach delivered by a large commercial health benefit carrier in the prevention of CVD secondary outcomes among disparity populations who have undergone coronary artery stenting (PCI). In particular, we seek to determine if a culturally tailored phone based Motivational Interviewing (MINT) intervention delivered to African American (AA) and Latino patients is effective at improving adherence to clopidogrel, a medically proven intervention that dramatically reduces stent thrombosis, myocardial infarction and death, and that is standard of care for at least 12 months after stent placement according to ACC/AHA guidelines. 07/02/2010 link
Medical treatments, items and services NIH Identifying Disparities in Type 2 Diabetes Among Asian Americans: The Pan Asian Cohort Study PALO ALTO MEDICAL FOUNDATION RES INST $557,936 The revision, a two-year study, aims to additionally compare the effectiveness of oral drugs for treatment of type 2 diabetes among Asian subgroups in the same electronically linked cohort. It is well-known that type 2 diabetes manifests differently in race/ethnic groups, and that race/ethnic groups respond differently to the same pharmacotherapy. 09/02/2011 link
Medical treatments, items and services NIH THE CO-CLINICAL PROJECT: INFORMING CLINICAL TRIALS USING PRECLINICAL MOUSE MODELS BETH ISRAEL DEACONESS MEDICAL CENTER $2,064,367 Succinctly put, what we propose with the "Co-Clinical Project" is that each clinical trial at the participating Institutions will be run "in parallel" with pre-clinical trials in appropriate, faithful and genetically relevant mouse models, and that the clinical, biological and pharmacological information (i.e. somatic mutational background, germline SNP variations, responsiveness to specific regimens; imaging, microarray and proteomics profiles) will be accrued, analyzed in parallel and integrated in order to facilitate the identification of patient subtypes, key genetic determinants, and biomarkers that predict response to specific treatments. 09/02/2010 link
Medical treatments, items and services NIH IMPACT OF EXERCISE AND ENGAGEMENT ON COGNITION IN OLDER ADULTS UNIVERSITY OF TEXAS DALLAS $392,071 The proposed project is one of the first attempts to study the joint effects of exercise and a cognitive intervention program by adding exercise conditions to an already-funded intervention study on cognitive engagement in the laboratory of Denise Park at the Center for Brain Health in Dallas. 09/02/2010 link
Medical treatments, items and services NIH RELIGIOUS RESPONSES TO HIV/AIDS IN BRAZIL COLUMBIA UNIVERSITY HEALTH SCIENCES $160,301 1) Develop a comparative analysis of the multiple ways in which Catholic, Evangelical Protestant, and Afro-Brazilian religions have responded (at the policy, institutional and population levels) to HIV/AIDS in Brazil; 2) Empirically document the importance that each of these 3 major religious traditions has given to HIV/AIDS, and the reasons that have led them to do so; 3) Assess, through a series of case studies, the ways in which the responses of each religious traditions has interacted with local communities, the wider social universe of civil society, and the nation- state, in impacting upon the broader response to AIDS; and, 4) Through comparative analysis, to more fully understand the ways in which both importance and impact have been influenced by the religious belief system or religious doctrine of each tradition, the organizational and institutional structures that each exhibits, and the ways in which each interacts with and articulates itself with communities, civil society, and the state, in order to shape the broader social and political response to AIDS. 10/01/2010 link
Medical treatments, items and services NIH ENTRAINMENT-BASED MECHANICAL VENTILATION MASSACHUSETTS INSTITUTE OF TECHNOLOGY $470,889 Propose a new mode of mechanical ventilation (entrainment-based mechanical ventilation, EMV) that is based on the classical physics theory of mutual entrainment between coupled oscillators, which may provide a cost- effective solution to the problem of patient-ventilator synchrony. 09/02/2010 link
Medical treatments, items and services NIH EFFECTIVENESS OF TENS ON HYPERALGESIA, PAIN WITH MOVEMENT, AND FUNCTION AFTER TKR UNIVERSITY OF IOWA $11,527 This application fits with the NINR Strategic Plan's Area of Research Emphasis, Promoting Health and Preventing Disease, by evaluating a new approach to transcutaneous electrical nerve stimulation (TENS) therapy to decrease pain, improve function, and prevent the development of new chronic pain syndromes in older adults after TKR. 11/02/2010 link
Medical treatments, items and services NIH SELF-MONITORING USING GPS- AND ACCELEROMETER-EQUIPPED SMARTPHONES UNIVERSITY OF CALIFORNIA LOS ANGELES $480,614 Aim to develop an innovative real-time assessment of behavioral exposures for cardiovascular disease (CVD). We will implement three new self-monitoring functions on GPS- and accelerometer-equipped smartphones to monitor diet, exercise, and stress for young overweight mothers. 08/02/2010 link
Medical treatments, items and services NIH NEURAL EFFECTS OF EXERCISE, COGNITIVE, OR COMBINED TRAINING IN AD AT-RISK ELDERS CLEVELAND CLINIC LERNER COLLEGE OF MEDICINE OF CASE WESTERN RESERVE UNIVERSITY $499,808 This project will be the first to (1) compare the relative efficacy of CT, ET, and a combined intervention; (2) use functional neuroimaging to assess intervention efficacy; and (3) intervene in older individuals at risk for developing AD. The long-range goal is to evaluate effective, low-risk, and relatively inexpensive interventions for addressing cognitive decline, with enormous implications for containing costs associated with health-care delivery to the ever increasing aging population of the United States. 09/02/2010 link
Medical treatments, items and services NIH VOLUMETRIC PERFUSION MRI OF LIVER TUMORS TO DETECT EARLY RESPONSE TO CHEMOTHERAPY UNIVERSITY OF WISCONSIN MADISON $488,120 Propose to evaluate the clinical and cost effectiveness of advanced perfusion MRI methods to characterize blood flow to liver tumors before and immediately after initiation of systemic therapy. We aim to determine the comparative effectiveness of advanced perfusion MRI with conventional cross- sectional imaging methods (CT) that measure tumor response based size, using tumor size criteria. 09/02/2010 link
Medical treatments, items and services NIH UAB CONTINENCE TREATMENT CENTER UNIVERSITY OF ALABAMA AT BIRMINGHAM $99,999 Propose a competitive revision to the UITN award to conduct a 12-month pilot and feasibility study for a 2-arm randomized controlled comparative effectiveness trial of the autologous rectus fascia pubovaginal sling and the synthetic mesh midurethral sling procedures for the treatment of recurrent or persistent SUI. 03/02/2011 link
Medical treatments, items and services NIH SMOKING INTERVENTIONS FOR HOSPITAL PATIENTS:A COMPARATIVE EFFECTIVENESS TRIAL MASSACHUSETTS GENERAL HOSPITAL $499,595 Conduct a randomized controlled comparative effectiveness trial of two strategies to promote smoking cessation in hospitalized patients: (1) a hospital-only intervention that meets NHQM quality standards ("Standard Care"), and (2) an "Enhanced Care" model that will facilitate the sustained use of smoking counseling and medication after discharge to produce long-term abstinence. 08/02/2010 link
Medical treatments, items and services NIH HABITS AND CUES IN ALCOHOL DRINKING: DYNAMIC STRIATAL ACTIVITY UNIVERSITY OF NORTH CAROLINA CHAPEL HILL $222,000 This competitive revision will expand the parent grant by comparatively evaluating the therapeutic efficacy of naltrexone and topiramate on goal-directed versus habit-driven alcohol drinking and relapse-like behavior. In compliance with the purpose of the Recovery Act, it will create new full-time and part-time employment. 09/02/2011 link
Medical treatments, items and services NIH DEVELOPMENT OF LOW COST AND BROADLY PROTECTIVE HUMAN PAPILLOMAVIRUS VACCINES JOHNS HOPKINS UNIVERSITY $499,998 The principal goal of this proposal is to develop a broadly protective HPV vaccine, at low cost, to meet the needs of HIV+ girls and women in the developing world who can neither afford the currently licensed and costly HPV vaccines, nor have access to cytologic screening. 09/02/2010 link
Medical treatments, items and services NIH IL-13 AND EOSINOPHILIC ESOPHAGITIS CHILDREN»S HOSPITAL MEDICAL CENTER (CINCINNATI) $1,580,324 Aim 1, we will develop a local internet based registry of subjects with EE to capture defined clinical, pathologic and translational outcome measures. We will use the EE registry to test the hypothesis that esophageal mucosal eosinophil levels and identified key EE cytokines such as IL-13 correlate with defined, validated clinical outcome measurements of symptom severity and quality of life. In Aim 2, we will compare the clinical effectiveness of dietary elimination to swallowed steroid medications for the treatment of pediatric EE. 09/02/2011 link
Medical treatments, items and services NIH COMPUTERIZED PSYCHOSOCIAL TREATMENT FOR OFFENDERS WITH SUBSTANCE USE DISORDERS NATIONAL DEVELOPMENT & RESEARCH INSTITUTES $1,882,638 Aim 1 is to test the comparative effectiveness of TES vs. Standard Care on measures of drug use (e.g., weeks of abstinence) and HIV risk behavior (both sex-related and drug-related HIV risk behavior) at 3- and 6-months post prison discharge, as well as on reincarceration rates using official Department of Corrections records. Aim 2 is to evaluate the cost and cost-effectiveness of TES relative to standard care. 09/02/2010 link
Medical treatments, items and services NIH EFFECTIVENESS OF EARLY STAGE PROSTATE CANCER TREATMENT BETH ISRAEL DEACONESS MEDICAL CENTER $499,994 Aim 1. To generate and validate models that use pre-treatment HRQOL, clinical status, and treatment details to predict HRQOL changes after each of the three most common primary treatments for early stage prostate cancer: prostatectomy, external radiotherapy, or brachytherapy Aim 2. To construct decision analytic Markov models to predict QALE of primary prostate cancer treatments using prospective cohort data to drive transition probabilities between HRQOL states. Aim 3. To characterize treatment-related costs and combine these with QALE in the Markov model framework to assess overall cost effectiveness as measured by incremental cost-effectiveness ratio (ICER), of prostatectomy, external radiotherapy, or brachytherapy for early stage prostate cancer. 09/02/2010 link
Medical treatments, items and services NIH EFFECTIVENESS OF ROBOTIC COMPARED TO STANDARD PROSTATECTOMY FOR PROSTATE CANCER BETH ISRAEL DEACONESS MEDICAL CENTER $500,000 Comparison of robotic procedures with standard invasive treatments should demonstrate the comparative effectiveness and comparative cost of robotic interventions for the clinical treatment of disease. 09/02/2010 link
Medical treatments, items and services NIH LIFESTYLE MODIFICATION VERSUS BARIATRIC SURGERY FOR TYPE 2 DIABETES UNIVERSITY OF PENNSYLVANIA $504,677 The large weight losses seen with bariatric surgery are often associated with improvements or resolution of several obesity-related comorbidities, including type 2 diabetes. The proposed project is designed to compare improvements in diabetes control in obese diabetic individuals who are assigned by chance to one of three groups: 1) Roux-en-Y gastric bypass; 2) laparoscopic adjustable gastric banding; or 3) intensive non-surgical weight management. In addition, the project will study the level of acceptance of surgical treatment of type 2 diabetes among physicians, health care providers, and insurance companies. 09/02/2010 link
Medical treatments, items and services NIH COMPARING THE EFFECTIVENESS OF CITY POLICY AND STRUCTURE IN HEALTH DISPARITIES LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER NEW ORLEANS $335,942 This study's goal is to compare the effectiveness of a city level policy in New Orleans to control problem alcohol outlets that contribute to health inequalities among poor and minority populations. 09/02/2010 link
Medical treatments, items and services NIH EFFECTIVENESS OF IMMEDIATE VS. DELAYED USE OF METFORMIN IN NEW-ONSET T2 DIABETES KAISER FOUNDATION RESEARCH INSTITUTE $481,722 Propose to examine the comparative effectiveness of immediate initiation of metformin monotherapy vs. delayed initiation of metformin or early/late initiation of sulfonylurea monotherapy for a variety of outcomes. 09/02/2010 link
Medical treatments, items and services NIH INTERDISCIPLINARY APPROACH TO RETINAL DISEASE GENE IDENTIFICATION UNIVERSITY OF IOWA $667,195 The goal of this project is the identification of genes that cause human retinal degeneration, specifically genes causing a syndromic form of photoreceptor degeneration known as Bardet- Biedl syndrome (BBS), as well as autosomal recessive retinitis pigmentosa (ARRP). 09/02/2011 link
Medical treatments, items and services NIH IMPROVING CARE CONTINUITY IN DRUG ABUSE TREATMENT JOHNS HOPKINS UNIVERSITY $479,911 The aim of this project is to improve rates of client transition from residential into outpatient aftercare treatment by implementing specific transition enhancement interventions. The drug abuse treatment systems in Baltimore will be improved by forming better linkages between residential and outpatient treatment programs 08/02/2010 link
Medical treatments, items and services NIH APPROPRIATE CARE OF URI IN CHILDREN OF LATINO IMMIGRANTS: THE ACURI PROJECT COLUMBIA UNIVERSITY HEALTH SCIENCES $499,815 The purpose of this study is to conduct a randomized controlled trial to comparatively assess the effectiveness of our tailored educational intervention, The Appropriate Care of URI (ACURI) Project, to improve health literacy levels regarding upper respiratory infections (URIs) and to decrease pediatric emergency department (PED) visits, among Latino households in Early Head Start/Head Start. 07/02/2010 link
Medical treatments, items and services NIH EVALUATING AN EMERGENCY DEPARTMENT OBSERVATION SYNCOPE PROTOCOL FOR OLDER ADULTS UNIVERSITY OF CALIFORNIA LOS ANGELES $283,117 The implementation of an expedited and standardized Emergency Department Observation Syncope Protocol (EDOSP) may safely reduce hospitalization of older patients with syncope. 09/02/2010 link
Medical treatments, items and services NIH COST-EFFECTIVENESS OF HIV-RELATED MENTAL HEALTH INTERVENTIONS MEDICAL UNIVERSITY OF SOUTH CAROLINA $298,708 This study will conduct comparative cost-effectiveness analysis of 3 pairs of critical HIV mental health interventions: (1) abstinence-based interventions versus comprehensive sex education, (2) condom social marketing versus free condom distribution programs, and (3) HIV voluntary counseling and testing versus provider initiated testing and counseling. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF ADVANCED DIAGNOSTIC IMAGING FOR HEPATIC FIBROSIS MAYO CLINIC COLL OF MEDICINE, ROCHESTER $479,082 Propose to examine the comparative effectiveness of novel quantitative elasticity imaging techniques and serum marker fibrosis panels for detecting clinically significant hepatic fibrosis measured by liver biopsy among human subjects with chronic liver disease. 09/02/2010 link
Medical treatments, items and services NIH URINARY INCONTINENCE TREATMENT NETWORK: DCC NEW ENGLAND RESEARCH INSTITUTES, INC. $627,705 Therefore, this study will compare the efficacy and safety of the retropubic and transobturator (inside-out and outside-in) procedures in a 2-arm RCT; 588 women with stress Ul will be enrolled. 10/01/2011 link
Medical treatments, items and services NIH EFFECTIVENESS OF FEEDING TUBES AMONG PERSON WITH ADVANCED COGNITIVE IMPAIRMENT BROWN UNIVERSITY $341,059 The proposed research has two overarching goals. First, we aim to use advanced methods to account for selection bias to provide a more definitive study of the potential benefits (survival, weight change, prevention and healing of pressure ulcers), risks (use of restraints, prescription of antipsychotics or benzodiazepines, and transitions to the ER and acute care hospital), and health care expenditures. A second goal is to understand the variation in hospital insertion rates of PEG feeding tubes. In this goal, we will examine potentially modifiable hospital characteristics, market factors, and state policies associated with this variation in hospitals' rate of PEG feeding tube insertion. 09/02/2010 link
Medical treatments, items and services NIH PREVENTING DEPRESSION IN PEOPLE WITH EPILEPSY: AN EXTENSION OF PROJECT UPLIFT EMORY UNIVERSITY $491,782 The goals of this multi-site project are two-fold: (1) to revise the Project UPLIFT materials for use in prevention (rather than treatment) of depression; and (2) to estimate their effectiveness in reducing the risk of depression in people with epilepsy as well as increasing their knowledge and skills for preventing depression and improving their quality of life. While this proposal targets people with epilepsy, the intervention could be easily adapted to serve other disparity populations, many of whom have elevated rates of depression. 07/02/2010 link
Medical treatments, items and services NIH COENZYME Q10 IN STATIN MYOPATHY HARTFORD HOSPITAL $457,436 Statins markedly reduce the incidence of cardiac events. These drugs are generally well-tolerated but can produce muscle side effects such as muscle cramps and weakness, which can ultimately require withdrawal of medications for statin-intolerant subjects. The current study investigates the utility of Coenzyme Q10 supplementation in patients with statin-associated muscle side effects to determine if Coenzyme Q10 supplementation is a novel therapeutic approach to improving statin tolerance. 10/01/2010 link
Medical treatments, items and services NIH PREDICTORS OF LONG-TERM OUTCOME OF UNRUPTURED INTRACRANIAL ANEURYSMS UNIVERSITY OF IOWA $485,313 The proposed analysis of the ISUIA cohort will further define the risk of aneurysm rupture, the competing causes of death and the effectiveness of hemorrhage prevention through surgical and endovascular treatment. 09/02/2010 link
Medical treatments, items and services NIH COST-EFFECTIVENESS OF HORMONAL THERAPY FOR CLINICALLY LOCALIZED PROSTATE CANCER KAISER FOUNDATION RESEARCH INSTITUTE $499,957 Propose a new comparative effectiveness study to provide information on the risks and potential benefits of immediate ADT in men diagnosed with localized prostate cancer. Our three aims include estimating the comparative effectiveness of immediate ADT versus observation in terms of all cause and prostate-cancer specific mortality and progression-free survival, estimating the longitudinal direct medical care costs to capture the impact of ADT, and calculating the cost- effectiveness (cost per life years saved) and cost-utility (quality-adjusted life years) using published patient utilities for multiple prostate cancer health states. 09/02/2010 link
Medical treatments, items and services NIH PRENATAL CYTOGENETIC DIAGNOSIS BY ARRAY-BASED COPY NUMBER ANALYSIS COLUMBIA UNIVERSITY HEALTH SCIENCES $744,988 Accordingly, we propose a study comparing the accuracy and efficacy of aCGH to conventional cytogenetics in routine prenatal diagnostic practice. 10/01/2011 link
Medical treatments, items and services NIH USING TECHNOLOGY TO DELIVER BRIEF INTERVENTIONS IN DUI PROGRAMS RAND CORPORATION $494,681 Address this challenge by asking whether providing brief interventions in alcohol education programs (AEP), the traditional method for preventing future alcohol-related incidents among 1st-time DUI offenders, is feasible and acceptable to offenders and providers, and whether adding a BI decreases alcohol consumption and risky drinking behaviors. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS RESEARCH USING NCCN DATA DANA-FARBER CANCER INSTITUTE $499,795 Propose to address two distinct but related challenges: (1) development of a research agenda for cancer comparative effectiveness research (CCER) that takes into account both the feasibility of the research and its potential importance to relevant stakeholders; and (2) completion of several high priority and high quality assessments of the comparative effectiveness of alternative cancer treatments for specific clinical subsets of cancer patients. 09/02/2010 link
Medical treatments, items and services NIH PREDICTING CARDIOVASCULAR RISK IN VULNERABLE PLAQUE RUPTURE CITY COLLEGE OF NEW YORK $408,078 In Aim 1 we will use a high resolution micro-CT imaging system to examine a much broader sample of ruptured and non-ruptured human thin cap fibroatheroma and statistically analyze the frequency, size, shape and spatial distribution of the cellular-level microcalcifications. In Aim 2 we quantitatively evaluate the impact of the microcalcifications on the biomechanical stability of the cap using a three-dimensional (3D) multi-level finite element model (FEM) of realistic 3D geometries of human coronary lesions based on high resolution micro-CT imaging. 08/02/2010 link
Medical treatments, items and services NIH ACCF-STS DATABASE COLLABORATION ON THE COMPARATIVE EFFECTIVENESS OF PCI AND CABG AMERICAN COLLEGE OF CARDIOLOGY $2,655,996 By linking three national patient record databases, this study will compare coronary artery bypass graft surgery and percutaneous coronary intervention in order to better understand the procedures and improve healthcare for patients with coronary artery disease, one of the major causes of morbidity and mortality in the United States. 08/02/2010 link
Medical treatments, items and services NIH NORTH LAWNDALE DIABETES COMMUNITY ACTION PROJECT SINAI HEALTH SYSTEM, INC. $500,000 The Sinai Urban Health Institute, Sinai Health Systems, Rush University Medical Center and a community based organization (Family Focus North Lawndale) are proposing to develop and deliver a multi- level community intervention using a media campaign, community engagement, and individual self- management training by "Diabetes Block Captains (DBC)" in a very poor African American community on the west side of Chicago. 09/02/2010 link
Medical treatments, items and services NIH RCT OF TWO SPEED OF PROCESSING MODES TO PREVENT COGNITIVE DECLINE IN OLDER ADULTS UNIVERSITY OF IOWA $499,578 Building on speed of processing theory, we propose to extend and expand the findings from the NIH-funded, multi-site Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study by using a newly developed, value-added version of the speed of processing software that can be used on virtually any home computer without supervision. 10/01/2010 link
Medical treatments, items and services NIH VACCINATION AGAINST RSV WITH CAPSID-MODIFIED AD VECTORS WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY $422,291 Respiratory syncytial virus is the most important virus causing serious respiratory tract disease in infants and young children. It is also receiving increasing recognition as an important cause for respiratory tract disease in the elderly. A vaccine against RSV could be an efficient way to prevent RSV disease and is so far not available. 06/02/2010 link
Medical treatments, items and services NIH CLINICAL VALIDITY AND UTILITY OF GENOMIC TARGETED CHEMOPREVENTION OF PCA WAKE FOREST UNIVERSITY HEALTH SCIENCES $1,972,330 Evaluate whether targeting groups of men based on genetic markers and family history of prostate cancer may improve the effectiveness of chemoprevention for prostate cancer. 09/02/2010 link
Medical treatments, items and services NIH RESISTANCE TO AORTIC ENDOGRAFT MIGRATION: COMPARATIVE EFFECTIVENESS OF FDA APPROVAL STANFORD UNIVERSITY $499,991 Endovascular repair has become the primary treatment for abdominal aortic aneurysm (AAA) disease. There are currently 5 FDA approved endograft devices for AAA repair. The true in-vivo biomechanical environment experienced by these devices is poorly understood. Furthermore, there are currently no studies that compare the performance of the different devices with regards to their long term positional stability (migration). 09/02/2010 link
Medical treatments, items and services NIH REDUCING ETHNIC AND RACIAL BIAS IN SCREENING FOR PSYCHIATRIC DISORDERS IN ADOLESCENTS CAMBRIDGE HEALTH ALLIANCE $499,950 Designed to improve the effectiveness of identification, referral and screening for mental health disorders potentially associated with ethnic/racial disparities in adolescents' receipt of mental health care. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS IN GENOMIC MEDICINE UNIVERSITY OF PENNSYLVANIA $1,990,198 Advances in genomics have the potential to improve the delivery of health care. Increasingly, there is a need to decide whether the use of genomic tests is better than doing what we are currently doing- i.e. comparative effectiveness. The overarching goal of this project is to develop a coordinated, multidisciplinary center for the generation and synthesis of evidence to support the translation of genomic tests into improvements in cancer prevention, screening, diagnosis, treatment and survivorship. 09/02/2010 link
Medical treatments, items and services NIH CHANGING BRAINS THROUGH INQUIRY, NOT DRUGS UNIVERSITY OF MINNESOTA TWIN CITIES $267,964 The University of Minnesota (UMN) Department of Neuroscience and Department of Curriculum and Instruction propose to develop, adapt, implement, evaluate, and disseminate a model inquiry-based neuroscience education program on the biological basis of drug abuse. The program will consist of professional development workshops for secondary science teachers, BrainU (BrainUs, plural), and an experimentally based curriculum for middle and high school students aligned to state and national standards. During BrainU, teachers will experience and learn inquiry-based teaching as they acquire knowledge of neuroscience and the biology of drug abuse. 05/02/2010 link
Medical treatments, items and services NIH META-ANALYSIS SYSTEMATIC AND DESIGN ERRORS: ALCOHOL USE AND DISEASE OUTCOMES SCIENTIFIC ANALYSIS CORPORATION $482,717 This meta-analysis of relevant epidemiological studies evaluating alcohol consumption and multiple disease outcomes should inform clinicians and public health policy by more carefully specifying alcohol's disease burden. It holds the promise of identifying the extent to which systematic errors in epidemiological studies may have led to false conclusions between potential risk factors and disease outcomes. If not corrected, these errors will undermine the quality and accuracy of public health policy. 09/02/2010 link
Medical treatments, items and services NIH NEW APPROACHES TO MEDIATION ANALYSIS USING CAUSAL INFERENCE METHODS BROWN UNIVERSITY $481,042 The proposed research will develop statistical approaches for discovering pathways and mechanisms of behavioral interventions targeted at alcohol abuse. A major outcome of the research program is development, testing and dissemination of appropriate software for implementing the models. Knowledge of mechanistic pathways allows deeper understanding of how and why certain interventions work, and opens the door to customizing interventions based on person-specific characteristics. 09/02/2010 link
Medical treatments, items and services NIH QUANTITATIVE ASSESSMENT OF THE BENEFITS AND RISKS OF CLINICAL PET/CT AND SPECT/CT UNIVERSITY OF ARIZONA $281,931 Develop and validate methods that researchers can use to assess the benefits and risks associated with multimodality PET/CT and SPECT/CT imaging. 09/02/2010 link
Medical treatments, items and services NIH TRANSFORMING PCI INFORMED CONSENT INTO AN EVIDENCE-BASED DECISION-MAKING TOOL SAINT LUKE»S HOSPITAL $2,121,454 This proposal will test the impact of the Personalized Risk Information Services Manager (PRISM), an information technology tool that generates individualized estimates of risk at the time of medical decision-making based upon complex risk prediction models, on the treatment of bleeding risk at the time of coronary angioplasty. Specifically, this study will provide an estimate of each patient's individual risk of bleeding and incorporate these estimates into an improved informed consent document that each patient signs and their physician uses to guide the application of bleeding avoidance therapies at the time of angioplasty. 08/02/2010 link
Medical treatments, items and services NIH A MEDICAL HOME PILOT EVALUATION: A MODEL FOR COMPARATIVE EFFECTIVENESS RESEARCH UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON $475,086 Evaluate a rapid implementation of a medical home model on costs, patient acceptance, doctor acceptance, and impact on quality of care indicators. The model is supported by an open source technology stack that is highly scalable. The short implementation timeframe for physician adoption and the financial incentives for data management to assure quality are of a sufficient nature to gain widespread acceptance by primary care physicians. link
Medical treatments, items and services AHRQ COMPARING THE EFFECTIVENESS OF MEDICATION USE SYSTEMS IN SMALL RURAL HOSPITALS UNIVERSITY OF NEBRASKA MEDICAL CENTER $0 The purpose of the proposed research is to compare the effectiveness of two medication use technologies used by critical access hospitals - bedside bar-code administration and telepharmacy. 07/02/2010 link
Medical treatments, items and services AHRQ LONGITUDINAL COMPARATIVE EFFECTIVENESS & SAFETY OF BIOLOGICS IN AUTOIMMUNITY UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 Although various biologic medications have excellent efficacy for chronic inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel disease, their comparative effectiveness in terms of clinical response and safety are unknown. A collaboration between 2 CERTs and the Consortium of Rheumatology Researchers of North America (CORRONA) will gain an improved understanding of comparative effectiveness by evaluating clinical data from a prospective cohort study and through an analysis of national Medicare data from 2006- 2011. 10/01/2010 link
Medical treatments, items and services AHRQ NEGLECTED BY THE EVIDENCE: THE INTERSECTION OF MEDICAL COMPLEXITY AND DEMENTIA RHODE ISLAND HOSPITAL $0 The research questions seek to investigate the cognitive, functional, and neurobehavioral outcomes associated with the use or discontinuation of certain psychoactive drugs in individuals with dementia and comorbid medical illness. 07/02/2010 link
Medical treatments, items and services AHRQ A COMPARISON OF COGNITIVE AND DYNAMIC THERAPY FOR MDD IN COMMUNITY SETTINGS UNIVERSITY OF PENNSYLVANIA $0 The goal of the current proposal is to conduct a randomized, comparative, non-inferiority clinical trial that tests the hypothesis that a widely used form of manualized dynamic psychotherapy (supportive expressive psychodynamic therapy) is not inferior to cognitive therapy when implemented in community mental health settings for the treatment of major depressive disorder. 08/02/2010 link
Medical treatments, items and services AHRQ COMPARATIVE EFFECTIVENESS OF CARDIOVASCULAR DEVICES AND MEDICARE COST GROWTH UNIVERSITY OF PENNSYLVANIA $0 Health care cost increases present a substantial challenge to the future fiscal stability of the Medicare program, and new health care technology is the leading cause of health care cost increases. This project will examine in detail how new technology increases health care costs, and it will investigate how cost growth due to new technology is influenced by conditions in local health care markets as well as Medicare's coverage policies. 08/02/2010 link
Medical treatments, items and services AHRQ TOOLS TO REDUCE INFANT RSV MORBIDITY AND ASTHMA: USE, ADHERENCE AND EFFECTIVENESS VANDERBILT UNIVERSITY $0 The objectives of this study are to determine the disparities in use, adherence and "real-world" effectiveness, and whether there are any important long-term protective effects on preventing diseases such as asthma, of a medication to prevent severe infant viral respiratory tract infections from a virus known as RSV. While there have been a number of clinical trials that have enrolled very select populations that have established "efficacy" (can it work?), the "effectiveness" (does it work?) data are limited and conflicting. We need to understand who gets this highly costly medication, who doesn't, does it work in the real-world, and can it prevent childhood asthma. 08/02/2010 link
Medical treatments, items and services AHRQ COMPARATIVE EFFECTIVENESS AND SAFETY OF DEPRESSION TREATMENTS DURING PREGNANCY HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) $0 Given the high prevalence of depression in pregnant women, the potential toxicity of antidepressant medications for the fetus, and the risk of relapse of major depression if untreated, it is critical to quantify the risks and benefits of alternative approaches used to manage depression during pregnancy. We propose to compare the effectiveness and safety of 1) specific selective serotonin reuptake inhibitors (SSRIs) and 2) continuing and discontinuing the medication for depression during pregnancy. 08/02/2010 link
Medical treatments, items and services AHRQ MEASURING PEDIATRIC INPATIENT MEDICATION USE UNIVERSITY OF RHODE ISLAND $0 An analysis of the Premier, Inc. database has the potential to produce estimates of inpatient use, and variation in patterns by hospital. These analyses will lay the basis for future studies of comparative effectiveness, may contribute to planning and design of observational and clinical studies, and can also be used in future studies to measure and reduce medical errors, improve quality of care, and describe off-label medication use in hospitalized children. These can in turn inform the full range of policy and practice decisions, including drug labeling, warnings, and removal from the market, which require an understanding of the number of children affected, their ages, and other patterns of use. 06/23/2010 link
Medical treatments, items and services AHRQ RANDOMIZED ACTIVESTEP COMPARATIVE EFFECTIVENESS TRIAL DARTMOUTH COLLEGE $0 Falls are the leading cause of fatal and non-fatal injuries in the elderly. Each year an estimated 1/3 of older adults fall and by the year 2020, the total cost of fall related injuries is estimated to be approximately $54.9 billion. The proposed randomized comparative effectiveness trial will evaluate a newly approved fall prevention program (ActiveStep(R) training system) compared to a traditional physical therapy program for reducing the incidence and severity of falls in a geriatric population. 08/02/2010 link
Medical treatments, items and services AHRQ SPECIFIC BIRTH DEFECTS AND ASTHMA MEDICATIONS IN PREGNANCY: DEMONSTRATION PROJECT BOSTON UNIVERSITY MEDICAL CAMPUS $0 To judge the comparative effectiveness of medications taken by pregnant women, both prescribers and patients need to know the comparative risks as well as the benefits. No comprehensive system exists to gather such information. Using a well-established study, we will demonstrate the feasibility of learning the risks of specific birth defects in relation to specific asthma medications most commonly used by pregnant women, and in collaboration with others, including an Independent Advisory Committee, demonstrate the feasibility of establishing an ongoing system for studying various adverse pregnancy outcomes in relation to the wide range of medications used in pregnancy, including prescription, over-the-counter, and herbal products. 08/02/2010 link
Medical treatments, items and services AHRQ DEEP SOUTH MUSCULOSKELETAL (DSM) CERTS UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 1) Improve safety and effectiveness of MSD therapeutics through four demonstration projects that effectively build on our major research domains of safety and effectiveness evidence generation and translating research into practice: (a) The Alabama NSAID Patient Safety Study, Phase II: Reducing Disparities in Risk Assessment and Communication; (b) Improving Osteoporosis Care for High-Risk Home Health Patients by a High-intensity Intervention; (c) Defining Serious Adverse Events from Biologic Therapies; and (d) Osteonecrosis of the Jaw: An Emerging Threat for Bisphosphonate Users; 2) Educate health care practitioners, insurers, and policy makers while broadening the public health impact of our research and educational portfolio about musculoskeletal therapeutics; and 3) In cooperation with AHRQ, other CERTs, and our network of partners, and building upon the themes, experience, and investigator talent pool of our CERTs, develop seed projects into full proposals that will be submitted to external funding agencies for peer review. 09/02/2010 link
Medical treatments, items and services AHRQ TRANSLATING INFORMATION ON COMPARATIVE EFFECTIVENESS INTO PRACTICE MAYO CLINIC COLL OF MEDICINE, ROCHESTER $0 In this study, we propose to study how using a decision aid during a patient office visit - a tool that helps patients understand the benefits and side-effects of each of the medications - can help patients make a decision and stick to their decision. We will also study what community-based practices need to do to effectively use these decision aids as part of their routine, and what factors affect the integration of the medication choice into patients' daily lives. 08/02/2010 link
Medical treatments, items and services AHRQ COMPARATIVE SAFETY AND EFFECTIVENESS OF STIMULANTS IN MEDICAID YOUTH WITH ADHD UNIVERSITY OF FLORIDA $0 Propose to expand our previous research with a retrospective cohort study of more than 500,000 youth with ADHD eligible for Medicaid benefits in 14 large states (representing 16 million youth and 70% of the entire pediatric Medicaid population) between 1999 - 2006 to: (1) evaluate the cardiac risk of stimulants overall, and of mixed amphetamine salts (MAS) versus methylphenidate (MPH) individually, on fatal or severe cardiovascular events; (2) assess whether stimulant risk is modified when used concomitantly with antipsychotics, antidepressants, or clonidine; (3) evaluate stimulant effectiveness overall, and between MAS versus MPH individually, on reduced risk for traffic citations and crashes. 10/01/2010 link
Medical treatments, items and services AHRQ POST-ACUTE CARE IN ELDERLY TRAUMA PATIENTS: USE, OUTCOMES AND COSTS JOHNS HOPKINS UNIVERSITY $0 The broad research goals of this study are to understand what factors influence who and where elderly receive post-acute care after a major trauma, to determine what types of post- acute care settings lead to improved functional outcomes, and to identify patterns of post- acute care utilization and costs. The specific aims of this research study are: (1) to identify factors that influence initial post-acute care receipt and setting, specifically a) patient-level factors, b) health system-level and post-acute care geographic supply factors, (2) to determine the impact of post-acute care receipt and type of setting on short and long-term functional outcomes in elderly trauma patients, and on nursing home residence one year post-trauma; and (3) to identify common post-acute care utilization patterns, their effects on re-hospitalizations and costs to Medicare, as well as to patients and their caregivers. 10/02/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Medication vs. CBT in Depressed Low-Income Women NORTHWESTERN UNIVERSITY $0 This project will estimate the different trajectories that participants follow in response to treatment for depression and the socioeconomic and clinical features associated with these trajectories The comparative effectiveness of antidepressant medication versus cognitive behavioral therapy will be estimated within trajectories The overall goal is to contribute to the development of personalized depression interventions for disadvantaged populations 04/02/2011 link
Medical treatments, items and services AHRQ Teamwork, Communication and Decision-Making: An Assessment Program Using Simulation Crises WASHINGTON UNIVERSITY $0 Two types of crisis medical teams will engage in simulation scenarios to determine what constitutes effective communication and decision-making processes and to determine how teams may avoid heuristics-driven diagnostic mistakes. Results will lead to better patient care nation-wide, as we aim to develop data-driven assessment and training procedures for future medical team members. 03/02/2011 link
Medical treatments, items and services AHRQ COMPARATIVE SAFETY OF ANTIRETROVIRALS AMONG HIV-INFECTED PATIENTS: MINIMIZING COR UNIVERSITY OF NORTH CAROLINA CHAPEL HILL $0 Propose to conduct analyses of the comparative safety and effectiveness of recent and long-term antiretroviral therapy on CHD morbidity and mortality, relying on a large HIV clinical cohort in the Southeastern United States (the UNC CFAR HIV Clinical Cohort) as well as the Medicaid and Medicare claims databases. 04/02/2011 link
Medical treatments, items and services AHRQ IMPROVING TRAUMA OUTCOMES USING HOSPITAL PERFORMANCE REPORTS UNIVERSITY OF ROCHESTER $0 The primary hypothesis to be tested is that providing trauma hospitals with information on their risk-adjusted outcomes will lead to improved outcomes. Trauma hospitals will be randomized to either receive or not to receive feedback on their comparative performance, and the effect of providing hospitals with benchmarking information will be analyzed. The proposed work will also determine whether "best practices" identified by surveying high-performance hospitals are associated with improved outcomes after controlling for patient risk and hospital quality. 04/02/2011 link
Medical treatments, items and services AHRQ IMPROVING END-OF-LIFE CARE FOR CANCER PATIENTS WITH VIDEO DECISION AIDS MASSACHUSETTS GENERAL HOSPITAL $0 Explore the use of video decision aids in assisting discussions between older patients with advanced cancer and their physicians. The present work of using video decision aids in end-of-life discussions in the context of cancer will serve as a prototype for other common diseases that involve difficult decisions. 03/02/2011 link
Medical treatments, items and services AHRQ IMPACT OF COGNITIVE TRAINING ON BALANCE AND GAIT IN OLDER ADULTS UNIVERSITY OF ILLINOIS AT CHICAGO $0 This pilot study builds on the literature by testing the ability of exposure to cognitive training on executive function tasks over 10-weeks to improve outcomes related to gait and balance in a population of older adults. 02/02/2011 link
Medical treatments, items and services AHRQ COST EFFECTIVENESS OF ANTICOAGULATION VERSUS GENETIC TESTING OF CYP2C9 & VKORC1 G HOWARD UNIVERSITY $0 This study proposes using a simulation model of the natural history of VTE to determine the cost-effectiveness of genetic testing for CYP2C9 and VKORC1 genes to guide long-term use of warfarin anticoagulation from the societal perspective. Methodology: A decision analysis using discrete event simulation will be developed to construct an economic model depicting the health states of a cohort of patients as the disease evolves over time. Associated costs and quality of life traits (utilities) of the complications will be captured. 08/02/2010 link
Medical treatments, items and services AHRQ PREGNANCY OUTCOMES AND ASTHMA MEDICATIONS IN PREGNANCY: A DEMONSTRATION PROJECT UNIVERSITY OF CALIFORNIA SAN DIEGO $0 The OTIS Collaborative Research Group proposes in this demonstration project to test the feasibility of such a system by conducting a cohort study of 600 pregnancies comparing outcomes among asthmatic women who take the newly marketed long-acting beta2 agonists with or without inhaled corticosteroids to asthmatic women who are treated only with the older short-acting beta2 agonists as well as non- asthmatic women who take no such medication. 08/02/2010 link
Medical treatments, items and services AHRQ MOTOR VEHICLE COLLISION PREVENTION VIA EARLIER CATARACT SURGERY UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 Simulation modeling will be used to examine how many motor vehicle collisions and deaths might be avoided if a threshold measure of vision, contrast sensitivity, were used to determine when cataract surgery ought to be performed and a draft guideline for earlier cataract surgery based on model findings will be developed and circulated for comment. 10/01/2010 link
Medical treatments, items and services AHRQ COMPARATIVE EFFECTIVENESS OF ACE INHIBITORS FOR AFRICAN AMERICANS NEW YORK UNIVERSITY SCHOOL OF MEDICINE $0 Despite their proven efficacy in lowering blood pressure, ACE inhibitors may not provide the same benefits in African Americans as in Caucasians. The proposed study will examine the safety and clinical effectiveness of ACE inhibitor for African Americans relative to Caucasians, as well as the cost effectiveness of ACE inhibitors relative to other classes of antihypertensive medications for African Americans. 08/02/2010 link
Medical treatments, items and services AHRQ COST-EFFECTIVENESS OF WEIGHT LOSS PREVENTION IN NURSING HOMES: A CONTROLLED TRIAL VANDERBILT UNIVERSITY $0 The purpose of the proposed study is to evaluate the comparative cost-effectiveness of two nutrition interventions for improving daily caloric intake and weight status in long-stay nursing home (NH) residents. A controlled, intervention design will be used to determine the cost-effectiveness of oral liquid nutrition supplements with an alternative nutrition intervention that offers residents a choice between supplements and other foods and fluids between meals in a group of 250 residents across 4 NH sites. Resident outcomes, which will be independently monitored by research staff, include changes in caloric intake, body weight, nutrition and hydration status and quality of life measures. 08/02/2010 link
Medical treatments, items and services AHRQ COMPARATIVE EFFECTIVENESS OF ALTERNATIVE LEVELS OF STROKE UNIVERSITY OF PENNSYLVANIA $0 Propose to compare 2 different levels of inpatient rehabilitation (acute rehabilitation services received while patients are still hospitalized for stroke). The first level is consultation where patients are seen by rehabilitation professionals while remaining on non-rehabilitation bed services within the hospital. The second level is higher intensity specialized. multidiciplinary rehabilitation services which occur when patients are admitted onto a specialized rehabilitation bed unit within the hospital. Primary outcomes will include functional recovery and home discharge from the acute hospital stay. One-year survival, long-term care placement, rehospitalization, and total health care costs will be secondary outcomes. The study is a retrospective observational comparative effectiveness study using data merged from 14 large administrative databases compiled from 153 VA Medical Centers. 08/02/2010 link
Medical treatments, items and services AHRQ COLORECTAL CANCER RISK AFTER COLONOSCOPY IN ELDERLY DIABETES PATIENT AND MEN UNIVERSITY OF PENNSYLVANIA $0 Screening for colorectal cancer can reduce the risk of cancer and cancer-related mortality. Given the increased incidence of CRC in elderly male patients or elderly DM patients, it is important to determine whether the recommended 10-year interval between colonoscopies without polyps offers adequate protection to these high risk groups. Our study will help establish the appropriate time interval for elderly men and elderly DM patients to undergo a second colonoscopy following a negative colonoscopy so that they will not be facing an unacceptably high rate of preventable CRC morbidity and mortality. 08/02/2010 link
Medical treatments, items and services AHRQ FUNCTIONAL RECOVERY IN LUMBAR SPINE SURGERY: INFLUENCE OF A BRIEF HEALTH BEHAVIOR JOHNS HOPKINS UNIVERSITY $0 The current proposal seeks to investigate the impact of a brief Health Behavior Change Counseling (HBCC) on patient activation and post-operative health behavior and functional recovery. We plan to enroll two consecutive cohorts of individuals undergoing elective surgery for degenerative disease of the lumbar spine. The first cohort will undergo standard preoperative care. The second cohort will undergo standard pre-operative care with an additional brief HBBC intervention session (a patient-centered directive method for eliciting motivation to change behavior). Both groups will be following for 24 months post-operatively. 08/02/2010 link
Medical treatments, items and services AHRQ DOES SCREENING VARIABILITY MAKE DVT AN UNRELIABLE QUALITY MEASURE OF TRAUMA CARE? JOHNS HOPKINS UNIVERSITY $0 SA#1 will examine the impact of hospital-level ultrasound rates on DVT rates reported after major trauma. SA#2 will determine whether hospital duplex and DVT rates correlate with the presence of a hospital duplex ultrasound screening protocol for high-risk trauma patients. SA#3 will determine if patients are more likely to have DVT diagnosed and reported based on hospital characteristics, controlling for patient-level DVT risk factors using multi-level multiple logistic regression. 07/02/2010 link
Medical treatments, items and services AHRQ COMPARATIVE EFFECTIVENESS OF ALTERNATIVE LEVELS OF STROKE UNIVERSITY OF PENNSYLVANIA $0 If successful, the project will develop, disseminate, and translate evidence about the expected outcomes and costs of alternative levels of acute rehabilitation in the care of persons with stroke-related functional limitations and disabilities. This study of the Veterans Health Administration's approach to the organization of acute rehabilitation will be directed not only to improving the care of veterans, but also to serving the Medicare and Medicaid programs by providing a disability management model for acute post-stroke rehabilitation. 08/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS IN GENOMIC & PERSONALIZED MEDICINE FOR COLON CANCER KAISER FOUNDATION RESEARCH INSTITUTE $1,999,998 Our comprehensive research program in GPM for colorectal cancer will have two main components: 1) secondary data collection through evidence synthesis and cost-effectiveness analysis, and 2) primary data collection through a proof-of-principle study to examine questions about personalized medicine for colorectal cancer. In the proof-of-principle study, we will evaluate the utilization of KRAS and Lynch Syndrome genetic tests within our health systems, and measure the effectiveness of KRAS testing compared with a patient population that does not receive testing. We will also conduct patient and physician interviews to measure psychosocial issues related to KRAS testing, and to help us understand how the genetic test results are used to inform decisions. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF BIOLOGICS FOR PSORIASIS UNIVERSITY OF PENNSYLVANIA $40,421 Create a highly innovative public-private partnership called CERSDN (pronounced "Sirs-DEN"), the acronym for the comparative effectiveness Research in Skin Disease Network, to rigorously study the comparative effectiveness of biologics for psoriasis. 12/14/3268 link
Medical treatments, items and services NIH RANDOMIZED OBSERVATION STUDY OF BIOLOGIC THERAPY FOR RHEUMATOID ARTHRITIS UNIVERSITY OF PITTSBURGH AT PITTSBURGH $40,421 we will obtain CCE data from collaborators at Harvard and also from the UPMC RACER. The UPMC RACER system will utilize a large network of UPMC rheumatologists that are already linked by an electronic medical record (EMR) system; the EMR will be used to identify RA patients and to capture information on treatment, medical costs and clinical laboratory data. goal of establishing the systems in order to effectively perform real-world cost-effectiveness research in patients with RA 05/27/5570 link
Medical treatments, items and services AHRQ Postmarketing Surveillance of Toxicities Associated with Cancer Chemotherapy UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON $0 link
Medical treatments, items and services AHRQ DOES SCREENING VARIABILITY MAKE DVT AN UNRELIABLE QUALITY MEASURE OF TRAUMA CARE? JOHNS HOPKINS UNIVERSITY $0 SA#1 will examine the impact of hospital-level ultrasound rates on DVT rates reported after major trauma. SA#2 will determine whether hospital duplex and DVT rates correlate with the presence of a hospital duplex ultrasound screening protocol for high-risk trauma patients. SA#3 will determine if patients are more likely to have DVT diagnosed and reported based on hospital characteristics, controlling for patient-level DVT risk factors using multi-level multiple logistic regression. 07/02/2010 link
Medical treatments, items and services AHRQ RACE AND CARDIAC CATHETERIZATION USE IN THE SETTING OF ACUTE MYOCARDIAL INFARCTION YALE UNIVERSITY $0 The proposed work, an investigation of racial variations in the use of cardiac catheterization in patients with myocardial infarction, is consonant with AHRQ's research mission of understanding factors influencing access to quality health care, and addresses two priority populations, minority groups and the elderly. The proposal's three projects - rigorously evaluating the quality of race data reporting in administrative data and medical records; determining whether racial variations in cardiac catheterization use reflect overtreatment of white patients, undertreatment of black patients, or a combination of processes; and the impact of racial differences in cardiac catheterization use on long-term survival - will help inform current efforts to address racial disparities in health and health care use. 12/02/2010 link
Medical treatments, items and services AHRQ ADHERENCE WITH SLEEP APNEA TREATMENTS: A META-ANALYSIS VETERANS MEDICAL RESEARCH FDN/SAN DIEGO $0 This project will systematically search the PubMed database (supplemented by PsyInfo and the Cochrane Central Register of Controlled Trials) and use the techniques of meta-analysis to organize, quantitatively summarize, and statistically integrate the results of all published empirical research analyzing all correlates, determinants, and consequences of patient adherence (compliance) to interventions for SRBD that are given by healthcare providers. 07/02/2010 link
Medical treatments, items and services AHRQ PREVENTING SUDDEN CARDIAC DEATH: HARNESSING THE POWER OF DECISION ANALYSIS, BAYESIAN STATISTICAL MODEL DUKE UNIVERSITY $0 Recent clinical trials of patients considered at risk for SCD have demonstrated that the implantable cardioverter defibrillator (ICD) is the most effective therapy currently available -- the magnitude of effectiveness of ICD therapy in clinically defined subgroups is unclear. The proposed research will combine patient-level data from 11 clinical trials along with decision analytic methods and Bayesian statistical techniques to explore several unanswered and timely clinical and policy questions related to the prevention of sudden cardiac death. 08/02/2010 link
Medical treatments, items and services NIH IMPROVED ESTIMATES OF THE COMPARATIVE TREATMENT EFFECTS OF CABG AND PCI STANFORD UNIVERSITY $499,846 This project will develop methods to use information from electronic medical records to reliably compare treatments for heart disease. Better methods to use electronic data collected in routine practice will help compare the benefits and risks of treatments in routine medical care settings. 08/02/2010 link
Medical treatments, items and services NIH ANALYSES OF REGISTRATION BIPOLAR PROPHYLAXIS TRIALS TO DEVELOP NEW STUDY DESIGNS UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER SAN ANTONIO $381,490 Researchers can conduct analyses of existing databases for systematic benefit/harm analyses or to compare interventions on "real life outcomes" such as level of functioning or acceptability, using meta-analytic methods by means of conducting a rigorous evaluation of the comparative effectiveness and overall impact of 7 different primary drugs employed in maintenance treatment of bipolar disorders. 09/02/2010 link
Medical treatments, items and services AHRQ DEVELOPING TREATMENT POLICIES FOR COMPLEX PATIENTS USING MODELING AND DATA MINING UNIVERSITY OF MINNESOTA TWIN CITIES $0 08/02/2010 link
Medical treatments, items and services AHRQ Realizing the Promise: Evidence-Based, Patient-Centered Care FOUNDATION/INFORMED MED/DECISION/MAKING $0 To identify and present the most promising conceptual frameworks system requirements methodological strategies and outcome measures required for implementing SDM and patient decision aids PtDAs into clinical practice with particular emphasis on: a Underserved populations low literacy low numeracy low income non English speaking rural patients inner city patients ; b Patients with chronic conditions; and c Cross cultural adaptation and dissemination of PtDAs and SDM 2 To examine the regulatory legal and payment policies required to accelerate the wide spread adoption of SDM and PtDAs into clinical practice 3 To identify the best ways to measure the effect of SDM on the quality of decisions and the implications for the quality and costs of care. link
Medical treatments, items and services NIH A COMPREHENSIVE MODEL TO ASSESS THE COST-EFFECTIVENESS OF PATIENT NAVIGATION UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER $357,468 The objective of the proposed study is to develop a comprehensive research framework to assess the cost-effectiveness of a PN program targeted at various points in the continuum of cancer care - screening, diagnosis, and treatment. 09/02/2010 link
Medical treatments, items and services CDC RECOVERY: Comparing the Effectiveness of Traditional Evidence-Based Tobacco Cessation Interventions to Newer and Innovative Interventions Used by Comprehensive Cancer Control Programs Research Triangle Institute $2,546,139 This procurement is to support the development and implementation of a research protocol to: (1) define the most effective strategies to promote tobacco quitline use, and (2) compare the effectiveness of evidence-based traditional quitline interventions, newer web-based cessation interventions, and both interventions together on tobacco cessation 07/18/2010 link
Medical treatments, items and services AHRQ COMPARATIVE EFFICACY OF TREATMENTS FOR LUMBAR SPINE UNIVERSITY OF WISCONSIN MADISON $0 We intend to establish a mechanism by which physicians of many specialties can contribute to a prospective database in order to allow for the comparison of outcomes following different treatments for similar disorders. The first step in this process is to agree upon the definitions, outcomes measures, and reporting mechanisms to be used. The proposed conference will be an important step in gathering relevant stakeholders together to work out the components of such a database. This is the first attempt to coordinate input from multiple medical societies, the insurance industry, and government overseers. 10/01/2010 link
Medical treatments, items and services AHRQ COMPARATIVE EFFECTIVENESS METHODS FOR EVALUATION OF IN-HOSPITAL EXPOSURES BRIGHAM & WOMEN»S HOSPITAL $134,182 link
Medical treatments, items and services AHRQ ASSESSING THE RELATIONSHIP BETWEEN IT SOPHISTICATION AND NURSING HOME QUALITY UNIVERSITY OF MISSOURI-COLUMBIA $0 The K08 application outlines a five-year plan to support a candidate who is already contributing to clinical research in long term care settings. The candidates proposed research program, Assessing the Relationship Between IT Sophistication and Nursing Home Quality has two specific aims: 1) Compare pressure ulcer quality measures in Nursing Home Compare data in nursing homes with high IT sophistication versus nursing homes with low IT sophistication; and 2) Explore strategies to communicate pressure ulcer preventions used in nursing homes with high IT sophistication versus nursing homes with low IT sophistication. 10/01/2010 link
Medical treatments, items and services AHRQ-HIS Infrastructure for CER on Innovative Delivery Systems for Complex Patients Rutgers, The State University of New Jersey $0 This project will establish a statewide data infrastructure for Comparative Effectiveness Research (CER) on healthcare delivery innovations for complex patients in low-income communities. It addresses two CER priorities established by the Institute of Medicine in 2009 to evaluate outcomes of: (1) "...comprehensive care coordination programs, such as the medical home, in managing children and adults with severe chronic disease, especially in populations with known health disparities"; and (2) "accountable care systems ...for geographically defined populations of patients with one or more chronic diseases." Responding to the Agency for Healthcare Research and Quality request for applications (RFA-HS-10-001) to expand research capability to study comparative effectiveness in complex patients, this project has three specific aims: 1. Build a sustainable longitudinal database of linked hospital, Medicaid, and charity care claims and encounter records in New Jersey for CER on strategies to improve the delivery of care to complex patients in low-income communities. 2. Build and evaluate measures of resource use and quality of care for CER on innovative delivery systems for complex patients in low-income communities using the database developed under Aim 1. 3. Demonstrate the potential of this new research infrastructure by conducting a pilot evaluation of health services resource use and quality for complex patients served by an innovative care coordination program in Camden, NJ. Designed to become an ongoing enterprise, the data infrastructure will initially consist of six years of state program administrative records. Products of this work will be disseminated widely and the database will be released for public use. The project builds on a long-standing collaboration between university researchers and agencies of New Jersey government, and will take place in the context of state policies encouraging innovation in health care delivery for low-income urban populations. New Jersey is especially well suited to CER on health system delivery innovations because it has exceptionally high rates of preventable utilization of expensive hospital care. 10/02/2010 link
Medical treatments, items and services AHRQ Planning, Evaluation and Technical Assistance of Delivery System Evaluation and Demonstration Initatives Econometrica, Inc. $1,060,353 The Agency for Healthcare Research and Quality (AHRQ) intends to issue a competitive task order against an Indefinite Delivery Indefinite Quantity Task Order with the Planning Evaluation and Analysis Task Order Contracts master contract holders. It is anticipated that AHRQ will award 1 task order. This task order is to organize and assist AHRQ's CER-Delivery System Initiative. The core of this initiative consists of projects funded by two ARRA-funded RFAs (RFA 10-012 and RFA 10-013). The contractor will provide technical assistance for the grantees under these RFAs; organize meetings of grantees, experts and stakeholders, provide white papers for these meetings, help develop products and tools that translate findings from the research grants into forms that are useful to provider organizations, payers, and policy makers; and prepare a report that evaluates key findings from the research grants and their implications for research, practice, and policy. 08/18/2010 link
Medical treatments, items and services AHRQ-Indian Health Service Comparative Effectiveness of Lipid-Lowering and Antihypertensive Medications Among HIV-Infected Individuals UNIVERSITY OF WASHINGTON $0 The goal of this project is to evaluate the comparative effectiveness of lipid-lowering and antihypertensive medications among HIV-infected individuals. HIV infection itself may impact metabolic abnormalities such as dyslipidemia leading to cardiovascular disease risk. In addition, the decline in mortality in the developed world for HIV-infected patients resulting from widespread use of highly active antiretroviral therapy has been accompanied by an increase in metabolic complications such as dyslipidemia and hypertension which can result in significant morbidity among HIV-infected individuals including cardiovascular disease, the leading cause of death and morbidity in the US. However, despite the increasing importance of these chronic conditions, uncertainty exists regarding management choices in clinical practice. We plan to use innovative statistical techniques including marginal structural models to account for time dependant confounding and inverse intensity rate ratio-weighted (IIRR) generalized estimating equations to account for the non structured visit schedule to estimate the comparative effectiveness of medications in the treatment of HIV- infected individuals. We will capitalize on the comprehensive clinical data available within the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS). This study addresses an important question that will impact provider decision-making regarding lipid-lowering and antihypertensive medications and, as a result, improve the clinical care of HIV-infected patients. In addition, this project will advance the methods available for comparative effectiveness analyses in observational settings. Improving these techniques has the potential to improve studies of comparative medication effectiveness studies for other conditions (beyond that of the HIV-infected patients). 10/02/2010 link
Medical treatments, items and services NIH CLINICAL AND COST-EFFECTIVENESS OF BIOLOGICS IN RHEUMATOID ARTHRITIS BOSTON UNIVERSITY MEDICAL CAMPUS $499,956 The proposed study will build upon our experience in meta-analysis, large-scale epidemiology, and cost-effectiveness research in rheumatoid arthritis (RA), using three large RA registries, a systematic literature review, and computerized projection modeling to study the clinical and cost-effectiveness of biologics to determine the best therapy for individual patients. 09/02/2010 link
Medical treatments, items and services NIH DIET AND EXERCISE (DE) PROGRAM FOR ALZHEIMER PREVENTION UNIVERSITY OF CALIFORNIA LOS ANGELES $500,000 Based on preliminary evidence indicating success, this project aims to develop a cheap, safe and effective prevention method with over the counter dietary supplements combined with exercise to prevent Alzheimer's and to show that efficacy with our approach in people has the potential to be quickly evaluated in the clinic, using surrogate "biomarkers" for treatment efficacy. 09/02/2010 link
Medical treatments, items and services NIH A RANDOMIZED TRIAL TO COMPARE SURGICAL AND MEDICAL TREATMENTS FOR TYPE 2 DIABETES UNIVERSITY OF PITTSBURGH AT PITTSBURGH $500,000 The proposed project will address the lack of randomized controlled studies and comparative effectiveness research in bariatric surgery by utilizing a three arm randomized trial to compare surgical and non-surgical treatments for Type 2 diabetes in obese subjects. Understanding more clearly the impact of bariatric surgery compared to a non-surgical, intensive lifestyle intervention for the treatment of diabetes in the setting of obesity will have a major impact on both the science and public health for the communities of obese and diabetic patients in this country and worldwide. 09/02/2010 link
Medical treatments, items and services AHRQ-Indian Health Service The Continuity of Medication Management (COMM) Study DUKE UNIVERSITY $0 Better continuity of care has been associated with improved quality of care, and reduced emergency room visits and hospitalizations for ambulatory care sensitive conditions. With better continuity, interactions between patients and providers are productive, trust is established, and patients receive appropriate and timely preventive care and chronic disease management. This idealized version of care continuity is rarely realized particularly for patients with multiple chronic conditions, because the average Medicare fee-for-service beneficiary saw two primary care physicians and five specialists in 2000-2002. To improve care coordination and management of patients with chronic conditions, the patient-centered medical home has been proposed to provide a single, consistent point of care that provides continuity of clinical information and treatment decisions for the patient. Medical homes that leverage information technology to promote longitudinal relationships, care coordination and comprehensiveness, hold promise for improving the care for patients with chronic conditions, particularly patients with multiple conditions. However, continuity of care and medical homes relate not just to appropriate and timely provision of health services with a single point of care, but also to appropriate and timely prescribing of new medications and changing in dosing for existing medications. However, no study to date has examined whether patient care that reflects the principles of a medical home improves the continuity of medication management and health and economic outcomes for patients with multiple chronic conditions. We will address this gap in five aims: 1) Do patients taking medications for two or more ACSCs have more prescribing providers than patients taking medications for one ACSC? 2) Do patients taking medications for two or more ACSCs have more medications prescribed and worse medication adherence than patients taking medications for one ACSC? 3) Do patients taking medications for two or more ACSCs have more emergency room visits and inpatient admissions than patients taking medications for one ACSC? 4) Do patients taking medications for two or more ACSCs have more self-reported medication problems than patients taking medications for one ACSC? 5) What do patients and their providers perceive as the advantages and disadvantages of having a single prescribing provider or multiple prescribing providers? Medical home implementation efforts may need to explicitly coordinate prescribing patterns to optimize patient outcomes if we find that patients with fewer (or a single) prescribers have better adherence, fewer emergency room visits and admissions, and fewer self-reported medication problems than patients with more prescribers. Study results are also likely to suggest targets for future evaluation in health systems where self-referral is common and targets for future intervention development. 10/02/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Comprehensive Care for Adults with SMI University of California, San Diego $0 Little work has examined models of comprehensive care for persons with chronic serious mental illness (SMI) such as schizophrenia. Given the debilitating nature of SMI, a comprehensive care model would include access to mental health, physical health, and substance abuse services as well as extensive community linkages, primarily in the form of housing support. This study will examine the comparative effectiveness (a) usual care versus (b) of the Housing First model of comprehensive care, which was implemented throughout California as Full Service Partnerships under the Mental Health Services Act (MHSA). 09/03/2010 link
Medical treatments, items and services AHRQ Comparative Effectiveness of Primary Care Practice Transformation by Two Insurers Michigan State University $0 While much evidence exists to support the positive relationship between high performing structures and processes, with improved population level health, little is known about the type of support by the delivery system, particularly health plans, necessary to achieve a high functioning health service system. The proposed research will examine the comparative effectiveness of two PCMH strategies, including different payment and facilitated support interventions, utilized by two different regional health plans, on improvement in outcomes - cost, quality and experience in pilot practices. The Health Service System model provides a conceptual framework for this evaluation project. 10/02/2010 link
Medical treatments, items and services NIH ELECTRICAL STIMULATION FOR HEMIPLEGIC SHOULDER PAIN CASE WESTERN RESERVE UNIVERSITY $405,189 Shoulder pain following stroke is a major rehabilitation problem affecting approximately 60% of all moderate to severely impaired stroke survivors, and is associated with poor recovery, impaired activities of daily living and reduced quality of life. This project will evaluate the effectiveness of a novel electrical stimulation treatment for reducing post-stroke shoulder pain. 09/02/2010 link
Medical treatments, items and services NIH BRAIN & COGNITIVE CHANGES AFTER REASONING OR PHYSICAL TRAINING IN COGNITIVELY NORMAL SENIORS UNIVERSITY OF TEXAS DALLAS $500,000 Brain & Cognitive Changes after Reasoning or Exercise Training in Cognitively Normal Seniors Seniors 65 years of age and older represent one of the fastest growing segments of our society with the population doubling within the next 25 years with dramatic rates of mental decline, costing society billions of dollars each year. The proposed research seeks to discover whether relatively short term mental or physical training can enhance gist reasoning, generalize to untrained cognitive areas and modify/strengthen brain function in areas susceptible to aging processes. To identify neuroprotective and non-pharmacological interventions to prevent mental decline and maximize cognitive brain health during the course of the adult lifespan has major public policy implications. 09/02/2010 link
Medical treatments, items and services NIH CONSERVATIVE VERSUS DIALYTIC MANAGEMENT IN STAGE V CHRONIC KIDNEY DISEASE STANFORD UNIVERSITY $478,672 Patients with advanced chronic kidney disease (CKD) may or may not benefit from the initiation of dialysis in the absence of symptomatic uremia (accumulation of the bloodstream with by- products of metabolism). This pilot clinical trial aims to determine the feasibility, safety and efficacy of two alternative strategies - one in which patients with advanced CKD begin dialysis, and another in which a series of conservative measures are instituted and dialysis is deferred until there is further loss of kidney function. If this pilot trial demonstrates feasibility in randomizing patients to these two strategies, results from this pilot study can be used to inform the design of a larger, more definitive trial. 08/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS: ERYTHROPOIETIC STIMULATING AGENTS IN TREATMENT OF MDS UNIVERSITY OF MARYLAND BALTIMORE $325,754 Narrative Myelodysplastic syndromes (MDS) are the most common hematologic malignancy in the elderly, with at least 10,000 new cases diagnosed each year. Erythropoietic stimulating agents (ESA) are effective in treating the symptomatic anemia that affects MDS patients, but little is known about longer term positive and negative health effects of ESAs, compared to supportive care with repeated blood transfusions. In this study, we will use data from regional cancer registries that is linked to Medicare enrollment and insurance claims data. We will examine the characteristics of Medicare beneficiaries with MDS, patterns of treatment, safety and effectiveness of ESA use, and costs of care. 10/01/2010 link
Medical treatments, items and services NIH COMPARISON OF DEPRESSION INTERVENTIONS AFTER ACUTE CORONARY SYNDROME (CODIACS) COLUMBIA UNIVERSITY HEALTH SCIENCES $2,155,291 Propose a multicenter feasibility/vanguard project comparing the effectiveness of two interventions for post-ACS depression. The project will culminate in a well-designed, well-organized multicenter Phase III clinical trial. Aim 1) To determine the feasibility and effectiveness of the COPES intervention at other sites by conducting a 5-site RCT comparing the COPES intervention to standard care for depression in post-ACS patients, and to obtain estimates of yield, acceptance, and retention for use in planning a large phase 3 clinical trial. Aim 2) To propose a Phase III single-blind, parallel-group, comparative effectiveness RCT for post-ACS patients, testing whether Enhanced depression care results in fewer major adverse cardiovascular events (MACE - recurrent myocardial infarction, hospitalization for unstable angina with documented CHD) and lower all-cause mortality (ACM) across an average 2 year follow-up, compared to Standard of depression care. 08/02/2010 link
Medical treatments, items and services NIH/AHRQ The Biological and Behavioral Bases of Decision-Making in Medical Professionals Baylor College of Medicine $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery and Reinvestment Act of 2009 (Recovery Act or ARRA), Public Law 111-5, invites applications to study how the principles of behavioral economics could be used to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. (For this FOA, applications should be thought of as large pilot or preliminary studies rather than definitive trials.) This funding opportunity seeks applications that will investigate whether the principles of behavioral economics could be used to enhance the uptake of the results CER among health care providers and also enhance the maintenance of such treatments in patient populations. Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER could be far more cost effective than other approaches including some pay for performance schemes (P4P). 10/02/2010 link
Medical treatments, items and services NIH/AHRQ HIV Screening Take-Up: Evaluating Incentives and Opt-Out Strategies University of California, Berkeley $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery and Reinvestment Act of 2009 (Recovery Act or ARRA), Public Law 111-5, invites applications to study how the principles of behavioral economics could be used to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. (For this FOA, applications should be thought of as large pilot or preliminary studies rather than definitive trials.) This funding opportunity seeks applications that will investigate whether the principles of behavioral economics could be used to enhance the uptake of the results CER among health care providers and also enhance the maintenance of such treatments in patient populations. Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER could be far more cost effective than other approaches including some pay for performance schemes (P4P). 09/23/2010 link
Medical treatments, items and services NIH/AHRQ Monetary Incentives and Intrinsic Motivation to Sustain Hypertension Control UCLA School of Medicine $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery and Reinvestment Act of 2009 (Recovery Act or ARRA), Public Law 111-5, invites applications to study how the principles of behavioral economics could be used to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. (For this FOA, applications should be thought of as large pilot or preliminary studies rather than definitive trials.) This funding opportunity seeks applications that will investigate whether the principles of behavioral economics could be used to enhance the uptake of the results CER among health care providers and also enhance the maintenance of such treatments in patient populations. Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER could be far more cost effective than other approaches including some pay for performance schemes (P4P). 09/23/2010 link
Medical treatments, items and services NIH/AHRQ Nudging Doctors to Collaborate with Pharmacists to Improve Medication Adherence TUFTS MEDICAL CENTER $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery and Reinvestment Act of 2009 (Recovery Act or ARRA), Public Law 111-5, invites applications to study how the principles of behavioral economics could be used to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. (For this FOA, applications should be thought of as large pilot or preliminary studies rather than definitive trials.) This funding opportunity seeks applications that will investigate whether the principles of behavioral economics could be used to enhance the uptake of the results CER among health care providers and also enhance the maintenance of such treatments in patient populations. Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER could be far more cost effective than other approaches including some pay for performance schemes (P4P). 09/25/2010 link
Medical treatments, items and services NIH/AHRQ Uptake of Comparative Effectiveness Research: Implications for Discharge Decision EMORY UNIVERSITY $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery and Reinvestment Act of 2009 (Recovery Act or ARRA), Public Law 111-5, invites applications to study how the principles of behavioral economics could be used to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. (For this FOA, applications should be thought of as large pilot or preliminary studies rather than definitive trials.) This funding opportunity seeks applications that will investigate whether the principles of behavioral economics could be used to enhance the uptake of the results CER among health care providers and also enhance the maintenance of such treatments in patient populations. Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER could be far more cost effective than other approaches including some pay for performance schemes (P4P). 09/23/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF NONINVASIVE CARDIAC IMAGING BRIGHAM AND WOMEN»S HOSPITAL $499,077 The proposed application under this challenge grant seek to answer the following questions: (1) What is the incremental cost-effectiveness of SPECT, PET, and CCTA as well as their respective accuracy for identification of obstructive CAD, and clinical event risk re-classification?; (2) Do these diagnostic strategies perform similarly with respect to risk prediction in all patient subgroups including women, diabetics, and obese individuals?; (3) Are these diagnostic strategies equal in identifying optimal patient management by predicting therapeutic benefit (medical therapy vs. revascularization)?; (4) Are differences between these noninvasive modalities with respect to risk prediction and cost-effectiveness influenced by the quality of image interpretation? 08/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS & MEDICAL INTERVENTIONS FOR PRIMARY OPEN ANGLE GLAUCOMA JOHNS HOPKINS UNIVERSITY $454,142 Propose to assess the comparative effectiveness of multiple medical interventions available for primary open angle glaucoma (POAG) using the state-of-art Bayesian MTC meta-analysis models. POAG poses substantial burdens on patients and health care resources. Utilizing data from existing high quality randomized controlled trials, we will perform MTC meta-analysis and rank multiple medical treatment options for POAG. We will validate the MTC meta-analysis models and assess the impact of publication bias. We will report and disseminate our findings on the comparative effectiveness of medical interventions for POAG, as well as utility and validity of MTC meta-analysis techniques for comparative effectiveness research. 10/01/2010 link
Medical treatments, items and services NIH A COMMUNITY PARTICIPATOR APPROACH TO IMPROVING HEALTH IN A HISPANIC POPULATION CAROLINAS MEDICAL CENTER $386,999 Leverage the resources within our network and community to eliminate Hispanic health disparities using principles of CBPR. This will be accomplished by: enhancing community partnerships; performing a needs assessment; identifying a disease to be addressed; and designing and implementing an intervention. The intervention will be evaluated by examining its impact on community health indicators, the changes that occur in patterns of healthcare utilization, and the overall cost effectiveness. 08/02/2010 link
Medical treatments, items and services NIH CONVENTIONAL VS MINDFULNESS INTERVENTION IN PARENTS OF CHILDREN WITH DISABILITIES VANDERBILT UNIVERSITY $498,782 This application compares the effectiveness of a conventional Parent Group intervention to a modified Mindfulness- Based Stress Reduction (MBSR) program in parents of children with ASD and other disabilities. 10/01/2010 link
Medical treatments, items and services NIH COMPARATIVE ANALYSIS OF SURGICAL TREATMENT OPTIONS FOR LOCALIZED PROSTATE CANCER SLOAN-KETTERING INSTITUTE FOR CANCER RESEARCH $358,515 There are various surgical approaches for treating prostate cancer, but unfortunately few high-quality studies have compared the different techniques. Better comparisons of complications, outcomes, and costs between minimally invasive and open radical prostatectomy would assist patients, physicians, and health care policy makers in treatment decisions, resulting in better patient care and potentially lower costs. 09/02/2010 link
Medical treatments, items and services NIH MULTIPLE RISK BEHAVIOR INTERVENTION IN HEALTH CARE SETTINGS DANA-FARBER CANCER INSTITUTE $463,376 The parent study, Healthy Directions 2, tests a low-cost cancer prevention intervention for community health centers. This revision will allow us to learn which of the intervention components are most important. As a result, this revision will provide very important information for the health care community on the best way to deliver cancer prevention interventions, which can have life-saving benefit for large numbers of people if implemented widely. 09/29/2011 link
Medical treatments, items and services NIH ADAPTING PEDIATRIC OBESITY TREATMENT DELIVERY TO ADDRESS HEALTH DISPARITIES UNIVERSITY OF PITTSBURGH AT PITTSBURGH $493,097 The proposed randomized clinical trial will examine the effects of an evidence-based intervention for pediatric obesity adapted for a low income, racially and ethnically diverse disparity population on child percent overBMI in a sample of 140 obese children ages 2-11 years. 09/02/2010 link
Medical treatments, items and services NIH WOMENS SUBSTANCE USE AND INTIMATE PARTNER VIOLENCE OREGON SOCIAL LEARNING CENTER, INC. $499,306 The proposed research will improve our understanding of (a) the contribution of substance use and dependence to the initiation of intimate partner violence for women in their twenties, (b) the association between women's substance use problems and their male partners' victimization of the women, and (c) whether women commit less intimate partner violence during times in their lives when they are abstinent from substances than when they are using, which has important implications for the effectiveness of substance use treatment as an intimate partner violence reduction intervention. 09/02/2010 link
Medical treatments, items and services NIH SPIN-LABELED PEPTIDE ANTIBIOTICS MEDICAL COLLEGE OF WISCONSIN $328,134 The prevalence of multi-drug resistant (MDR) infections is one of the most serious problems in health care today, both in the United States and worldwide, leading to increased treatment costs and a growing incidence of treatment failure. There is a critical need for the development of new antibiotics, and in particular for new classes of compounds that target non-traditional sites other than cell-wall synthesis and the bacterial ribosome. Antimicrobial peptides, which display remarkable efficacy against a broad spectrum of pathogens, including those resistant to conventional antibiotics, offer a novel approach to the treatment of drug-resistant infections. Developing a more complete understanding of the interactions of antimicrobial peptides with their target cells will enhance our ability to design and develop more effective peptide and peptidomimetic antibiotics. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF HEALTH INSURANCE REFORM ON CANCER DISPARITIES BOSTON UNIVERSITY MEDICAL CAMPUS $489,905 We propose to investigate the comparative and cost effectiveness of health insurance reform that was instituted in 2006 in the Commonwealth of Massachusetts, on the cancer outcomes of traditionally underserved women who have abnormal cervical and breast cancer screening studies. We propose to conduct this analysis using a unique database our research group has collected as part of the Boston University Patient Navigation Research Program. We have collected detailed clinical, demographic, insurance, and outcome data on over 3300 women, the entire cohort of women with abnormal breast and cervical cancer screening studies between 2004-5 and 2007-9 at 6 community health centers in Boston. 07/02/2010 link
Medical treatments, items and services NIH CT COLONOSCOPY SCREENING FOR CRC:COMPARATIVE EFFECTIVENESS VS TRADITIONAL MODELS MASSACHUSETTS GENERAL HOSPITAL $394,651 The goal of the proposed research is to determine the comparative effectiveness of CT colonography (CTC) vs. colonoscopy, flexible sigmoidoscopy and fecal occult blood testing for tailored colorectal cancer screening and surveillance. 09/02/2010 link
Medical treatments, items and services NIH COST EFFECTIVENESS OF A HOME SUPPORT PROGRAM FOR DEPRESSION IN BLACK ELDERS THOMAS JEFFERSON UNIVERSITY $498,354 Beat The Blues (BTB) - We propose an economic evaluation of a home support depression program for older African Americans elders. Our study will contribute to the science of economic evaluation by comparing utility indices for sensitivity with an older African American depressed population, translational research to enable delivery by a community organization, and health policy by linking coverage decisions to adequate scientific evidence of cost effectiveness. 09/02/2010 link
Medical treatments, items and services NIH COLLABORATIVE BEHAVIORAL E-CARE TO DECREASE CARDIOVASCULAR RISK (E-COMPARE) GROUP HEALTH COOPERATIVE $499,972 Adults with high blood pressure (BP) and obesity are at higher risk for heart disease and strokes. A recent study (e-BP) showed that patients who monitored their BP at home and received pharmacist care over the Web had improved BP control. We will be studying whether similar care delivered by dietitians over the Web leads to improved BP control and weight loss. 08/02/2010 link
Medical treatments, items and services NIH INSTITUTIONAL VARIATION IN SURGICAL CARE FOR BREAST CANCER IN US COMMUNITY HOSPITALS BRIGHAM AND WOMEN»S HOSPITAL $499,935 This proposal investigates institutional variation in the surgical treatment of breast cancer at community hospitals. In particular, we seek to determine whether the supply of plastic surgeons and radiation oncologists at a given institution correlates with the type of surgery preferentially performed. 09/02/2010 link
Medical treatments, items and services NIH REDUCING OBESITY & DIABETES IN HIGH RISK YOUTH YALE UNIVERSITY $496,230 1. Modify a classroom-based educational and coping skills training (CST) intervention developed to reduce obesity and T2D risk in minority teens (Tween") and an internet CST program developed for youth with T1D (TeenCope") collaboratively with teens, parents, high school teachers, our Information Technology (IT) team, and our research team. 2. Conduct a pilot test of all processes and procedures associated with delivering the internet programs in a classroom setting to high school students. 3. Compare the effect of the health-e-teen program and the health-e-teen + CST program delivered to high school students on BMI, nutrition and physical activity behaviors, and self-efficacy over 6 months. 08/02/2010 link
Medical treatments, items and services NIH A CARDIOVASCULAR RISK REDUCTION LEARNING COMMUNITY IN DARTNET UNIVERSITY OF COLORADO DENVER $499,926 This project proposes to improve the control of high blood pressure and elevated cholesterol, two of the major reversible risk factors for all three of these serious cardiovascular problems, through innovative electronic audit and feedback to primary care providers of more than 320,000 patients in the Distributed Ambulatory Research in Therapeutics Network. 08/02/2010 link
Medical treatments, items and services NIH EVALUATING EFFECTIVENESS OF A STATEWIDE PUBLIC MENTAL HEALTH RE-ENTRY PROGRAM UNIVERSITY OF MASSACHUSETTS BOSTON $411,072 Propose to evaluate the effectiveness of a comprehensive re-entry intervention for individuals with severe mental illness (SMI), both in terms of post-incarceration outcomes and comparative economics. To achieve the objectives we undertake a interagency collaboration to harmonize existing administrative databases to compare individuals receiving re-entry services in comparison to released prisoners with SMI who have not. 09/02/2010 link
Medical treatments, items and services NIH METHOTREXATE RESPONSE IN TREATMENT OF UC UNIVERSITY OF NORTH CAROLINA CHAPEL HILL $388,089 Ulcerative colitis is characterized by a chronic inflammation of the colon, which often leads to substantial impairment of life quality. Since the therapeutic options of this condition are very limited, we propose a multi-center trial to evaluate the short and long- term efficacy of methotrexate in patients with active ulcerative colitis, who have failed or could not tolerate therapies with steroids, anti-TNF agents or azathioprine/6-MP. 07/02/2010 link
Medical treatments, items and services NIH EFFICACY OF PLYOMETRICS TO INCREASE BONE MASS IN MEN UNIVERSITY OF MISSOURI-COLUMBIA $71,435 The overall goal of the proposed study is to compare the efficacy of a plyometric-based intervention to increase bone mineral content (BMC) and density (BMD) with that of resistance training and to explore the mechanism of changes in BMD by measurement of bone turnover markers and hormones in apparently healthy adult males with osteopenia of the spine and/or hip. 09/02/2010 link
Medical treatments, items and services NIH DOWNREGULATION OF ROD METABOLISM IN RETINOPATHY OF PREMATURITY UNIVERSITY OF ARIZONA $496,544 Research which will address the highest-priority challenge 05-EY-102 Treatment of Pediatric Eye Diseases and Disorders. Specifically, it will compare results from two preclinical trials of novel interventions in retinopathy of prematurity (ROP). 10/01/2010 link
Medical treatments, items and services NIH SD INCONTINENCE TREATMENT CENTER UNIVERSITY OF CALIFORNIA SAN DIEGO $51,910 A comparative effectiveness trial of surgical procedures for the treatment of persistent or recurring stress urinary incontinence (SUI) following a prior continence surgery. 07/02/2010 link
Medical treatments, items and services NIH INCREASING THE UTILITY OF CONTRAST AGENTS FOR MRI UNIVERSITY OF CALIFORNIA LOS ANGELES $500,000 Compared to standard abdominal sacrocolpopexy, the classic gold standard operation for vaginal apical prolapse, minimally-invasive robotic sacrocolpopexy has the potential to provide a safer and more precise treatment, with less patient morbidity. The overall goal of this study is to compare outcomes of the robotic sacrocolpopexy with traditional open sacrocolpopexy, with emphasis on time to return to activities, patient safety, pain scores, and cost. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS AND FEASIBILITY OF SBIRT IN A GENERAL DENTAL CLINIC UNIVERSITY OF CONNECTICUT SCH OF MED/DNT $485,003 Believe there is now a real research opportunity to not only evaluate the effectiveness of SBIRT with dental patients, but also to improve the technology so that oral health practitioners can feel confident conducting screening, brief intervention and referrals for at-risk users of tobacco, alcohol and other substances. 09/02/2010 link
Medical treatments, items and services NIH SUDDEN CARDIAC DEATH IN HEART FAILURE TRIAL 10 YEAR FOLLOW-UP (SCD-HEFT 10 YR.) SEATTLE INSTITUTE FOR CARDIAC RESEARCH $496,015 The relevance of this comparative effectiveness research trial builds on the quality, numbers, and duration of follow-up of the largest ICD trial ever undertaken: the NHLBI sponsored Sudden Cardiac Death in Heart Failure Trial that compared ICD therapy to placebo and amiodarone to placebo (double blind). By increasing follow-up to 10-years for the entire SCD-HeFT population, we will provide a unique data. 09/02/2010 link
Medical treatments, items and services NIH MINIMALLY INVASIVE SURGICAL PULMONARY VEIN INSOLATION VS. MEDICAL MANAGEMENT IN P UNIVERSITY OF FLORIDA $397,631 Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting over 2.5 million Americans at a cost of over 7 billion dollars per year to Medicare alone. Importantly, 15% of all strokes are attributed to atrial fibrillation with the atrial appendage implicated as the likely source of emboli in these patients. This proposal specifically addresses stroke patients with AF by comparing optimal medical therapy with a novel surgical ablative procedure that restores sinus rhythm and ligates the atrial appendage. 09/02/2010 link
Medical treatments, items and services NIH PROSTATE CANCER NURSE-NAVIGATOR TREATMENT DECISION SUPPORT PALO ALTO MEDICAL FOUNDATION RES INST $193,311 Treatment decisions for prostate cancer, the second most frequent cause of cancer deaths for men, should take into account the man's personal values and preferences, since treatment options may offer similar mortality benefits but have very different, significant, long-term side effects. We propose to pilot test an education and decision support program to find out if it facilitates more informed and satisfying choices, leading to reduced uncertainty, anxiety, and regrets about treatment decisions and improved patient quality of life. 06/02/2010 link
Medical treatments, items and services NIH BEHAVIORAL AND GENETIC BIOMARKER DEVELOPMENT FOR AUTISM AND RELATED DISORDERS RUTGERS THE ST UNIV OF NJ NEW BRUNSWICK $499,543 The overall goal of this proposal is to advance the development of behavioral and genetic biomarkers for autism and related disorders. We will use our existing family set with an extensive existing database of clinical and genetic data from all family members, where each family contains at least one proband with autism and at least one proband with a language deficit, to define biomarkers for risk. 09/02/2010 link
Medical treatments, items and services NIH TAILORING "REAL MEN ARE SAFE" FOR AFRICAN AMERICAN AND HISPANIC MEN UNIVERSITY OF WASHINGTON $448,112 Prior research has demonstrated that the Real Men Are Safe (REMAS) HIV prevention intervention has been effective in helping men in substance abuse treatment lessen their sexual risk behavior. However, the intervention appeared to be more effective with whites as compared to African Americans and possibly Hispanics. The goal of this research is to develop a version of REMAS culturally tailored to be appropriate with African American and Hispanic men. 09/02/2010 link
Medical treatments, items and services NIH DOES ENHANCED SCHOOL-READINESS AFFECT ADULT HEALTH OF AFRICAN AMERICANS? UNIVERSITY OF NORTH CAROLINA CHAPEL HILL $335,334 Two randomized controlled trials of early childhood educational intervention were established at the Frank Porter Graham Child Development Institute (then "Center") in the 1970s. Propose to re-recruit them for a 2-year study of their adult wellness and health-related behaviors to learn if the known benefits in cognitive functioning and economic indicators are associated with detectable differences in their physical health and health practices. We will be looking for markers and precursors of cardiovascular disease, stroke, obesity, and diabetes. 07/02/2010 link
Medical treatments, items and services NIH VALIDATING NEW NIH CLINICAL TOOLS IN PARKINSON'S DISEASE WITH/WITHOUT DEPRESSION UNIVERSITY OF TEXAS SW MED CTR/DALLAS $494,488 This research study Validating New NIH Clinical Tools in Parkinson's Disease with/without Depression will utilize the Neuro-QOL and the NIH Toolbox in a representative and well described cohort of 160 patients with Parkinson's disease (aim 1) and will discern the effects attributable to Parkinson's or depressive symptomatology (aim 2). 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF INTERVENTIONS FOR CHRONIC PAIN MANAGEMENT WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY $1,017,585 Propose a comparative effectiveness study to determine which patients will derive maximum benefit from the currently available interventions used for the management of chronic pain patients. 09/02/2010 link
Medical treatments, items and services NIH COGNITIVE INTERVENTIONS DELIVERED TO ELDERS IN THE HOME VIA COACHING TECHNOLOGY OREGON HEALTH AND SCIENCE UNIVERSITY $477,611 Propose to integrate cognitive intervention protocols into our health coaching technology and evaluate the feasibility of a novel and scalable method for delivering tailored cognitive health interventions to elders in their home environment. 09/02/2010 link
Medical treatments, items and services NIH DELIVERY OF BIOLOGICALLY ACTIVE NUCLEIC ACIDS TO EPIDERMAL CELLS TRANSDERM, INC. $1,503,903 The goal of this proposal is to bridge gap between test tube knowledge about modifying gene expression using nucleic acids and clinical application. 09/02/2010 link
Medical treatments, items and services NIH PARTIAL MENISCECTOMY VS. NONOPERATIVE MGMT. IN MENISCAL TEAR WITH OA: AN RCT BRIGHAM AND WOMEN»S HOSPITAL $170,000 The study has three specific aims: Aim 1: To conduct a randomized controlled trial to compare the efficacy of APM versus a standardized non-operative management program among patients with symptomatic meniscal tear and knee OA. Aim 2: To follow the trial cohort for two years in order to determine whether differences between APM and nonoperative therapy in pain relief and functional improvement persist for two years. Aim 3: To evaluate the cost-effectiveness of APM in the management of patients with symptomatic meniscal tears in the setting of knee osteoarthritis. 09/24/2010 link
Medical treatments, items and services NIH WEB-BASED BEHAVIORAL INTERVENTION FOR RETURNING VETERANS WITH RISKY ALCOHOL USE BOSTON UNIVERSITY MEDICAL CAMPUS $477,764 This project will build a Web-based treatment program for returning veterans with alcohol problems and symptoms of combat-related symptoms of post-traumatic stress disorder. This is important because some veterans have difficulty accessing treatment because of distance or other factors. Creating a computerized program also guarantees that the program is delivered as it is designed, and can be used by many more people than can be seen by a therapist. 09/02/2010 link
Medical treatments, items and services NIH POPULATION VERSUS PRACTICE-BASED INTERVENTIONS TO INCREASE IMMUNIZATION RATES UNIVERSITY OF COLORADO DENVER $500,000 This study will compare two interventions for increasing immunization rates in this age group, one using well-studied primary care practice-based methods and the other using innovative technologies to increase immunization rates at the population-level. Results of this study will provide data that will be relevant nationally in guiding future investment of resources to increase up-to-date rates in young children prior to school entry. 10/01/2010 link
Medical treatments, items and services NIH MAXIMIZING EFFECTIVENESS OF INTEGRATED TREATMENT APPROACHES JOHNS HOPKINS UNIVERSITY $485,325 Research on promising strategies to improve the care of drug-dependent patients with comorbid psychiatric disorders remains a major priority for treatment providers and health care policymakers. This challenge grant application will make several substantial contributions to this work by using a well-controlled experimental design to evaluate the efficacy of contingency management for improving psychiatric service utilization and reducing psychiatric distress and impairment in opioid-dependent patients with any psychiatric disorder at a community-based drug abuse treatment program. 09/02/2010 link
Medical treatments, items and services NIH IMPROVING SUBSTANCE ABUSE COUNSELING ADHERENCE USING WEB-BASED VIDEOCONFERENCING JOHNS HOPKINS UNIVERSITY $495,966 This study will be the first to evaluate the efficacy of an accredited and currently available, Internet web- based videoconferencing platform to deliver routine schedules of counseling in an opioid agonist treatment program. 09/02/2010 link
Medical treatments, items and services NIH COMPARATIVE EFFECTIVENESS OF WEB-BASED MOBILE SUPPORT FOR THE DC TOBACCO QUITLINE AMERICAN LEGACY FOUNDATION $497,893 The proposed project represents an extraordinary opportunity to spearhead the use of web-enabled mobile devices to directly supplement and thereby enhance the efficiency, fidelity, and impact of an established community-based tobacco quitline program that targets underserved communities in Washington D.C.; bolstering the effectiveness of tobacco quitlines via web-based mobile technologies is a critical and timely endeavor, promising to expand the potential public health impact of this "broad reach" treatment modality. 09/02/2010 link
Medical treatments, items and services NIH EPIDEMIOLOGY AND MECHANISMS OF ACCELERATED AGING IN HIV INFECTION JOHNS HOPKINS UNIVERSITY $498,606 Using longitudinal data collected in the AIDS Linked to the IntraVenous Experience (ALIVE) study for up to 7 years, we will define trajectories and identify demographic, behavioral, and clinical correlates of physical function decline and a frailty-related phenotype. Utilizing our extensive biological repository and building on prior mechanistic work which identified selected inflammatory genes involved in frailty, we will evaluate circulating inflammatory markers and inflammatory gene expression levels in participants with or without physical function declines using a nested case-control study design. 09/02/2010 link

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Your search returned 253 of 497 records
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Type
NIH COMPARING ACUTE AND CONTINUOUS DRUG ABUSE TREATMENT: A RANDOMIZED CLINICAL TRIAL WRIGHT STATE UNIVERSITY $500,000 The proposed study is a clinical effectiveness trial in which 200 drug-dependent, adult outpatients from a community treatment center will be randomly assigned to Treatment as Usual or a newly developed, long-term treatment, referred to as "Long-Term Recovery Management." The results will benefit public health by adapting treatment and recovery services to the chronic nature of addiction. 09/02/2010 link substance abuse health system
NIH TARGETED THERAPIES FOR SELECTED PHENOTYPES OF OBSTRUCTIVE SLEEP APNEA UNIVERSITY OF WISCONSIN MADISON $399,974 Hope to improve the breathing during sleep in patients with OSA by individualizing their treatment to the patients' specific problem(s) associated with upper airway collapsibility and/or breathing stability. 09/02/2010 link respiratory
NIH EVALUATING ECONOMIC SUBSIDIES TO IMPROVE DIETARY INTAKE AMONG LOW INCOME FAMILIES UNIVERSITY OF ILLINOIS AT CHICAGO $495,446 In an effort to improve dietary intake and address the high prevalence of obesity among low-income children, the Special Supplemental Nutrition Program for Women Infants and Children (WIC) plans to revise their food packages. The overall purpose of the proposed study is to examine the mechanisms by which economic incentives offered in a large food assistance program impacts dietary intake of children. If the planned economic incentives produce improved dietary intake and altered weight gain trajectory among these high-risk children, this could have profound implications for heath disparities in this population. 09/02/2010 link obesity
NIH LC-MS/MS ANALYSIS OF CSF AND ANTECEDENT BIOMARKERS OF AD WASHINGTON UNIVERSITY $410,000 Hypothesize that can distinguish novel patterns in the CSF proteome that will enhance our ability to diagnose the preclinical stage of AD, and identify subjects who will soon progress to dementia. 09/02/2010 link dementia, Alzheimer's
NIH EPIGENETIC CHANGES PREDICT DISEASE COURSE OF HPV-RELATED LESIONS IN WOMEN 16-24 UNIVERSITY OF WASHINGTON $660,862 Aim one: define specific promoter region CpGs and chromatin modifications central to development of ICC by mapping methylation and histone marks of DAPK1, IGSF4, PAX1, TIMP3 and TFPI2 present in stored biopsies of ICC, CIS and normal cervical tissues; Aim two: enroll 100 16-25 year old women with biopsy confirmed CIN 2-3 and define the status of the promoter region CpGs and chromatin modifications identified in Aim 1 in their biopsies and same day exfoliated cell samples. Aim 3: Follow enrolled women every 6 months (for up to 18 months) by colposcopy and collection of exfoliated cell samples for cytology and testing to determine whether changes in methylation status and/or the pattern of chromatin marks associated with TWIST1, DAPK1, IGSF4, PAX1, TIMP3 and TFPI2 occur over time, and further, whether such changes are associated with colposcopic and cytologic changes. 09/02/2010 link cancer
NIH REFERRAL PATTERNS AND RISK OF EARLY REVISION AFTER PRIMARY TOTAL JOINT ARTHROPLASTY HOSPITAL FOR SPECIAL SURGERY $372,857 Revision arthroplasty is often a complex, costly procedure with worse outcomes than primary arthroplasty. Revision procedures are thought to be more commonly performed at tertiary care centers and by higher volume surgeons, but referral patterns are actually unknown. This study proposes to identify patterns for referral for revision arthroplasty in New York and California between 1996 and 2007 and to identify risk factors for early revision (within 10 years of primary surgery) and risk factors for complication following revision surgery. 09/02/2010 link functional limitations, disability health system
NIH IMPROVING CHILDHOOD IMMUNIZATION COMPLIANCE USING ELECTRONIC HEALTH RECORDS JOHNS HOPKINS UNIVERSITY $397,606 The overall goal of the proposed research is to improve the entire spectrum of school-aged childhood immunization rates among a predominantly African American, inner city population, utilizing and comparing 2 interventions: 1. an automated Electronic Health Record-derived provider-specific performance feedback report, and 2. automated Electronic Health Record-derived trigger alerts when patients in need of immunizations present to clinic. 10/01/2010 link unspecified health system
NIH DETERMINANTS OF PARTICIPATION IN AN ANAL CANCER PREVENTION TRIAL UNIVERSITY OF CALIFORNIA SAN FRANCISCO $499,999 This application will provide critical information that will support the conduct of such a study, namely determinants of participation in a randomized clinical trial in which 50 percent of participants with HGAIN will be screened and treated, and 50 percent will be observed without treatment. At the end of a 5-year period, the number of anal cancer cases will be compared in both arms. 09/02/2010 link cancer
NIH COMPUTER-ASSISTED GUIDANCE FOR TOBACCO DEPENDENCE INTERVENTIONS IN DENTAL OFFICES HEALTHPARTNERS RESEARCH FOUNDATION $447,509 This project will examine whether dentists and hygienists will assess interest in quitting and deliver a tobacco intervention more frequently when provided with computer assisted guidance compared to a control group. Specifically we will measure the delivery of questions assessing willingness to change and appropriate interventions based on willingness to change by measuring the recording of these activities in the EDR and patient receipt of these recommendations through a phone survey. 09/02/2010 link substance abuse health system
NIH COMPARING FOCUSED ULTRASOUND AND UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS MAYO CLINIC COLL OF MEDICINE, ROCHESTER $500,110 This study will characterize the amount of pelvic pain women with fibroids have with their menstrual periods and at other times in the month and whether pain is decreased by uterine artery embolization (UAE) and magnetic resonance guided focused ultrasound (MRgFUS), two minimally-invasive treatments for fibroids. 09/02/2010 link other
NIH COMPARATIVE BIOINFORMATICS AND TP53 EXPRESSION PURDUE UNIVERSITY WEST LAFAYETTE $69,066 This project's aims are as follows: (1) Very dense comparative alignment of the TP53/GBN5 cis-regulatory region across mammals; (2) Characterization of transcriptional responses using cell lines from a wide variety of species; (3) Molecular footprinting of this promoter region across mammals; (4) Test hypotheses of regulatory evolution using deletion/site-directed mutation constructs with reporter gene assays. As with (2) a key novel aspect of this work is the use of wildtype fibroblast cell lines from many different orders of mammals; (5) Using a novel pair-wise cell line assay, separate cis (local) from trans (non-local) effects in the evolution of transcriptional regulation; (6) Use, test, and develop bioinformatic/genomic and molecular evolutionary techniques on the dense sequence alignment of (1), plus genomes of over 14 species of mammals. 08/20/2011 link cancer
NIH COMPLICATIONS OF SURGERY FOR SPINAL STENOSIS: A CLINICAL PREDICTION RULE OREGON HEALTH AND SCIENCE UNIVERSITY $169,214 (1) Determine rates and reasons for repeat spine surgery in the population and salient subgroups; (2) determine rates of life-threatening complications and 30-day mortality as a function of age, comorbidity, prior surgery, and surgical invasiveness; and (3) develop and validate prediction rules for major adverse events. These studies will enhance surgeons' ability to estimate operative risks and advise patients about the benefits and risks of spine surgery, thus improving patient safety in a high-risk context. 09/22/2011 link other health system
AHRQ IMPACT OF REGIONALIZATION OF CARE IN ACUTE STROKE PATIENTS UNIVERSITY OF CALIFORNIA SAN FRANCISCO $0 To address these issues, I propose to conduct a study with the primary goal of studying comparative patient outcomes in regionalized and non-regionalized stroke systems. The secondary goals will be to assess the cost-effectiveness of regionalized care and accuracy of prehospital stroke recognition before and after regionalization of systems. 04/02/2010 link other
AHRQ COMPARATIVE EFFECTIVENESS OF TREATMENTS FOR DEGENERATIVE SPINE DISEASE DARTMOUTH COLLEGE $0 The proposed research will provide policy-relevant evidence on the comparative clinical effectiveness, safety, and economic value of emerging devices/biologics to treat common back-pain-related degenerative spine conditions in the elderly. 08/02/2010 link other
AHRQ QUANTITATIVE PRETEST PROBABILITY TO REDUCE CARDIOPULMONARY IMAGING IN THE EMERGENCY DEPARTMENT CAROLINAS MEDICAL CENTER $0 This study will test if the presentation of computerized, quantitative pretest probability for ACS and PE is associated with reduced radiation exposure in these patients. 08/02/2010 link cardiovascular
NIH GENETIC, GENOMIC, AND IMAGING BIOMARKERS IN DEGENERATIVE DEMENTIA UNIVERSITY OF CALIFORNIA LOS ANGELES $454,999 Identification of biomarkers enriching diagnostic, prognostic, and therapeutic capabilities is an important goal in dementia. We propose to build a molecular classifier based on peripheral blood samples and imaging data from demented patients. This would be a valuable tool for biomarker identification, improved patients classification, therapy evaluation, and to further our understanding of disease pathophysiology. 1 09/02/2010 link dementia, Alzheimer's
NIH ADVANCING INNOVATIVE COMPARATIVE EFFECTIVENESS RESEARCH-CANCER DIAGNOSTICS ADVICE UNIVERSITY OF WASHINGTON $1,997,996 This project proposes to establish a consortium of researchers and health care providing organizations that will devote their expertise to understanding the strengths and weaknesses of these tests and to produce research that will result in guidelines for the use of these tests and a future program of studies to rigorously evaluate these tests. 09/02/2010 link cancer
HRSA Maternal and Child Health (MCH) Pediatric Research Network Program American Academy of Pediatrics $0 The goal of the ARRA Pediatric Research Network Program is to support the infrastructure within an established pediatric applied research network to enable it to more readily conduct comparative effectiveness research in pediatric primary care sites around the United States. These funds will be used to facilitate the pediatric research network to create a subnetwork of practices that use certified electronic health reocrds(EHRs)to address critical child health issues and generate new knowledge to improve pediatric practice. 08/29/2010 link other
AHRQ Comparative Effectiveness of Virginia Coordinated Care Versus the Traditional Virginia Commonwealth University $0 The primary Aim of this study is to compare the effectiveness of the VCC, particularly the primary care component, with that of a traditional safety net delivery system at reducing the frequency of emergency department utilization, hospital utilization, and adverse health outcomes among uninsured patients who used the Virginia Commonwealth University Health System (VCUHS) from January 2003- December 2009. Attention will be paid to understanding the conditions and the types of patients for which the program was most effective. The Secondary Aim of the study is to identify the successful and replicable elements of primary care case management, care coordination, and other attributes of the patient-centered primary care model that make the VCC program effective. Attention will be paid to understanding how and why these elements are critical for different patient populations. This will be achieved by qualitative analyses, consisting of key informant interviews and focus groups with four stakeholder groups: program executives/leadership, provider physicians, care coordinators, and patients, informed by results from previous work and from analyses performed under the first Aim. 10/02/2010 link unspecified
AHRQ-Indian Health Service B-Blocker Effect on a Range of Health Outcomes in Older Adults with CAD and COPD YALE UNIVERSITY $0 With this analytic epidemiologic study, we begin investigating situations in which the treatment of one condition may exacerbate other conditions or adversely affect other health outcomes. Despite potential harms to the large number of older individuals with multiple co-occurring health conditions, this topic has received little research attention. We explore the capability of using large national population-based cohorts and novel analytical techniques to compare the benefits and harms of different intervention strategies, across a range of health outcome domains, in complex older adults with multi-morbidity. To develop our strategy, we begin by investigating Beta-Blocker (2-Blocker) intensity in persons with co-occurring coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD). Once we have tested the method with this important clinical question, we will extent to other sets of conditions and medications. This project builds on our ongoing research on multi-morbidity that includes mapping disease-specific outcomes onto universal health outcomes, determining tradeoffs among competing conditions, and ascertaining the contribution of multiple co-occurring conditions to death and other health outcomes. Our methodological aim is to develop an innovative method for comparing different treatment strategies in situations in which the treatment of one condition could exacerbate other conditions or affect other health outcomes. Using our novel methods, we will test the hypothesis that, among comparable older adults with co- occurring CAD and COPD, greater 2-Blocker intensity is associated with fewer CV events and lower mortality but more frequent adverse pulmonary outcomes; worse dyspnea, fatigue, and activity levels and greater disability than no or lower 2-Blocker intensity. In secondary analyses, we will explore these aims in relevant subgroups defined by age, CAD and COPD severity, gender, race, and co-morbidity burden. Two national, population-based cohorts, the Medicare Current Beneficiary Survey and the Medical Expenditure Panel Survey will be studied (study sample 35,000-40,000). Both have a wealth of longitudinal participant-reported, medication, and claims/health care utilization data. This depth and breadth of data allows us to use innovative analytical techniques to assess the effects of treatments on disease-specific and universal health outcomes (e.g. disability, symptoms burden, functional limitations, and death), accounting for propensity to receive the treatment, and other confounders. We propose a new paradigm for quantifying the harms and benefits of treatments in complex older persons with multiple conditions. Our ultimate goal is to develop a method for determining the optimal treatments for older adults with multiple conditions that maximizes benefits and minimizes harms within the outcome domain(s) of highest priority for each patient. 10/02/2010 link cardiovascular
AHRQ-Indian Health Service Determining Processes of Cardiovascular Care Relevant to Complex Patients KAISER FOUNDATION RESEARCH INSTITUTE $0 Clinicians who care for persons with complex chronic medical conditions face both competing demands and a lack of evidence regarding best processes of care for this heterogeneous population. Those clinicians facing decisions about prevention of coronary heart disease (CHD) following a new diagnosis of cancer must take into account cancer prognosis, cardiovascular risk status, overall burden of morbidity, and the patient's goals, preferences and values. To help inform such decisions, we propose to use analytic epidemiology methods to study an historical cohort of all (over 30,000) Kaiser Permanente Colorado (KPCO) adult members who received an initial diagnosis of cancer during the period 1999 to 2007. In this cohort, we will a) assess the attainment of goals for specific components of primary, secondary, and 'tertiary' prevention of CHD as a function of cancer prognosis, overall morbidity and the interaction between them, and b) assess the comparative effectiveness of these CHD prevention interventions (in relevant sub-cohorts) on receipt of, and time to, a composite of CHD events and all-cause mortality. We hypothesize that: a) Overall morbidity, cancer prognosis, and the interaction between them will affect attainment of goals of preventive interventions for CHD; and b) specific strata of morbidity and cancer prognosis will modify the effectiveness of these interventions on the CHD outcomes. In evaluating these prevention strategies on CHD outcomes, we will study the processes of care for the comorbidities of hypertension, diabetes, hyperlipidemia, and pre-existing CHD. We will use linear regression models and Cox proportional hazard models to assess the impact of the cancer prognosis and other morbidity scores (and their interactions) on the CHD prevention outcomes. A Cox proportional hazards model will be used to assess the effectiveness of the prevention measures on time to the CHD composite outcome across strata defined by prognosis/morbidity. Finally, we will describe which prevention measures most influence which components of the CHD outcomes. Information from this investigation will inform recommendations for the use of these specific preventive interventions in patients with a range of morbidities in order to make these recommendations congruent with an evidence base that acknowledges complex patients' priorities, time, and resources. 10/02/2010 link cardiovascular
AHRQ-Indian Health Service Individualized Treatment Strategies and Optimal Hematocrit Target for complex Dialysis Patient Background Medical Technology and Practice Patterns $0 Almost all renal failure patients suffer from anemia as an important co- morbid condition. Epoetin therapy, approved by the FDA in 1989, is the mainstay of treatment for anemia among this population. After almost 20 years, key questions regarding the effectiveness of epoetin therapy remain unanswered. In particular, the role of comorbid conditions highly prevalent among renal failure patients with anemia is unknown. Do patients with co-morbidities including cardiovascular disease and diabetes require a different therapeutic endpoint given several recent randomized trials and Black Box warnings by the FDA to use the lowest dose of epoetin possible. Currently, there appears to be uncertainty in the nephrology community as to the optimal target hematocrit and epoetin dosing protocols for various patient groups. Objectives. The objective of our proposed study is to address the key question: What is the optimal treatment strategy based on the presence of co-morbidities such as cardiovascular disease and diabetes? The only existing epoetin RCT for the dialysis population suggests that patients with cardiovascular disease should not be targeted to normal hematocrit levels. Dialysis patients with diabetes have more severe anemia and are more resistant to treatment. To address this research question, we will also examine how does the presence of such comorbidities affect patient responsiveness to epoetin therapy? Specifically, for complex patients who are responsive to epoetin therapy (and use lower than average dose), does targeting higher than FDA-recommended hematocrits lead to better outcomes? For patients with co-morbid conditions who are not responsive (with low hematocrits and high doses), does administering high doses to target the FDA- recommended hematocrit lead to worse outcomes? Finally, given the presence of diabetes or cardiovascular disease, what is the optimal treatment strategy further disaggregated further by patient demographics such as race, gender and age affect outcome? Methods. We propose to apply causal analytical methods (inverse probability weighting models) that, unlike standard statistical methods, appropriately adjust for time-dependent confounders that are affected by prior treatment. The proposed methods are therefore well suited to address key questions concerning anemia management and mortality of dialysis patients. Significance. To date, limited RCTs and observational studies have been disaggregated by patient co-morbidities when evaluating patient outcomes in the renal failure population. The continuing use of a single hematocrit target range and dosing protocols for all dialysis patients ignores individual patient needs of those with comorbid diabetes or cardiovascular disease. Causal inference techniques have been developed and validated using randomized clinical trial data in other treatment areas. In this grant, we propose to apply these innovative techniques using Medicare administrative data to provide a basis for improved patient outcomes using 'individualized' guidelines based on common patient comorbid characteristics. Study findings might provide the basis for improved clinical guidelines and more cost-effective payer policies. 10/02/2010 link unspecified
AHRQ-Indian Health Service Outpatient Versus Residential Treatment Comparison for Pregnant Substance Abusers OREGON HEALTH AND SCIENCE UNIVERSITY $0 Addictive disorders are chronic conditions for many women. Substance use during pregnancy is especially worrisome. Moreover, major depressive disorder often co-occurs with substance abuse among women. Therefore, pregnant women with substance abuse are complex patients. Priority populations (e.g., minority group members) are greatly over-represented among pregnant substance abusers. Treatment can be effective for female substance abusers but few (if any) data are available regarding comparative effectiveness of residential versus outpatient treatment for pregnant women with addictions. Residential treatment, by definition, provides shelter and reduces availability of substances in addition to delivering care for chemical dependency. However, residential treatment removes patients from their usual home and work environments and is more expensive than outpatient care. Although not focusing on pregnant substance abusers, studies have generally found little difference in outcomes for residential versus outpatient chemical dependency treatment. On the other hand, research has also suggested patient factors (such as addiction severity) may moderate treatment impact so that sub-groups of substance abusers differentially benefit from residential (versus outpatient) care. To address these issues, the proposed project responds to RFA-HS-10-009: Recovery Act 2009 Limited Competition OS ARRA: Comparative Effectiveness Research to Optimize Prevention and Healthcare Management for the Complex Patient (R21). The work will be an analytic epidemiologic study addressing "the benefits and harms of preventive or therapeutic interventions in 'real world' settings for patients who have multiple chronic co-morbid conditions." The chief focus will be pregnant women (many of whom also have major depressive disorder) obtaining treatment for chemical dependency. Two of the co- occurring conditions are substance abuse and pregnancy (both are in the current list of conditions given in the Request for Applications). As required by the Request for Applications, a physical condition (pregnancy) will be addressed. Many participants will have (as a third co-existing condition) major depressive disorder (which is also listed in the Request for Applications). In compliance with the Request for Applications, the study population will include (as a comparison group) female substance abuse treatment patients who are not pregnant. The intervention will be specialty sector substance abuse treatment. The "real world" settings will be publicly financed substance abuse treatment programs. Among several data sets, the project will employ newly available information from the nation-wide Treatment Episode Data Set discharge database. Innovative statistical techniques (including non-linear instrumental variables approaches) will be employed. Comparative effectiveness of outpatient versus residential substance abuse treatment will be examined. 10/02/2010 link substance abuse
AHRQ-Indian Health Service Should High-Risk Statin Utilization Rates Be Increased for Complex AMI Patients? UNIVERSITY OF IOWA $0 Filling the evidence gaps within cardiovascular disease (CVD) has been identified as a priority by the Agency for Healthcare Policy and Research (AHRQ), and, as emphasized by a report from the AHRQ Effective Healthcare Program, important questions remain regarding the effectiveness of high-dose statins for the secondary prevention of CVD in complex patient subgroups. Randomized controlled trials have shown that aggressively lowering low density lipoprotein cholesterol (LDL-C) with high-dose statins can result in an additional 16% reduction in CVD events compared to moderate-dose statins. Subgroup analyses of trial data also suggest that the benefits of high-dose statins may be even greater for complex CVD patients. Current US guidelines recommend at least a 50% reduction in LDL-C as desirable for cardiovascular prevention and that a more aggressive LDL-C goal <70 mg/dl be considered for very high risk patients. Although most patients require a high-dose statin to achieve guideline recommendations, only <25% of high risk patients in practice receive one. Wide prescribing variation, use of lower potency generic statins due to cost concerns, concerns about safety, and the existence of a "treatment risk paradox" in which complex patients are less likely treated, suggest that providers remain uncertain as to the benefits and harms of treatments for many complex CVD patients. Providers may believe that the benefits and harms of high-dose statins are heterogeneous across patients and in practice they are sorting patients based on these beliefs. Are providers missing benefit opportunities by not expanding high-dose statin prescribing rates among complex CVD patients or do current high-dose statin prescribing rates represent a correct balancing by providers of the benefits and harms across patients? As stated many years ago by John Wennberg, the real question is "Which rate is right?" This proposal is responding to the analytical epidemiological studies component of RFA-HS- 10-009. In this study we will conduct a retrospective cohort study assessing the comparative effectiveness of high-dose statins for complex patients post acute myocardial infarction (AMI) since those with AMI have a clear indication for high-dose statin therapy. We will take advantage of the large number of Medicare patients with AMI that have Medicare "Part D" prescription drug coverage in the Centers for Medicare & Medicaid Services (CMS) Chronic Condition Data Warehouse (CCW) to analyze the effectiveness of high-dose statins within subsets of complex AMI patients. Complex AMI patients will be defined by the presence of diabetes, congestive heart failure (CHF), and chronic kidney disease (CKD), conditions that place AMI patients at very high cardiovascular risk.3, 39, 40 Our analytical framework includes using both risk adjustment (RA) estimators (including propensity score methods) and moment-based instrumental variable (IV) estimators and interprets their estimates in terms of the distinct treatment effect concept produced by each estimator. Because it appears that high- dose statin utilization rates have lagged behind guideline recommendations, we hypothesize that (1) the patients that received high-dose statins had cardiovascular event-free survival gains sufficient to justify side-effect risks and healthcare costs; and (2) that higher high-dose statin treatment rates would increase cardiovascular event-free survival rates enough to justify increased side-effect rates and healthcare costs. The aims of this research are consistent with both the clinical and methodological goals of the AHRQ Comparative Effectiveness Portfolio. Our methodological approach is innovative because we will (1) assess the comparative effectiveness of high-dose statins using both RA and IV approaches in light of the correct interpretations of estimates from these methods; and (2) exploit the large number of AMI Medicare patients from the CCW to estimate the comparative effectiveness of high-dose statins complex subsets of AMI patients The research team has the unique combination of clinical, methodological, and empirical expertise that is necessary to perform the proposed research. 10/02/2010 link cardiovascular
AHRQ Comparative Effectiveness of Diabetes Prevention Strategies in Women with Gestational Diabetes KAISER FOUNDATION RESEARCH INSTITUTE $0 Type 2 diabetes (T2DM) develops in 50 percent of women with gestational diabetes (GDM) within 5 years after delivery. So far, no lifestyle interventions have been translated for women with GDM in the postpartum period. The main goal of this study is to examine the effect of diabetes prevention strategies in women with gestational diabetes (GDM) for improving the following: obesity, hyperglycemia, hypertension and depression in a real-world clinical setting. It is a cluster randomized lifestyle intervention trial that assesses the effect of an organizational-level intervention on weight management in GDM patients. Randomization will occur at the medical center level; 44 medical centers of Kaiser Permanente Northern California (KP) will participate and data will be collected for more than 2,400 pregnant women with GDM (36% Asian, 31% Hispanic, 25% white, 4% African American and 5% other ethnic groups). The intervention will be compared to usual care. The intervention will extend an existing KP case-management program offered by the KP Perinatal Center to patients with GDM during pregnancy. Intervention patients will be offered a postpartum lifestyle curriculum of individual telephone counseling augmented with e-mails and an interactive study website. The primary aim is to implement and evaluate an intervention of diet and physical activity (PA) with the primary goals of: (a) reaching pre-pregnancy weight for women with a normal weight prior to pregnancy; or (b) reaching a 5 percent reduction of their pre-pregnancy body weight if the women were overweight or obese prior to pregnancy. Targets for the intervention during pregnancy (Prenatal Phase I) are to help GDM patients comply with IOM guidelines for gestational weight gain. Finding that this intervention is cost-effective in this setting should motivate its adoption at KP as well as in other health care systems. 09/03/2010 link diabetes
AHRQ Impact of Medicaid Policy on Cardiovascular Drug Use and Clinical Outcomes BRIGHAM & WOMEN»S HOSPITAL $0 Policies to control the use of cardiovascular medications are commonly used in public and private programs despite a lack of comparative evidence on whether they achieve savings and how such savings might balance against changes in clinical events. Drawing on years of experience in studying Medicaid policy and using large patient-level Medicaid data sets, we will measure the comparative effectiveness of Medicaid policies on cardiovascular drug spending and assess whether reduced drug use is associated with adverse clinical outcomes, providing critical information for policy-makers and health system design decision makers. 09/03/2010 link cardiovascular
AHRQ Informing Sound Policy: Linking Medical Home Measures and Child Health Outcomes Indiana University-Purdue University at Indianapolis $0 The proposed research is relevant to public health because it will help practices, payers and policymakers identify which features of pediatric primary care medical home practices optimize outcomes for children so that they may make targeted investment and intervention decisions. 10/02/2010 link unspecified
AHRQ Physician Quality Reporting and Patient Outcomes in Medicare UNIVERSITY OF MINNESOTA TWIN CITIES $0 One of the most important developments in the U.S. health care system has been the collection of data on quality of care. Medicare's Physician Quality Reporting Initiative (PQRI) is the nation's largest data collection effort on health care quality from individual providers. To understand if this quality reporting makes a difference, this study will analyze relationships among physician reporting, quality outcomes, and expenditures, with special attention to whether results vary according to the race, ethnicity, or sex of the patient, or by type of chronic disease diagnosis. 10/02/2010 link unspecified
ASPE NIH/NIDDK--Increasing Adoption of Early Intervention to Prevent Diabetes After Gestational DM Social & Scientific Systems $1,999,917 This project is funded by the American Recovery and Reinvestment Act of 2009 (ARRA). Gestational diabetes mellitus (GDM) is a form of diabetes that is first diagnosed during pregnancy. About 7 percent of all US pregnancies - about 200,000 each year - are complicated by gestational diabetes. Women who have been diagnosed with GDM are at a markedly increased risk of having it again during future pregnancies or developing type 2 diabetes later in life. The purpose of this task order is to provide Recovery Act funding for a study focusing on this population that is at the highest risk for developing type 2 diabetes, that will identify effective ways to bring proven interventions into clinical practice, and engage women with a history of GDM and their health care providers in lifestyle behavior changes and/or medical therapy to prevent or delay type 2 diabetes. 08/20/2010 link diabetes
AHRQ Back Pain Outcomes Using Longitudinal Data (BOLD) UNIVERSITY OF WASHINGTON $0 Low back pain is one of the most important causes of functional limitation and disability, an Institute of Medicine priority condition, and it remains a particularly important problem for the elderly, an AHRQ priority population. The overall goal of this project is to establish a sustainable and rich registry to evaluate prospectively the effectiveness, safety, and cost-effectiveness of interventions for patients over age 65 with low back pain. We propose 3 specific aims: 1) To establish the Back pain Outcomes using Longitudinal Data (BOLD) registry; 2) To conduct a randomized controlled trial (RCT) in elderly patients (an AHRQ priority population) with spinal stenosis to test if the effectiveness of epidural steroid injections (ESI) plus local anesthetics (LA) is greater than LA alone; 3) To conduct a prospective, observational cohort study to compare the effectiveness of early (within 6 weeks of presentation) advanced imaging (MRI and CT) to no advanced imaging in elderly patients with new episodes of low back pain without radiculopathy with respect to pain, function and subsequent resource utilization. 10/02/2010 link functional limitations, disability
AHRQ BELT: Blacks & Exacerbations on LABA vs. Tiotropium Harvard Clinical Research Institute $0 The results of this study will provide the information necessary to make evidence-based, individualized, recommendations concerning treatment algorithms and potential alternative treatment recommendations for the 3.5 million Blacks with asthma. The performance of this study in real life primary care settings will hasten the translation of these findings into day to day practice for this minority population that experiences a disproportionate burden of asthma and has been underrepresented in previous asthma studies. 10/02/2010 link respiratory
AHRQ Comparative Effectiveness of Environmental Intervention and Standard Care COLUMBIA UNIVERSITY HEALTH SCIENCES $0 DiMango, Emily/Kattan, Meyer Exposure to allergens within the household is a major public health concern in asthma, one that is critical for the entire asthma population, but is most salient for residents of inner cities. The proposed study rigorously tests national guidelines in asthma care and fills a gap in understanding the importance of environmental remediation as it compares with need for pharmacological therapy for asthma control. Results of the study have the potential to affect public health policy as well as reimbursement from third party health care insurance companies. PHS 398/2590 (Rev. 11/07) Page Continuation Format Page 09/03/2010 link respiratory
AHRQ Comparative Effectiveness Study for Bipolar Disorder Massachusetts General Hospital $0 This study will compare two treatments over 6 months for participants with bipolar disorder who present with at least mild symptoms and who require a change in treatment. The two treatments will be the second generation antipsychotic mood stabilizer quetiapine and the classic mood stabilizer lithium. In addition to quetiapine or lithium, participants can be treated with other medications as needed. 10/02/2010 link mental health
AHRQ Comparative Effectiveness of Treatments of Localized Prostate Cancer Vanderbilt University Medical Center $0 This study will compare the effectiveness of surgery and radiation for localized prostate cancer, the most common male cancer. It will focus on modern technologies and control for differences in patients and treatments that may affect outcomes. By figuring out what treatments "work best, in which patients and in whose hands", we will help men with prostate cancer make better decisions regarding their care. 08/14/2010 link cancer
AHRQ Project CLEAR--Changing Lives by Eradicating Antibiotic Resistance University of California Irvine $0 This randomized controlled trial will compare strategies to reduce the risk of methicillin-resistant Staphylococcus aureus (MRSA) infection and re-hospitalization in MRSA carriers. This trial will provide critical answers about the role of decolonization versus standard-of-care education in preventing MRSA infections in the large group of high risk MRSA+ patients being discharged from hospitals. Findings could potentially impact best practice for the 1.8 million MRSA carriers who are discharged from U.S. hospitals each year. 10/02/2010 link infectious disease
AHRQ Promoting Adherence to Improve Effectiveness of Cardiovascular Disease Therapies KAISER FOUNDATION RESEARCH INSTITUTE $0 The primary goal of the PATIENT study is to increase both initial use and ongoing adherence to three classes of medications used to treat diabetes or cardiovascular disease. The PATIENT interventions use interactive voice recognition, with and without supplemental personalized mailings to patients and messages to providers, to deliver medication refill reminders, educate members about their conditions, and connect members with pharmacists and their doctors. If PATIENT's methods are successful, this research should lead to reduced hospitalizations and deaths, and to increased quality of life for people with diabetes or cardiovascular disease. This research should also be broadly applicable to other diseases and treatments. 09/03/2010 link diabetes
AHRQ RESCUE: Randomized Evaluation of Patients with Stable Angina Comparing Utilization American College of Radiology $0 RESCUE is a multi-center randomized, controlled trial comparing coronary CT angiography (CCTA) and single photon emission tomography myocardial perfusion imaging (SPECT-MPI) integrated into a stable angina care paradigm featuring optimized medical therapy for patients diagnosed with CAD without significant disease in the left main coronary artery. Patients will be followed for a composite endpoint of major adverse cardiac events (MACE) and cross-over to revascularization over a 12-24 month period. Several comparative effectiveness analyses will be performed. The investigators hypothesize that the CCTA arm will be associated with no increase in major coronary events (MACE) or revascularization, decreased cost and increased cost-effectiveness in comparison to SPECT-MPI. Findings are expected to result in validation of an evolving new standard of care for patients with stable angina that takes advantage of CCTA to more cost effectively drive appropriate care. 10/02/2010 link cardiovascular
AHRQ RCT of US versus CT for Patients in the ED with Suspected Renal Colic UNIVERSITY OF CALIFORNIA SAN FRANCISCO $0 This study compares different imaging strategies for patients seen in large emergency departments with symptoms concerning for urolithiasis (kidney stones). The study proposes a multicenter, randomized controlled trial of ultrasonography compared with computed tomography for the evaluation of patients with suspected kidney stones. The study will enroll patients at 10 large urban Emergency Departments (ED) and patients will be randomized to one of three arms: 1) ultrasonography in the ED, 2) ultrasonography in radiology, or 3) computed tomography in radiology. The study will then collect precise and unbiased data on a comprehensive range of outcomes that will allow assessment of effectiveness, safety, accuracy and cost between patients randomized to one of the three groups. Taken together, these measures are intended to provide the basis for a valid comparison of imaging of patients with suspected urolithiasis seen in the ED. The results of this trial could lead to a change in clinical practice that is associated with both improved patient outcomes and reduced cost. 10/02/2010 link other
AHRQ Variations in Care: Comparing Heart Failure Care Transit UNIVERSITY OF CALIFORNIA LOS ANGELES $0 Heart failure is a prevalent condition among the elderly that has high rates of potentially avoidable readmissions. Readmissions can be reduced through programs to improve the transition of care from inpatient to outpatient settings, but these programs are not currently widespread due to implementation costs at the hospital level. This research compares the costs and the effectiveness of two separate adaptations of care transition interventions on reducing readmissions for elderly heart failure patients, and their effectiveness on reducing the variation between six medical centers on readmission rates for elderly heart failure patients. 09/03/2010 link cardiovascular
AHRQ Wound EMR to Decrease Limb Amputations in Persons with Diabetes NEW YORK UNIVERSITY SCHOOL OF MEDICINE $0 The goal of this project is to demonstrate that effective utilization of the Online Wound Electronic Medical Record (OWEMR) can prevent DFU progression to amputation in a variety of healthcare settings. Successful completion of this project will provide level-1 evidence for the effectiveness of the OWEMR as a clinical intervention for reducing DFU-related foot amputations. It also will close a knowledge gap in DFU treatment by defining the effectiveness of long-term glycemic control in reducing DFU-associated amputations. Primary stakeholders in diabetes care - professional associations of wound care specialists and diabetes advocates - will facilitate the translation and dissemination of revised DFU treatment guidelines resulting from this project through their web sites, publications, continuing education programs and conferences. 10/02/2010 link other
AHRQ ARRA "Decide Methods Center (DMC) BRIGHAM & WOMEN»S HOSPITAL $3,934,148 07/21/2010 link unspecified
AHRQ Comparing the Long-term and Real-world Effectiveness of Initial Management Strategies for Ductal Carcinoma In Situ BRIGHAM & WOMEN»S HOSPITAL $3,040,076 07/17/2010 link cancer
AHRQ Comparative Effectiveness of Therapies for Heart Failure DUKE UNIVERSITY $2,073,232 07/17/2010 link cardiovascular
AHRQ Comparative Effectiveness Studies to Improve Patient Outcomes in End Stage Renal Disease (ESRD) JOHNS HOPKINS UNIVERSITY $4,556,778 07/17/2010 link other
AHRQ Comparing the Effectiveness of Treatment Strategies for Primary Open-Angle Glaucoma Outcome Sciences, Inc. $4,055,617 07/17/2010 link other
AHRQ Comparative Effectiveness of Intravenous Iron Formulations in End-Stage Renal Disease University of North Carolina at Chapel Hill $2,836,647 07/17/2010 link other
AHRQ Comparative Effectiveness of Management Options for Localized Prostate Cancer University of North Carolina at Chapel Hill $3,378,263 07/17/2010 link cancer
NIH IMPROVING MEDICATION THERAPY FOR OLDER PATIENTS WITH COMMON CO-MORBIDITIES JEWISH HOME OF SAN FRANCISCO $414,643 The overall goal is to improve the use of medications for older people with multiple medical disorders. 09/02/2010 link unspecified health system
AHRQ-Indian Health Service Comparative Effectivness Research to Enhance the Delivery of Services within the Indian Health Service Denver Health $3,070,882 The Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services (DHHS) intends to issue a Request for Task Order Proposal under the ACTION Program to support the development of data infrastructure that will accelerate comparative effectiveness research (CER) for the American Indian/Alaska Native (AI/AN) population and to support efforts to prioritize health systems delivery strategies for chronic disease management. The goal of the task order is to use electronic clinical data from the Indian Health Service (IHS) national health information system (RPMS – Resource and Patient Management System) to enhance the capacity to electronically measure quality of care consistent with national HIT standards and conduct comparative effectiveness research that will identify care delivery models with the Indian Health System that result in improved health outcomes. Advanced practice pharmacy within the Indian Health System will be the object of CER for this project. 09/29/2010 link unspecified
AHRQ-Indian Health Service Fluoride Effectiveness in Prevention of Dental Caries in High Caries Risk Adults BOSTON UNIVERSITY MEDICAL CAMPUS $0 The proposed work addresses several of the Institute of Medicine's (IOM's) national priorities in clinical effectiveness research: disparities in oral health and health care. Combining extant dental data with other components of the rich VA patient databases, we will be able to examine the effectiveness of fluoride in preventing caries in patients with five of the 14 priority conditions specified by AHRQ: medically compromised veterans with dementia, depression and bipolar disorder, diabetes, HIV-Aids and persons with alcohol dependence. Recent data suggest that dental caries is as much of a problem in adults as children (Dye, et al., 2007). However, significant knowledge gaps remain in our knowledge base regarding prevention of caries in adults (Griffin et al., 2007). Using an extant, rich electronic data base from a health care system providing dental treatment to over 342,000 veterans annually, this proposed retrospective, longitudinal study takes maximum advantage of a unique opportunity to examine the following specific aims in a population of medically complex veterans. Aim 1. Examine the effectiveness of prescription-strength, self-applied fluoride and professionally applied fluoride in the prevention of caries in medically compromised veterans who are at high risk for caries. Veterans will be defined as at risk for caries if they have had two or more restorations in the previous year. Aim 2. While recent evidence suggests that fluoride is effective in preventing caries in adults, and multiple exposures to fluoride reduces caries risk in children (Weintraub, 2006), limited data exist showing that multiple exposures or modalities are more effective than a single modality in adults. Thus, we have a unique opportunity to examine whether multiple exposures to fluoride will be more effective than a single exposure. Aim 3. Over the past year, the Department of Veterans Affairs introduced a quality measure (the fluoride monitor) that examines, on a quarterly basis, the percent of veterans at high risk for caries who receive fluoride treatments. This project will examine the effectiveness of the introduction of this fluoride monitor in reducing the rate of restorations in medically compromised veterans at high risk for caries. 10/02/2010 link other
AHRQ-Indian Health Service Impact of Mental Illness and/or Substance Abuse on Diabetes Intervention and Outcomes Maine State Department of Health and Human Services $0 Research suggests that there are significant interactions between mental illness and chronic medical conditions, with greater morbidity, cost and poorer outcomes, both for the chronic medical disorder and for the mental illness in persons with both conditions. This analytic epidemiologic study aims to further scientific knowledge about the effectiveness and outcomes of treatments for both diabetes and behavioral health disorders, including depression, serious and persistent mental illness (SPMI) and substance abuse, when these conditions co-exist in Mainers served by the publicly funded health and mental health systems. The project will provide data to clarify how co-existing mental illness and chronic medical disorders modify the utilization and comparative effectiveness of proven prevention and treatment interventions for each condition and the impact of these co-morbidities on overall health and disease specific outcomes in these complex populations. This study will lay the foundation for Maine's efforts to identify and implement more effective, integrated and person centered interventions to promote the overall health and safety of the complex individuals in the state's publicly funded health and human service system. Based on diagnoses on two years of Medicaid services claims, all 18-64 year old Medicaid members with continuous eligibility and full benefits will be assigned to one of three cohorts, a group with mental illness diagnoses, but no substance abuse; a group with both mental illness and substance abuse; and a group with neither behavioral health diagnosis. The mental illness groups will be further subdivided into subgroups with SPMI or depression. These cohorts will be further subdivided by the presence of diabetes. The index cohorts will be as follows: SPMI and diabetes, depression and diabetes and dual diagnosis depression or SPMI and diabetes. The cohorts with mental illness only, diabetes only and neither mental illness nor diabetes will be comparison groups. Utilization of prevention and treatment interventions, quality metrics and outcomes, defined in AHRQ publications, will be compared among the different cohorts. Where none exist, novel metrics will be created to categorize behavioral health interventions; by examining which of these are associated with better outcomes, the project will add to the evidence base on behavioral health quality interventions and metrics. Analyses will be bi- directional, examining the impact of mental illness on the utilization, quality, effectiveness of interventions, cost and outcome for diabetes, as well as the impact of diabetes and other medical co-morbidities on utilization, cost and outcome in the groups with mental illness. The findings of this project are expected to lay a foundation for future research on strategies that improve the health of complex individuals and promote the integration of mental and physical health in our traditionally separate mental, physical and public health systems of care. 10/02/2010 link diabetes
AHRQ Comparative Outcomes Management with Electronic Data Technology (COMET) Study STANFORD UNIVERSITY $0 We plan to develop an electronic network that will enable the transfer of information from various hospitals and medical centers, patients and research subjects, different types and severity of medical problems, various equipment and test types, and across several patient visits. This network will allow physicians and scientists to access comprehensive information about their patients and research subjects, and the sharing of this information across several academic institutions may ultimately lead to improvement in medical outcomes. We also plan to conduct a study evaluating two common treatments for obstructive sleep apnea (OSA), a highly prevalent sleep-related breathing disorder, and we anticipate that this study will provide comparative data for determining the effectiveness of these treatments in reducing cardiovascular risk in a population at high risk for cardiovascular disease, and will enhance clinical decision making in determining the optimal treatment strategies for patients with OSA. 10/02/2010 link cardiovascular
AHRQ-Indian Health Service Multiple Chronic Conditions in Very Low Birth Weight Infants: Epidemiology, NICU Care, and Outcome Research Institute Nationwide Children»s Hospital $0 Prematurity and its complications are the leading causes of death among children in the first year of life and causes of morbidity lasting for the entire lifespan. Premature and very low birth weight infants (PVLBW, defined as gestational age d 32 weeks and birth weight d 1500g) are 100 times more likely than a normal infant to die in the first year of life, and they are at high risk for developmental delays, functional disabilities, and often have multiple complex chronic conditions affecting the lungs, gut, brain, eyes, and other organs. Specifically, PVLBW children are at high risk for bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and intraventricular hemorrhages (IVH). We propose to conduct an epidemiologic description of the co-occurrence of these conditions, through a secondary analysis of 15470 premature children admitted to NICUs from 2006- 2010 at 33 children's hospitals in the Pediatric Health Information System (PHIS) database, looking at the effects of these chronic conditions on PVLBW infants receiving care in NICUs. The outcomes of interest include death during the NICU stay, cumulative burden of therapies received during the NICU stay, and re- hospitalization within 30 days following discharge from the NICU. We will: 1) Describe the incidence of the chronic conditions among PVLBW infants during the initial NICU admission, singly and in combination. 2) Describe the associations between the chronic conditions, singly and in combination, and three outcomes of the first NICU admission: death during the NICU stay, the cumulative burden of therapies received during the NICU stay, and re-hospitalization following discharge from the NICU. 3) We will document the consequences of one key intervention on the outcomes: the use of inhaled Nitric Oxide to prevent and treat BPD. The rates of both prematurity and VLBW are rising in the U.S. VLBW occurs at > 2.5 times the rate among blacks compared to the rest of the U.S. population and is therefore a significant vector of health disparities. In all analyses, we will look for evidence of disparate incidence, outcomes, treatment or efficacy of treatment of the chronic conditions based on race or payer status. We will also look for hospital- or region-specific variation in the incidence, outcomes, or treatment of the chronic conditions. Because PVLBW babies are often subject to multiple chronic disorders and are over-represented in an underserved community, they are a priority population for comparative effectiveness research. The proposed study will be significant because it will be the first to systematically describe, in a large sample, the incidence, outcomes, and treatment of multiple co- occurring severe chronic conditions in PVLBW infants, a population experiencing significant mortality and morbidity. 10/02/2010 link other
AHRQ-Indian Health Service Optimizing Chronic Disease Prevention and Management in Advanced Dementia University of Massachusetts Medical School, Worcester $0 The Agency for Healthcare Research and Quality has invited grant applications for the purpose of understanding the comparative value of different strategies in the prevention and management of chronic illness in persons with multiple chronic conditions. In this application, "Optimizing Chronic Disease Prevention and Management in Advanced Dementia", we propose to study the effectiveness of medication prophylaxis for chronic illness in the medically complex population of nursing home (NH) residents with advanced dementia. Over half of the 1.6 million residents of US NHs have dementia, and those with advanced dementia have a prognosis comparable to that of metastatic breast cancer or stage IV heart failure. Our prior work shows that medications inappropriate in advanced dementia are used by almost 40% of NH residents with advanced dementia, and are continued in almost 20% of these patients in the last week of life. These agents such as lipid-lowering and osteoporosis drugs may not be consistent with goals of care, increase the risk of adverse drug events and drug-drug interactions, are costly, and contribute to polypharmacy. Efforts to improve prescribing in advanced dementia are hampered by a lack of studies examining medication effectiveness and drug withdrawal safety in this population. The goal of this R21 is to develop the infrastructure to systematically investigate the effectiveness and safety of strategies to reconsider medications for chronic non-dementia illnesses in NH residents with advanced dementia. We describe the first in a series of studies evaluating the comparative effectiveness of medications of questionable benefit in advanced dementia, in order to rationally prioritize therapy for this vulnerable and understudied population. A particular focus is on the evaluation of the prevalence, cost, and factors associated with using medications inappropriate in NH residents with advanced dementia, and in evaluating the clinical impact of the use and discontinuation of statins for cardiovascular disease in this population. Studies will utilize administrative claims data linked to federally- mandated NH resident assessment data from 2 large populations: 1) over 12,500 NH residents with dementia who received prescription services from a nationwide long term care pharmacy between 2005-2008; and 2) NH residents of 5 states (Minnesota, Massachusetts, Pennsylvania, California and Florida), including ~95,000 NH residents with dementia who used Medicare Part D drug benefits between 2006-2007. Data sources for these populations include: drug claims for all dispensed medications; resident demographics; hospitalization claims; NH facility characteristics and mortality. Analyses will adapt techniques to address selection bias in observational studies (propensity scores, comparator group restriction, and self-controlled case-series), and methods for longitudinal and clustered data to account for repeat prescriptions in the same residents within NHs. These studies advance analytic strategies for evaluating prescribing strategies and their effects on NH residents with advanced dementia and lay the foundation for efforts to optimize prescribing in this population. 10/02/2010 link dementia, Alzheimer's
AHRQ-Indian Health Service Safety and Effectiveness Evaluations for Kidney Disease in Complex Patients BOSTON UNIVERSITY MEDICAL CAMPUS $0 This application addresses broad needs for comparative effectiveness research and proposes to conduct and analytic epidemiologic studies of retrospective cohort design, to assess the benefits and harms of preventive or therapeutic interventions in "real world" settings for patients who have multiple chronic co morbid conditions. It proposes research on chronic kidney disease (CKD) in diabetes patients and its progression to end stage renal disease (ESRD), conditions that are devastating and increasingly prevalent, with high mortality and high direct costs of care. Although a number of treatments are widely recommended for slowing progression of CKD and reducing risks of associated cardiovascular disease (CVD), ESRD, and mortality, there is little experimental evidence to support these recommendations and there have been few trials comparing drugs within classes in terms of effectiveness and safety. Such trials are unlikely to be done in the near future and much can be learned from careful observational studies of existing patient data to identify the most safe and effective treatments. We propose to conduct such studies in the diabetes patient population served by the Veterans Health Administration (VA), the largest sample of older adults in an integrated health care system in the U.S. with comprehensive electronic medical records. These patients have high prevalence of CKD and other morbidities, and represent those who are often excluded from clinical trials. We have shown in our previous work that large, rigorous, longitudinal studies can be done in the VA and we have developed and evaluated methodologies for such research. We now propose to study complex diabetes patients with CKD and other co-morbidities in order to evaluate comparative effectiveness and safety in slowing the progression of kidney disease (decline in estimated glomerular filtration rate (eGFR), transition in CKD stage, transition to ESRD), reducing risks of other outcomes (CVD events, mortality), and having low associated risks of medication-related adverse renal outcomes (acute kidney injury, hyperkalemia) and other adverse events (hypoglycemia, angioedema, falls). Class-to class and drug-to-drug comparisons will be made within the following classes or groups of medications recommended for treating CKD: angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, and HMGcoA reductase inhibitors (statins). Samples and exposure groups will be selected carefully to replicate common clinical decisions in treatment and up to 11 years of national data will be used with application of rigorous epidemiologic methods to reduce potential bias and provide valid and meaningful results. This research represents a real opportunity to better understand benefits and risks associated with treatments for CKD in complex diabetes patients and application of its findings should result in safer and more effective prescribing practices. 10/02/2010 link other
NIH/AHRQ Use of Behavioral Economics to Improve Treatment of Acute Respiratory Infections University of Southern California $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery and Reinvestment Act of 2009 (Recovery Act or ARRA), Public Law 111-5, invites applications proposing clinical trials using the principles of behavioral economics to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. For this FOA, applicants must propose controlled trials that randomize units (whether individuals or clusters such as practices, hospitals, or larger units) to conditions, resulting in a randomized clinical trial (RCT) or cluster randomized trial (CRT). Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER (e.g., those that rely on manipulating a providers default options) could be more cost effective than conventional approaches including some pay for performance schemes (P4P). For the purposes of this FOA, the definition of comparative effectiveness research will adhere to that adopted by the Federal Coordinating Council given at http://www.hhs.gov/recovery/programs/cer/cerannualrpt.pdf. Behavioral economics refers to the interdisciplinary efforts involving cognitive and social psychologists, decision scientists, and other social scientists together with economists to model economic decision-making and consequent actions. The approach is inclusive, since at its heart it tries to take into account what is known about how people actually make decisions rather than relying on the assumption that economic agents are fundamentally rational in the sense of expected utility theory (see, e.g., Kahneman and Tverskys (1979) work on Prospect Theory and Kahnemans (2003) Nobel lecture). It is hoped that this line of research will lead to significantly greater consideration of CER by health care providers and therefore enhance the quality of the nations health. 09/18/2010 link respiratory
AHRQ-Indian Health Service Statins and Ace Inhibitors in Adults With Diabetes and Comorbid Conditions UNIVERSITY OF WASHINGTON $0 10/02/2010 link unspecified
AHRQ-Indian Health Service A Study of Trends in Obesity Progression Among Complex Patients Palo Alto Medical Foundation Research Institute $0 Obesity accounts for up to 15% of all deaths in the U.S. In 2007-2008, the prevalence of obesity among adults was 33.8%. Obesity threatens to reverse the net benefit of declining smoking rates on the U.S. population. It contributes to untimely mortality and reduces quality of life, both of which are further influenced by the frequent co-occurrence of debilitating co-morbidities including depression and cardiovascular diseases. This translates to tremendous health and economic costs. We propose an innovative exploratory research project focusing on patients with a constellation of three chronic conditions: (1) obesity, (2) hypertension, and (3) depression. A team with complementary capacities has been assembled for an analytical epidemiological study at the Palo Alto Medical Foundation Research Institute (PAMFRI), an AHRQ ACTION network member and a component of the Palo Alto Medical Foundation (PAMF), a large non-profit multi-specialty delivery system. PAMF has implemented the EpicCare Electronic Health Record (EHR) system since 2000. Many research and quality improvement efforts related to these three conditions are ongoing at PAMF, including a study jointly funded by the NIH and the American Heart Association, entitled Evaluation of Lifestyle Interventions to Treat Elevated cardiometabolic risk (E-LITE). Underway at one PAMF clinic, E-LITE is a randomized controlled trial (RCT) of two modified forms of a highly successful lifestyle intervention to treat overweight or obese adults. The specific aims are to: (1) Follow the clinical paths of patients with obesity alone versus with the obesity-hypertension-depression constellation, using EHR data from 2000 to 2010. We will examine the interventions these patients receive, including but not limited to, shared medical appointments for obesity or mental health, bariatric surgery, behavioral interventions, and pharmacologic treatment. We will evaluate the progression of the conditions in the constellation among patients stratified by age, gender, race, and disease states and assess the impact of various interventions. (2) Leverage the prospectively collected data in E-LITE to examine the effectiveness of intensive lifestyle interventions for subsets of E-LITE patients with various combinations of the three priority conditions. We will test if the presence of hypertension and/or depression influences the effectiveness of E-LITE interventions in reducing obesity and cardiometabolic risk. (3) Assess how well the sample of patients and physicians in E-LITE represents the patients and physicians in the study clinic and other clinics in PAMF. We will compare characteristics and clinical trajectories of patient participants in E-LITE with non-participating patients who also have obesity in that clinic or elsewhere in PAMF. We will also compare practice styles of E-LITE physicians with non-E-LITE physicians at PAMF. Results of the study can inform current PAMF and national quality improvement measures and treatment guidelines for managing patients with obesity-hypertension-depression, a common and costly constellation of priority conditions. 10/02/2010 link obesity
AHRQ-Indian Health Service Comparative Effectiveness of Quality Improvement Efforts Among American Indian and Alaska Native Communities Westat, Inc. $1,686,484 The Agency for Healthcare Research and Quality (AHRQ) intends to issue a competitive task order against an Indefinite Delivery Indefinite Quantity Task Order with the National Resource Center Domain 2 master contract holders. It is anticipated that AHRQ will award 1 task order. The purpose of this task order is to support the development of data infrastructure that will accelerate comparative effectiveness research on the American Indian/Alaska Native (AI/AN) population and to support efforts to prioritize prevention, treatment and chronic disease management interventions for this population through comparative effectiveness research. The goal of this task order is to use electronic clinical data from the Indian Health Service (IHS) national health information system (RPMS - Resource and Patient Management System) to enhance the capacity to electronically measure quality of care consistent with national HIT standards and conduct comparative effectiveness research that will identify care delivery models within the Indian/Tribal and Urban systems that result in improved health outcomes. 09/03/2010 link unspecified
HRSA Implementation of the PECARN Traumatic Brain Injury Prediction Rules for Children Using Computerized Clinical Decision Support: An Interrupted Time Series Trial Columbia University $0 The grant is intended to meet HHS/OS priorities of improving the research network infrastructure for purposes of comparative effectiveness research. Applicants should address specific needs in the field of pediatric emergency care that transcend state boundaries. Objectives must meet a demonstrable need, and methodologies and strategies for achieving the objectives must be realistic, appropriate and scientifically sound. Each application must contain an evaluation plan that includes measurable outcomes and clearly defined time frames for conducting the evaluation. 07/30/2010 link other
AHRQ Enhancing Clinical Effectiveness Research with Natural Language Processing of EMR KAISER FOUNDATION RESEARCH INSTITUTE $0 Comparative effectiveness research (CER) requires that clinical data be in standard forms allowing multiple, large databases to be efficiently combined, and requires that all of the data be coded so that automated summarization of the data is possible. However, much of the clinical data necessary for CER is in the text clinical notes written by clinicians when caring for patients. We will build a centralized website where CER researchers can build software applications that will process their electronic medical records, including both the text and coded data, creating standardized datasets permitting comparative effectiveness research. We will demonstrate the utility of this infrastructure by conducting CER studies investigating the effectiveness of interventions in asthma and smoking, across the 6 participating health systems. 10/02/2010 link unspecified
AHRQ Indiana PROSPECT Indiana University-Purdue University at Indianapolis $0 Project Narrative This proposal seeks to enhance the existing information technology infrastructure in Central Indiana to improve the nation's capacity to conduct comparative effectiveness research (CER) and apply these new capacities to a novel CER project evaluating treatment for Alzheimer's disease. 10/02/2010 link dementia, Alzheimer's
AHRQ Multi-Institutional Consortium for CER in Diabetes Treatment and Prevention KAISER FOUNDATION RESEARCH INSTITUTE $0 A network of 32 health services and intervention scientists affiliated with the HMO Research Network propose to build a national database for conducting comparative effectiveness research on treatment and on approaches to preventing diabetes mellitus. The database will include information on more than 750,000 persons with diabetes. It will be used to generate ongoing information on the occurrence, treatments and outcomes of diabetes and to conduct 2 studies of approaches to treating and preventing this condition. 10/02/2010 link diabetes
AHRQ The Population-Based Effectiveness in Asthma and Lung Disease Harvard Pilgrim Health Care, Inc. $0 Project Narrative This project will create a new infrastructure to accelerate comparative effectiveness research in asthma and other lung diseases in diverse populations. We will form the Population-Based Effectiveness in Asthma and Lung Diseases (PEAL) Network, creating highly detailed, standardized, linked computerized datasets from a state Medicaid plan and four health plans. We will conduct comparative effectiveness research on asthma controller medications, evaluating adherence and other real-world factors. This project is innovative in that we will link claims, electronic medical record, patient, and provider data, and will build new linkages with a Medicaid plan to include vulnerable groups who are disproportionately burdened by asthma. 10/02/2010 link respiratory
AHRQ Washington Heights Initiative Community-based Comparative Effectiveness Research COLUMBIA UNIVERSITY HEALTH SCIENCES $0 This research has the potential to improve the evidence base for treatment hypertension and other clinical conditions for a medically underserved, minority, low income, immigrant patient population. Currently, the evidence base for care delivery is not strong for this population, resulting in disparities in health care and outcomes. Insights gained through working with this specific population will then be generalizable to other such communities and populations. 10/02/2010 link unspecified
NIH/AHRQ A Randomized Trial of Behavioral Economic Interventions to Reduce CVD Risk UNIVERSITY OF PENNSYLVANIA $0 This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery and Reinvestment Act of 2009 (Recovery Act or ARRA), Public Law 111-5, invites applications proposing clinical trials using the principles of behavioral economics to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. For this FOA, applicants must propose controlled trials that randomize units (whether individuals or clusters such as practices, hospitals, or larger units) to conditions, resulting in a randomized clinical trial (RCT) or cluster randomized trial (CRT). Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER (e.g., those that rely on manipulating a providers default options) could be more cost effective than conventional approaches including some pay for performance schemes (P4P). For the purposes of this FOA, the definition of comparative effectiveness research will adhere to that adopted by the Federal Coordinating Council given at http://www.hhs.gov/recovery/programs/cer/cerannualrpt.pdf. Behavioral economics refers to the interdisciplinary efforts involving cognitive and social psychologists, decision scientists, and other social scientists together with economists to model economic decision-making and consequent actions. The approach is inclusive, since at its heart it tries to take into account what is known about how people actually make decisions rather than relying on the assumption that economic agents are fundamentally rational in the sense of expected utility theory (see, e.g., Kahneman and Tverskys (1979) work on Prospect Theory and Kahnemans (2003) Nobel lecture). It is hoped that this line of research will lead to significantly greater consideration of CER by health care providers and therefore enhance the quality of the nations health. 10/02/2010 link cardiovascular
NIH DENTAL AND MEDICAL OFFICE IMET TO REDUCE TEEN TOBACCO, ALCOHOL, AND DRUG USE CHILDREN»S HOSPITAL BOSTON $475,105 The purpose of this project is to improve adolescent behavioral counseling services in healthcare settings with a new Internet/Intranet-based Motivational Enhancement Therapy (iMET) intervention that targets the use of tobacco, alcohol, and other drugs. If proven effective, we will disseminate iMET to primary care dental and medical offices across the U.S. 09/02/2010 link substance abuse health system
NIH COMPARATIVE EFFECTIVENESS OF MEDICAL THERAPY VS. BARIATRIC SURGERY FOR OBESE T2DM BRIGHAM AND WOMEN»S HOSPITAL $500,000 Adult onset diabetes is now at epidemic proportions in the United States. Surgery for obesity often results in resolution of diabetes. This trial will compare the effectiveness of obesity surgery versus maximal medical management in resolving adult onset diabetes in a less obese population. 09/02/2010 link diabetes other health technology, procedure
NIH COMPARATIVE EFFECTIVENESS OF BRAIN IMAGING AND BLOOD BIOMARKERS IN ALZHEIMER??S D UNIVERSITY OF ILLINOIS AT CHICAGO $409,999 Using brain imaging and gene expression analysis in brain, cerebrospinal fluid and plasma of transgenic mice, human subjects with cognitive impairments and Alzheimer's disease patients, this project will determine early biomarkers for the diagnosis of Alzheimer's disease. 09/02/2010 link dementia, Alzheimer's
NIH ROLE OF ADVANCED SCREENING TECHNOLOGIES IN EARLY DETECTION OF BREAST CANCER DANA-FARBER CANCER INSTITUTE $432,434 Role of Advanced Screening Technologies for Early Detection of Breast Cancer Project Narrative Magnetic resonance imaging (MRI) may be utilized for breast cancer screening in high risk populations and digital mammography may be advantageous for screening women with dense breasts. This project will use the Lee-Zelen's (2008) mathematical model to evaluate mortality benefit as well as to find optimal screening strategies for these advanced screening modalities. 09/02/2010 link cancer other health technology, procedure
NIH A RANDOMIZED TRIAL OF LETROZOLE VS CLOMIPHENE IN INFERTILE WOMEN WITH PCOS PENNSYLVANIA STATE UNIVERSITY HERSHEY MEDICAL CENTER $274,042 Propose a concept protocol, which builds on the findings and experience garnered in PPCOS, and propose a double blind randomized two armed trial of clomiphene citrate vs. letrozole in infertile women with PCOS to establish superiority in terms of the primary outcome of live birth as well as to delineate the safety profile of the two drugs. 10/01/2011 link rare diseases pharmaceutical only
NIH COMPARATIVE EFFECTIVENESS OF ECG SCREENING IN CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER TUFTS MEDICAL CENTER $495,907 Our overarching goal is to use existing data to its best advantage to clarify the comparative effectiveness of three different screening and management approaches: (1) comprehensive screening (i.e., all children receive a history, physical and ECG), (2) targeted screening (i.e., all children receive a history and physical, and ECG screening is reserved for those children with risk factors identified on the history and/or physical), and (3) no screening. 09/02/2010 link developmental delays, ADHD, autism other health technology, procedure
NIH COMPARATIVE EFFECTIVENESS OF FIT VS. COLONOSCOPY FOR COLON CANCER SCREENING UNIVERSITY OF IOWA $404,139 Compare the test characteristics of a fecal immunochemical test (FIT) with colonoscopy in 700 average risk individuals undergoing screening colonoscopy; assess patient preferences for FIT vs. colonoscopy in the study sample; and compare projected costs using these screening strategies. 09/02/2010 link cancer other health technology, procedure
NIH COMPARATIVE EFFECTIVENESS OF MEDICATIONS USED IN CONGENITAL HEART SURGERY DUKE UNIVERSITY $450,815 This application will focus on investigating medications in 3 therapeutic areas: anti-fibrinolytic agents used during surgery, afterload reduction in the post-operative setting, and peri-operative antibiotic prophylaxis. Our overall hypothesis is that the linking and analysis of existing large pediatric data sources can address many of these current knowledge gaps and provide robust data in 3 specific areas: 1) identifying current practice patterns and variation in peri-operative care of children undergoing congenital heart surgery; 2) performing observational comparative effectiveness studies which will provide data on efficacy and safety, as well as sample sizes, event rates, and drug effect to be used in planning subsequent trials; 4) establishing a network of sites willing to participate in subsequent studies. 09/02/2010 link cardiovascular pharmaceutical only
NIH EXERCISE VERSUS COGNITIVE INTERVENTIONS FOR ELDERS AT RISK FOR DEMENTIA UNIVERSITY OF MIAMI SCHOOL OF MEDICINE $497,820 The study will assess the impact of exercise training, cognitive training, and a combination of exercise and cognitive training on physical fitness, inflammatory and immunological biomarkers, and cognitive function among Hispanic and non-Hispanic older adults with MCI. 09/02/2010 link other
NIH EVALUATE LONG-TERM PROGNOSIS OF LOCALIZED PROSTATE CANCER FOLLOWING INITIAL RADIATION UNIVERSITY OF MEDICINE AND DENTISTRY OF NEW JERSEY - ROBERT WOOD JOHNSON MEDICAL SCHOOL $422,740 The primary objectives of the study will be to define the prognosis of elderly patients with localized prostate cancer, in terms of overall and disease-specific survival, subsequent use of cancer therapies, and serious cancer-related complications, following radiation therapy compared to conservative management. 09/02/2010 link cancer other health technology, procedure
NIH ENHANCEMENT OF MS SIGNAL PROCESSING TOWARD IMPROVED CANCER BIOMARKER DISCOVERY COLLEGE OF WILLIAM AND MARY $187,282 Will develop computational tools aimed at increasing the effectiveness of cancer biomarker discovery from label-free MALDI-TOF (matrix-assisted laser- desorption/ionization time-of-flight) mass spectra for verification and identification. The computational algorithms and tools will result in more than an order of magnitude increase in both sensitivity and selectivity For molecular biomarker screening. 09/02/2010 link cancer
NIH CYTOPROTECTIVE CYTOKINE SIGNALING AND REPERFUSION INJURY WASHINGTON UNIVERSITY $392,147 The long-term goal of this research initiative is to delineate the cytoprotective role of proinflammatory cytokines in myocardial ischemia reperfusion (I/R) injury. 09/02/2010 link cardiovascular
NIH VALIDATING THE NIH TOOLBOX IN THE ACUTE NEUROREHABILITATION SETTING UNIVERSITY OF ALABAMA AT BIRMINGHAM $255,487 This 2-year Challenge Grant will conduct an initial and exploratory validation study of the NIH Toolbox in the acute neurologic inpatient rehabilitation environment. The Toolbox assesses diverse neurologic functions (cognition, emotion, sensation, and movement) in a 2-hour examination. The proposed research will determine the sensitivity and specificity of the Toolbox to acute neurological illness and its feasibility with assessing adult inpatients with a wide variety of debilitating neurological disorders. 09/02/2010 link neurological disorders health system
NIH COMPUTER-DELIVERY OF EFFECTIVE, PSYCHOSOCIAL INTERVENTIONS IN METHADONE TREATMENT NATIONAL DEVELOPMENT & RES INSTITUTES $183,352 To our knowledge, the proposed study is the first to use mobile phone technology to deliver an interactive, science-based psychosocial intervention targeting illicit substance use that can be easily accessed in an individual's natural environment and provide therapeutic support on-demand. This tool may greatly improve the potency of existing psychosocial interventions for substance use disorders. 10/01/2010 link substance abuse pharmaceutical only
NIH COMPARATIVE EFFECTIVENESS OF WEB-BASED VS. TRADITIONAL ADOLESCENT HIV PREVENTION NATIONAL DEVELOPMENT & RES INSTITUTES $489,063 The computerized intervention we propose to evaluate in this project, if found effective and cost-effective, could substantially advance the adolescent substance abuse treatment system by markedly improving the availability and quality of HIV (and infectious disease) prevention interventions delivered to youth in such settings. Further, this intervention is web-based, thus enabling its use in a wide variety of settings where HIV prevention interventions for youth are typically limited (e.g., schools, health care providers' offices, online social networks). 09/02/2010 link HIV/AIDS health system
NIH MINDFULNESS BASED STRESS REDUCTION FOR PSYCHO-IMMUNE DYSREGULATION IN CANCER LOYOLA UNIVERSITY CHICAGO $306,637 Using a randomized controlled design, this study will evaluate the potential benefits of Mindfulness based stress reduction (MBSR) on psychosocial distress, neuroendocrine stress activation, immune function, and health-related quality of life (HRQOL). 08/02/2011 link cancer
NIH MINDFULNESS BASED STRESS REDUCTION FOR PSYCHO-IMMUNE DYSREGULATION IN CANCER LOYOLA UNIVERSITY CHICAGO $83,388 Using a randomized controlled design, this study will evaluate the potential benefits of MBSR on psychosocial distress, neuroendocrine stress activation, immune function, and HRQOL. 09/02/2011 link cancer
NIH COMPARISON OF THE EFFECTIVENESS OF CAM THERAPIES IN PEDIATRIC PATIENTS UNDERGOING SEDATION FOR IMAGING STUDIES WAYNE STATE UNIVERSITY $441,460 The primary goal of our study is to compare the effectiveness of three CAM therapies in reducing the level of stress and anxiety in pediatric patients, ages 1-12 years, undergoing sedation for imaging studies and importantly reducing the need for higher doses of sedation medicines. 10/01/2010 link unspecified pharmaceutical only
NIH FAS PREVENTION: A TRIAL OF THE IOM MODEL UNIVERSITY OF NEW MEXICO $252,000 This is a multi-site, efficacy trial of a comprehensive, public health model, community-wide, FAS prevention program defined by the Institute of Medicine (IOM). Utilizing lOM-recommended techniques of research and prevention applied previously in American Indian communities, this study will determine the efficacy of community-wide prevention of FAS in SA, and which specific components are most viable. 07/02/2011 link substance abuse health system
NIH NOVEL VACCINE TO CMV BASED ON A DISC VIRUS UNIVERSITY OF MINNESOTA TWIN CITIES $186,710 The proposed research will define the antibody and cellular immune responses to a series of vaccine candidate Cytomegalovirus (CMV) disabled infectious single cycle (DISC) strains. 07/02/2010 link other other health technology, procedure
NIH EFFECTIVENESS OF AN ENHANCED ADAPTIVE CONTINUING CARE MODEL FOR COCAINE DEPENDENCY UNIVERSITY OF PENNSYLVANIA $498,869 Treatment for drug use disorders generally consists of relatively brief episodes of care that do not properly address the chronic, relapsing nature of these disorders. In prior work, we have developed a telephone-based adaptive continuing care model that provides extended care and has proved efficacious in several carefully controlled studies. The proposed supplement will determine whether a new 12 month version of this adaptive continuing care protocol that incorporates stepped care algorithms, patient choice, incentives for participation, and several other improvements designed to increase sustained participation rates will be more effective than standard care and yield larger effect sizes than our prior version of the protocol. 09/02/2010 link substance abuse
NIH VARIATION IN THE SAFETY OF BACK PAIN-RELATED SURGERY DARTMOUTH COLLEGE $496,570 Compare differences in quality of care for back surgery across different hospitals and different surgeons by seeing how often a second operation is needed 30-days, 1-year, and 4-years after the initial operation as a quality indicator. The Spine Patient Outcomes Research Trial, the largest ever back surgery study in which top surgeons and top hospitals performed surgery on carefully selected patients, sets the standard for how "safe" back surgery can be. We will see where back surgery safety falls short of the SPORT benchmarks, and which hospital factors and surgeon factors are associated with making back surgery less safe. 09/02/2010 link other other health technology, procedure
NIH INTENSIVE OUTPATIENT V. OUTPATIENT TREATMENT WITH BUPRENORPHINE AMONG AFRICAN AMERICANS FRIENDS RESEARCH INSTITUTE, INC. $498,748 This study will examine the comparative effectiveness of two common counseling approaches offered with buprenorphine in clinics treating large numbers of African Americans, a population with significant need and limited access to this type of effective treatment which reduces drug use and HIV-risk. 09/02/2010 link substance abuse pharmaceutical only
NIH TREATING ADDICTION AS A CHRONIC ILLNESS NATIONAL CENTER ON ADDICTION/SUB ABUSE $499,999 The proposal has two specific aims: 1) to develop a state-level model to treat addiction as a chronic illness across multiple agencies (e.g., substance abuse and criminal justice) and system components (e.g., financing, regulation, service delivery) and 2) to conduct all developmental work necessary to design a rigorous comparative effectiveness research (CER) trial to test a chronic care model for SUD offenders. 01/02/2011 link substance abuse health system
NIH SURGERY, IMMUNOLOGY AND IMMUNOTHERAPY OF HUMAN CANCER JOHN WAYNE CANCER INSTITUTE $2,005,765 The CER study described in this competitive revision will establish the role of surgical versus nonsurgical approaches in patients whose melanoma has spread to distant sites. Results will help clinicians develop a standardized initial approach that prolongs survival and optimizes quality of life. Results also will indicate whether BCG postoperative immunotherapy significantly improves the outcome of patients treated with surgery. 04/02/2011 link cancer other health technology, procedure
NIH ADOPTION FIDELITY AND EFFECTIVENESS OF ALCOHOL SBIRT IN DENTAL PRACTICE OLD DOMINION UNIVERSITY $474,730 The proposed project seeks to tailor existing Screening, Brief Intervention, Referral and Treatment (SBIRT) protocols for alcohol abuse to be used in dental practice settings. 09/02/2010 link substance abuse health system
NIH DECOMPRESSIVE CRANIOTOMY VERSUS MEDICAL THERAPY FOR REFRACTORY INTRACRANIAL HYPERTENSION UNIVERSITY OF UTAH $499,315 This comparative effectiveness research proposal employs a propensity score analysis which creates balanced groups of patients and compares their survival according to whether or not they underwent DC. 09/02/2010 link other other health technology, procedure
NIH COMPARATIVE EFFECTIVENESS OF ART FOR HIV IN PATIENTS WITH COMORBIDITIES STANFORD UNIVERSITY $499,243 The project will compare antiretroviral strategies in HIV-infected individuals with cardiovascular risk factors or cardiovascular disease, and in patients with multi-drug resistant HIV. 09/02/2010 link HIV/AIDS pharmaceutical only
NIH PREVENTING OBESITY IN THE BRONX: IMPACT OF THE "MOVING SMART" INTERVENTION ON PRO MONTEFIORE MEDICAL CENTER (BRONX, NY) $656,601 This proposal will evaluate "Moving Smart", an in-classroom, education-focused physical activity intervention that may revolutionize the current school policy on physical activity and serve as a model for other obesity prevention school-based programs nationwide. 10/03/2009 link obesity
NIH PREVENTING OBESITY IN THE BRONX: IMPACT OF THE "MOVING SMART" INTERVENTION ON PRO ALBERT EINSTEIN COLLEGE OF MEDICINE - YESHIVA UNIVERSITY $674,896 This proposal will evaluate "Moving Smart", an in-classroom, education-focused physical activity intervention that may revolutionize the current school policy on physical activity and serve as a model for other obesity prevention school-based programs nationwide. 09/02/2010 link obesity
NIH IMPROVING ADHERENCE TO POST PCI ANTIPLATELET THERAPHY IN MINORITY POPULATIONS UNIVERSITY OF MIAMI SCHOOL OF MEDICINE $498,034 The focus of the proposed study is to examine a non-traditional care- management approach delivered by a large commercial health benefit carrier in the prevention of CVD secondary outcomes among disparity populations who have undergone coronary artery stenting (PCI). In particular, we seek to determine if a culturally tailored phone based Motivational Interviewing (MINT) intervention delivered to African American (AA) and Latino patients is effective at improving adherence to clopidogrel, a medically proven intervention that dramatically reduces stent thrombosis, myocardial infarction and death, and that is standard of care for at least 12 months after stent placement according to ACC/AHA guidelines. 07/02/2010 link cardiovascular
NIH Identifying Disparities in Type 2 Diabetes Among Asian Americans: The Pan Asian Cohort Study PALO ALTO MEDICAL FOUNDATION RES INST $557,936 The revision, a two-year study, aims to additionally compare the effectiveness of oral drugs for treatment of type 2 diabetes among Asian subgroups in the same electronically linked cohort. It is well-known that type 2 diabetes manifests differently in race/ethnic groups, and that race/ethnic groups respond differently to the same pharmacotherapy. 09/02/2011 link diabetes pharmaceutical only
NIH THE CO-CLINICAL PROJECT: INFORMING CLINICAL TRIALS USING PRECLINICAL MOUSE MODELS BETH ISRAEL DEACONESS MEDICAL CENTER $2,064,367 Succinctly put, what we propose with the "Co-Clinical Project" is that each clinical trial at the participating Institutions will be run "in parallel" with pre-clinical trials in appropriate, faithful and genetically relevant mouse models, and that the clinical, biological and pharmacological information (i.e. somatic mutational background, germline SNP variations, responsiveness to specific regimens; imaging, microarray and proteomics profiles) will be accrued, analyzed in parallel and integrated in order to facilitate the identification of patient subtypes, key genetic determinants, and biomarkers that predict response to specific treatments. 09/02/2010 link cancer
NIH IMPACT OF EXERCISE AND ENGAGEMENT ON COGNITION IN OLDER ADULTS UNIVERSITY OF TEXAS DALLAS $392,071 The proposed project is one of the first attempts to study the joint effects of exercise and a cognitive intervention program by adding exercise conditions to an already-funded intervention study on cognitive engagement in the laboratory of Denise Park at the Center for Brain Health in Dallas. 09/02/2010 link dementia, Alzheimer's
NIH RELIGIOUS RESPONSES TO HIV/AIDS IN BRAZIL COLUMBIA UNIVERSITY HEALTH SCIENCES $160,301 1) Develop a comparative analysis of the multiple ways in which Catholic, Evangelical Protestant, and Afro-Brazilian religions have responded (at the policy, institutional and population levels) to HIV/AIDS in Brazil; 2) Empirically document the importance that each of these 3 major religious traditions has given to HIV/AIDS, and the reasons that have led them to do so; 3) Assess, through a series of case studies, the ways in which the responses of each religious traditions has interacted with local communities, the wider social universe of civil society, and the nation- state, in impacting upon the broader response to AIDS; and, 4) Through comparative analysis, to more fully understand the ways in which both importance and impact have been influenced by the religious belief system or religious doctrine of each tradition, the organizational and institutional structures that each exhibits, and the ways in which each interacts with and articulates itself with communities, civil society, and the state, in order to shape the broader social and political response to AIDS. 10/01/2010 link HIV/AIDS health system
NIH ENTRAINMENT-BASED MECHANICAL VENTILATION MASSACHUSETTS INSTITUTE OF TECHNOLOGY $470,889 Propose a new mode of mechanical ventilation (entrainment-based mechanical ventilation, EMV) that is based on the classical physics theory of mutual entrainment between coupled oscillators, which may provide a cost- effective solution to the problem of patient-ventilator synchrony. 09/02/2010 link respiratory other health technology, procedure
NIH EFFECTIVENESS OF TENS ON HYPERALGESIA, PAIN WITH MOVEMENT, AND FUNCTION AFTER TKR UNIVERSITY OF IOWA $11,527 This application fits with the NINR Strategic Plan's Area of Research Emphasis, Promoting Health and Preventing Disease, by evaluating a new approach to transcutaneous electrical nerve stimulation (TENS) therapy to decrease pain, improve function, and prevent the development of new chronic pain syndromes in older adults after TKR. 11/02/2010 link other
NIH SELF-MONITORING USING GPS- AND ACCELEROMETER-EQUIPPED SMARTPHONES UNIVERSITY OF CALIFORNIA LOS ANGELES $480,614 Aim to develop an innovative real-time assessment of behavioral exposures for cardiovascular disease (CVD). We will implement three new self-monitoring functions on GPS- and accelerometer-equipped smartphones to monitor diet, exercise, and stress for young overweight mothers. 08/02/2010 link cardiovascular health system
NIH NEURAL EFFECTS OF EXERCISE, COGNITIVE, OR COMBINED TRAINING IN AD AT-RISK ELDERS CLEVELAND CLINIC LERNER COLLEGE OF MEDICINE OF CASE WESTERN RESERVE UNIVERSITY $499,808 This project will be the first to (1) compare the relative efficacy of CT, ET, and a combined intervention; (2) use functional neuroimaging to assess intervention efficacy; and (3) intervene in older individuals at risk for developing AD. The long-range goal is to evaluate effective, low-risk, and relatively inexpensive interventions for addressing cognitive decline, with enormous implications for containing costs associated with health-care delivery to the ever increasing aging population of the United States. 09/02/2010 link dementia, Alzheimer's pharmaceutical, other technology
NIH VOLUMETRIC PERFUSION MRI OF LIVER TUMORS TO DETECT EARLY RESPONSE TO CHEMOTHERAPY UNIVERSITY OF WISCONSIN MADISON $488,120 Propose to evaluate the clinical and cost effectiveness of advanced perfusion MRI methods to characterize blood flow to liver tumors before and immediately after initiation of systemic therapy. We aim to determine the comparative effectiveness of advanced perfusion MRI with conventional cross- sectional imaging methods (CT) that measure tumor response based size, using tumor size criteria. 09/02/2010 link cancer other health technology, procedure
NIH UAB CONTINENCE TREATMENT CENTER UNIVERSITY OF ALABAMA AT BIRMINGHAM $99,999 Propose a competitive revision to the UITN award to conduct a 12-month pilot and feasibility study for a 2-arm randomized controlled comparative effectiveness trial of the autologous rectus fascia pubovaginal sling and the synthetic mesh midurethral sling procedures for the treatment of recurrent or persistent SUI. 03/02/2011 link substance abuse
NIH SMOKING INTERVENTIONS FOR HOSPITAL PATIENTS:A COMPARATIVE EFFECTIVENESS TRIAL MASSACHUSETTS GENERAL HOSPITAL $499,595 Conduct a randomized controlled comparative effectiveness trial of two strategies to promote smoking cessation in hospitalized patients: (1) a hospital-only intervention that meets NHQM quality standards ("Standard Care"), and (2) an "Enhanced Care" model that will facilitate the sustained use of smoking counseling and medication after discharge to produce long-term abstinence. 08/02/2010 link substance abuse
NIH HABITS AND CUES IN ALCOHOL DRINKING: DYNAMIC STRIATAL ACTIVITY UNIVERSITY OF NORTH CAROLINA CHAPEL HILL $222,000 This competitive revision will expand the parent grant by comparatively evaluating the therapeutic efficacy of naltrexone and topiramate on goal-directed versus habit-driven alcohol drinking and relapse-like behavior. In compliance with the purpose of the Recovery Act, it will create new full-time and part-time employment. 09/02/2011 link substance abuse pharmaceutical only
NIH DEVELOPMENT OF LOW COST AND BROADLY PROTECTIVE HUMAN PAPILLOMAVIRUS VACCINES JOHNS HOPKINS UNIVERSITY $499,998 The principal goal of this proposal is to develop a broadly protective HPV vaccine, at low cost, to meet the needs of HIV+ girls and women in the developing world who can neither afford the currently licensed and costly HPV vaccines, nor have access to cytologic screening. 09/02/2010 link HIV/AIDS
NIH IL-13 AND EOSINOPHILIC ESOPHAGITIS CHILDREN»S HOSPITAL MEDICAL CENTER (CINCINNATI) $1,580,324 Aim 1, we will develop a local internet based registry of subjects with EE to capture defined clinical, pathologic and translational outcome measures. We will use the EE registry to test the hypothesis that esophageal mucosal eosinophil levels and identified key EE cytokines such as IL-13 correlate with defined, validated clinical outcome measurements of symptom severity and quality of life. In Aim 2, we will compare the clinical effectiveness of dietary elimination to swallowed steroid medications for the treatment of pediatric EE. 09/02/2011 link rare diseases health system
NIH COMPUTERIZED PSYCHOSOCIAL TREATMENT FOR OFFENDERS WITH SUBSTANCE USE DISORDERS NATIONAL DEVELOPMENT & RESEARCH INSTITUTES $1,882,638 Aim 1 is to test the comparative effectiveness of TES vs. Standard Care on measures of drug use (e.g., weeks of abstinence) and HIV risk behavior (both sex-related and drug-related HIV risk behavior) at 3- and 6-months post prison discharge, as well as on reincarceration rates using official Department of Corrections records. Aim 2 is to evaluate the cost and cost-effectiveness of TES relative to standard care. 09/02/2010 link substance abuse health system
NIH EFFECTIVENESS OF EARLY STAGE PROSTATE CANCER TREATMENT BETH ISRAEL DEACONESS MEDICAL CENTER $499,994 Aim 1. To generate and validate models that use pre-treatment HRQOL, clinical status, and treatment details to predict HRQOL changes after each of the three most common primary treatments for early stage prostate cancer: prostatectomy, external radiotherapy, or brachytherapy Aim 2. To construct decision analytic Markov models to predict QALE of primary prostate cancer treatments using prospective cohort data to drive transition probabilities between HRQOL states. Aim 3. To characterize treatment-related costs and combine these with QALE in the Markov model framework to assess overall cost effectiveness as measured by incremental cost-effectiveness ratio (ICER), of prostatectomy, external radiotherapy, or brachytherapy for early stage prostate cancer. 09/02/2010 link cancer health system
NIH EFFECTIVENESS OF ROBOTIC COMPARED TO STANDARD PROSTATECTOMY FOR PROSTATE CANCER BETH ISRAEL DEACONESS MEDICAL CENTER $500,000 Comparison of robotic procedures with standard invasive treatments should demonstrate the comparative effectiveness and comparative cost of robotic interventions for the clinical treatment of disease. 09/02/2010 link cancer other health technology, procedure
NIH LIFESTYLE MODIFICATION VERSUS BARIATRIC SURGERY FOR TYPE 2 DIABETES UNIVERSITY OF PENNSYLVANIA $504,677 The large weight losses seen with bariatric surgery are often associated with improvements or resolution of several obesity-related comorbidities, including type 2 diabetes. The proposed project is designed to compare improvements in diabetes control in obese diabetic individuals who are assigned by chance to one of three groups: 1) Roux-en-Y gastric bypass; 2) laparoscopic adjustable gastric banding; or 3) intensive non-surgical weight management. In addition, the project will study the level of acceptance of surgical treatment of type 2 diabetes among physicians, health care providers, and insurance companies. 09/02/2010 link diabetes other health technology, procedure
NIH COMPARING THE EFFECTIVENESS OF CITY POLICY AND STRUCTURE IN HEALTH DISPARITIES LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER NEW ORLEANS $335,942 This study's goal is to compare the effectiveness of a city level policy in New Orleans to control problem alcohol outlets that contribute to health inequalities among poor and minority populations. 09/02/2010 link unspecified
NIH EFFECTIVENESS OF IMMEDIATE VS. DELAYED USE OF METFORMIN IN NEW-ONSET T2 DIABETES KAISER FOUNDATION RESEARCH INSTITUTE $481,722 Propose to examine the comparative effectiveness of immediate initiation of metformin monotherapy vs. delayed initiation of metformin or early/late initiation of sulfonylurea monotherapy for a variety of outcomes. 09/02/2010 link diabetes pharmaceutical only
NIH INTERDISCIPLINARY APPROACH TO RETINAL DISEASE GENE IDENTIFICATION UNIVERSITY OF IOWA $667,195 The goal of this project is the identification of genes that cause human retinal degeneration, specifically genes causing a syndromic form of photoreceptor degeneration known as Bardet- Biedl syndrome (BBS), as well as autosomal recessive retinitis pigmentosa (ARRP). 09/02/2011 link other
NIH IMPROVING CARE CONTINUITY IN DRUG ABUSE TREATMENT JOHNS HOPKINS UNIVERSITY $479,911 The aim of this project is to improve rates of client transition from residential into outpatient aftercare treatment by implementing specific transition enhancement interventions. The drug abuse treatment systems in Baltimore will be improved by forming better linkages between residential and outpatient treatment programs 08/02/2010 link substance abuse health system
NIH APPROPRIATE CARE OF URI IN CHILDREN OF LATINO IMMIGRANTS: THE ACURI PROJECT COLUMBIA UNIVERSITY HEALTH SCIENCES $499,815 The purpose of this study is to conduct a randomized controlled trial to comparatively assess the effectiveness of our tailored educational intervention, The Appropriate Care of URI (ACURI) Project, to improve health literacy levels regarding upper respiratory infections (URIs) and to decrease pediatric emergency department (PED) visits, among Latino households in Early Head Start/Head Start. 07/02/2010 link other health system
NIH EVALUATING AN EMERGENCY DEPARTMENT OBSERVATION SYNCOPE PROTOCOL FOR OLDER ADULTS UNIVERSITY OF CALIFORNIA LOS ANGELES $283,117 The implementation of an expedited and standardized Emergency Department Observation Syncope Protocol (EDOSP) may safely reduce hospitalization of older patients with syncope. 09/02/2010 link other health system
NIH COST-EFFECTIVENESS OF HIV-RELATED MENTAL HEALTH INTERVENTIONS MEDICAL UNIVERSITY OF SOUTH CAROLINA $298,708 This study will conduct comparative cost-effectiveness analysis of 3 pairs of critical HIV mental health interventions: (1) abstinence-based interventions versus comprehensive sex education, (2) condom social marketing versus free condom distribution programs, and (3) HIV voluntary counseling and testing versus provider initiated testing and counseling. 09/02/2010 link HIV/AIDS health system
NIH COMPARATIVE EFFECTIVENESS OF ADVANCED DIAGNOSTIC IMAGING FOR HEPATIC FIBROSIS MAYO CLINIC COLL OF MEDICINE, ROCHESTER $479,082 Propose to examine the comparative effectiveness of novel quantitative elasticity imaging techniques and serum marker fibrosis panels for detecting clinically significant hepatic fibrosis measured by liver biopsy among human subjects with chronic liver disease. 09/02/2010 link other other health technology, procedure
NIH URINARY INCONTINENCE TREATMENT NETWORK: DCC NEW ENGLAND RESEARCH INSTITUTES, INC. $627,705 Therefore, this study will compare the efficacy and safety of the retropubic and transobturator (inside-out and outside-in) procedures in a 2-arm RCT; 588 women with stress Ul will be enrolled. 10/01/2011 link other other health technology, procedure
NIH EFFECTIVENESS OF FEEDING TUBES AMONG PERSON WITH ADVANCED COGNITIVE IMPAIRMENT BROWN UNIVERSITY $341,059 The proposed research has two overarching goals. First, we aim to use advanced methods to account for selection bias to provide a more definitive study of the potential benefits (survival, weight change, prevention and healing of pressure ulcers), risks (use of restraints, prescription of antipsychotics or benzodiazepines, and transitions to the ER and acute care hospital), and health care expenditures. A second goal is to understand the variation in hospital insertion rates of PEG feeding tubes. In this goal, we will examine potentially modifiable hospital characteristics, market factors, and state policies associated with this variation in hospitals' rate of PEG feeding tube insertion. 09/02/2010 link dementia, Alzheimer's other health technology, procedure
NIH PREVENTING DEPRESSION IN PEOPLE WITH EPILEPSY: AN EXTENSION OF PROJECT UPLIFT EMORY UNIVERSITY $491,782 The goals of this multi-site project are two-fold: (1) to revise the Project UPLIFT materials for use in prevention (rather than treatment) of depression; and (2) to estimate their effectiveness in reducing the risk of depression in people with epilepsy as well as increasing their knowledge and skills for preventing depression and improving their quality of life. While this proposal targets people with epilepsy, the intervention could be easily adapted to serve other disparity populations, many of whom have elevated rates of depression. 07/02/2010 link mental health health system
NIH COENZYME Q10 IN STATIN MYOPATHY HARTFORD HOSPITAL $457,436 Statins markedly reduce the incidence of cardiac events. These drugs are generally well-tolerated but can produce muscle side effects such as muscle cramps and weakness, which can ultimately require withdrawal of medications for statin-intolerant subjects. The current study investigates the utility of Coenzyme Q10 supplementation in patients with statin-associated muscle side effects to determine if Coenzyme Q10 supplementation is a novel therapeutic approach to improving statin tolerance. 10/01/2010 link cardiovascular pharmaceutical only
NIH PREDICTORS OF LONG-TERM OUTCOME OF UNRUPTURED INTRACRANIAL ANEURYSMS UNIVERSITY OF IOWA $485,313 The proposed analysis of the ISUIA cohort will further define the risk of aneurysm rupture, the competing causes of death and the effectiveness of hemorrhage prevention through surgical and endovascular treatment. 09/02/2010 link neurological disorders health system
NIH COST-EFFECTIVENESS OF HORMONAL THERAPY FOR CLINICALLY LOCALIZED PROSTATE CANCER KAISER FOUNDATION RESEARCH INSTITUTE $499,957 Propose a new comparative effectiveness study to provide information on the risks and potential benefits of immediate ADT in men diagnosed with localized prostate cancer. Our three aims include estimating the comparative effectiveness of immediate ADT versus observation in terms of all cause and prostate-cancer specific mortality and progression-free survival, estimating the longitudinal direct medical care costs to capture the impact of ADT, and calculating the cost- effectiveness (cost per life years saved) and cost-utility (quality-adjusted life years) using published patient utilities for multiple prostate cancer health states. 09/02/2010 link cancer other health technology, procedure
NIH PRENATAL CYTOGENETIC DIAGNOSIS BY ARRAY-BASED COPY NUMBER ANALYSIS COLUMBIA UNIVERSITY HEALTH SCIENCES $744,988 Accordingly, we propose a study comparing the accuracy and efficacy of aCGH to conventional cytogenetics in routine prenatal diagnostic practice. 10/01/2011 link unspecified
NIH USING TECHNOLOGY TO DELIVER BRIEF INTERVENTIONS IN DUI PROGRAMS RAND CORPORATION $494,681 Address this challenge by asking whether providing brief interventions in alcohol education programs (AEP), the traditional method for preventing future alcohol-related incidents among 1st-time DUI offenders, is feasible and acceptable to offenders and providers, and whether adding a BI decreases alcohol consumption and risky drinking behaviors. 09/02/2010 link substance abuse health system
NIH COMPARATIVE EFFECTIVENESS RESEARCH USING NCCN DATA DANA-FARBER CANCER INSTITUTE $499,795 Propose to address two distinct but related challenges: (1) development of a research agenda for cancer comparative effectiveness research (CCER) that takes into account both the feasibility of the research and its potential importance to relevant stakeholders; and (2) completion of several high priority and high quality assessments of the comparative effectiveness of alternative cancer treatments for specific clinical subsets of cancer patients. 09/02/2010 link cancer health system
NIH PREDICTING CARDIOVASCULAR RISK IN VULNERABLE PLAQUE RUPTURE CITY COLLEGE OF NEW YORK $408,078 In Aim 1 we will use a high resolution micro-CT imaging system to examine a much broader sample of ruptured and non-ruptured human thin cap fibroatheroma and statistically analyze the frequency, size, shape and spatial distribution of the cellular-level microcalcifications. In Aim 2 we quantitatively evaluate the impact of the microcalcifications on the biomechanical stability of the cap using a three-dimensional (3D) multi-level finite element model (FEM) of realistic 3D geometries of human coronary lesions based on high resolution micro-CT imaging. 08/02/2010 link cardiovascular
NIH ACCF-STS DATABASE COLLABORATION ON THE COMPARATIVE EFFECTIVENESS OF PCI AND CABG AMERICAN COLLEGE OF CARDIOLOGY $2,655,996 By linking three national patient record databases, this study will compare coronary artery bypass graft surgery and percutaneous coronary intervention in order to better understand the procedures and improve healthcare for patients with coronary artery disease, one of the major causes of morbidity and mortality in the United States. 08/02/2010 link cardiovascular health system
NIH NORTH LAWNDALE DIABETES COMMUNITY ACTION PROJECT SINAI HEALTH SYSTEM, INC. $500,000 The Sinai Urban Health Institute, Sinai Health Systems, Rush University Medical Center and a community based organization (Family Focus North Lawndale) are proposing to develop and deliver a multi- level community intervention using a media campaign, community engagement, and individual self- management training by "Diabetes Block Captains (DBC)" in a very poor African American community on the west side of Chicago. 09/02/2010 link diabetes
NIH RCT OF TWO SPEED OF PROCESSING MODES TO PREVENT COGNITIVE DECLINE IN OLDER ADULTS UNIVERSITY OF IOWA $499,578 Building on speed of processing theory, we propose to extend and expand the findings from the NIH-funded, multi-site Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study by using a newly developed, value-added version of the speed of processing software that can be used on virtually any home computer without supervision. 10/01/2010 link other
NIH VACCINATION AGAINST RSV WITH CAPSID-MODIFIED AD VECTORS WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY $422,291 Respiratory syncytial virus is the most important virus causing serious respiratory tract disease in infants and young children. It is also receiving increasing recognition as an important cause for respiratory tract disease in the elderly. A vaccine against RSV could be an efficient way to prevent RSV disease and is so far not available. 06/02/2010 link respiratory pharmaceutical only
NIH CLINICAL VALIDITY AND UTILITY OF GENOMIC TARGETED CHEMOPREVENTION OF PCA WAKE FOREST UNIVERSITY HEALTH SCIENCES $1,972,330 Evaluate whether targeting groups of men based on genetic markers and family history of prostate cancer may improve the effectiveness of chemoprevention for prostate cancer. 09/02/2010 link cancer
NIH RESISTANCE TO AORTIC ENDOGRAFT MIGRATION: COMPARATIVE EFFECTIVENESS OF FDA APPROVAL STANFORD UNIVERSITY $499,991 Endovascular repair has become the primary treatment for abdominal aortic aneurysm (AAA) disease. There are currently 5 FDA approved endograft devices for AAA repair. The true in-vivo biomechanical environment experienced by these devices is poorly understood. Furthermore, there are currently no studies that compare the performance of the different devices with regards to their long term positional stability (migration). 09/02/2010 link other health system
NIH REDUCING ETHNIC AND RACIAL BIAS IN SCREENING FOR PSYCHIATRIC DISORDERS IN ADOLESCENTS CAMBRIDGE HEALTH ALLIANCE $499,950 Designed to improve the effectiveness of identification, referral and screening for mental health disorders potentially associated with ethnic/racial disparities in adolescents' receipt of mental health care. 09/02/2010 link mental health
NIH COMPARATIVE EFFECTIVENESS IN GENOMIC MEDICINE UNIVERSITY OF PENNSYLVANIA $1,990,198 Advances in genomics have the potential to improve the delivery of health care. Increasingly, there is a need to decide whether the use of genomic tests is better than doing what we are currently doing- i.e. comparative effectiveness. The overarching goal of this project is to develop a coordinated, multidisciplinary center for the generation and synthesis of evidence to support the translation of genomic tests into improvements in cancer prevention, screening, diagnosis, treatment and survivorship. 09/02/2010 link unspecified
NIH CHANGING BRAINS THROUGH INQUIRY, NOT DRUGS UNIVERSITY OF MINNESOTA TWIN CITIES $267,964 The University of Minnesota (UMN) Department of Neuroscience and Department of Curriculum and Instruction propose to develop, adapt, implement, evaluate, and disseminate a model inquiry-based neuroscience education program on the biological basis of drug abuse. The program will consist of professional development workshops for secondary science teachers, BrainU (BrainUs, plural), and an experimentally based curriculum for middle and high school students aligned to state and national standards. During BrainU, teachers will experience and learn inquiry-based teaching as they acquire knowledge of neuroscience and the biology of drug abuse. 05/02/2010 link substance abuse health system
NIH META-ANALYSIS SYSTEMATIC AND DESIGN ERRORS: ALCOHOL USE AND DISEASE OUTCOMES SCIENTIFIC ANALYSIS CORPORATION $482,717 This meta-analysis of relevant epidemiological studies evaluating alcohol consumption and multiple disease outcomes should inform clinicians and public health policy by more carefully specifying alcohol's disease burden. It holds the promise of identifying the extent to which systematic errors in epidemiological studies may have led to false conclusions between potential risk factors and disease outcomes. If not corrected, these errors will undermine the quality and accuracy of public health policy. 09/02/2010 link substance abuse
NIH NEW APPROACHES TO MEDIATION ANALYSIS USING CAUSAL INFERENCE METHODS BROWN UNIVERSITY $481,042 The proposed research will develop statistical approaches for discovering pathways and mechanisms of behavioral interventions targeted at alcohol abuse. A major outcome of the research program is development, testing and dissemination of appropriate software for implementing the models. Knowledge of mechanistic pathways allows deeper understanding of how and why certain interventions work, and opens the door to customizing interventions based on person-specific characteristics. 09/02/2010 link substance abuse health system
NIH QUANTITATIVE ASSESSMENT OF THE BENEFITS AND RISKS OF CLINICAL PET/CT AND SPECT/CT UNIVERSITY OF ARIZONA $281,931 Develop and validate methods that researchers can use to assess the benefits and risks associated with multimodality PET/CT and SPECT/CT imaging. 09/02/2010 link unspecified health system
NIH TRANSFORMING PCI INFORMED CONSENT INTO AN EVIDENCE-BASED DECISION-MAKING TOOL SAINT LUKE»S HOSPITAL $2,121,454 This proposal will test the impact of the Personalized Risk Information Services Manager (PRISM), an information technology tool that generates individualized estimates of risk at the time of medical decision-making based upon complex risk prediction models, on the treatment of bleeding risk at the time of coronary angioplasty. Specifically, this study will provide an estimate of each patient's individual risk of bleeding and incorporate these estimates into an improved informed consent document that each patient signs and their physician uses to guide the application of bleeding avoidance therapies at the time of angioplasty. 08/02/2010 link cardiovascular health system
NIH A MEDICAL HOME PILOT EVALUATION: A MODEL FOR COMPARATIVE EFFECTIVENESS RESEARCH UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON $475,086 Evaluate a rapid implementation of a medical home model on costs, patient acceptance, doctor acceptance, and impact on quality of care indicators. The model is supported by an open source technology stack that is highly scalable. The short implementation timeframe for physician adoption and the financial incentives for data management to assure quality are of a sufficient nature to gain widespread acceptance by primary care physicians. link unspecified health system
AHRQ COMPARING THE EFFECTIVENESS OF MEDICATION USE SYSTEMS IN SMALL RURAL HOSPITALS UNIVERSITY OF NEBRASKA MEDICAL CENTER $0 The purpose of the proposed research is to compare the effectiveness of two medication use technologies used by critical access hospitals - bedside bar-code administration and telepharmacy. 07/02/2010 link unspecified health system
AHRQ LONGITUDINAL COMPARATIVE EFFECTIVENESS & SAFETY OF BIOLOGICS IN AUTOIMMUNITY UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 Although various biologic medications have excellent efficacy for chronic inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel disease, their comparative effectiveness in terms of clinical response and safety are unknown. A collaboration between 2 CERTs and the Consortium of Rheumatology Researchers of North America (CORRONA) will gain an improved understanding of comparative effectiveness by evaluating clinical data from a prospective cohort study and through an analysis of national Medicare data from 2006- 2011. 10/01/2010 link other pharmaceutical only
AHRQ NEGLECTED BY THE EVIDENCE: THE INTERSECTION OF MEDICAL COMPLEXITY AND DEMENTIA RHODE ISLAND HOSPITAL $0 The research questions seek to investigate the cognitive, functional, and neurobehavioral outcomes associated with the use or discontinuation of certain psychoactive drugs in individuals with dementia and comorbid medical illness. 07/02/2010 link dementia, Alzheimer's pharmaceutical only
AHRQ A COMPARISON OF COGNITIVE AND DYNAMIC THERAPY FOR MDD IN COMMUNITY SETTINGS UNIVERSITY OF PENNSYLVANIA $0 The goal of the current proposal is to conduct a randomized, comparative, non-inferiority clinical trial that tests the hypothesis that a widely used form of manualized dynamic psychotherapy (supportive expressive psychodynamic therapy) is not inferior to cognitive therapy when implemented in community mental health settings for the treatment of major depressive disorder. 08/02/2010 link mental health
AHRQ COMPARATIVE EFFECTIVENESS OF CARDIOVASCULAR DEVICES AND MEDICARE COST GROWTH UNIVERSITY OF PENNSYLVANIA $0 Health care cost increases present a substantial challenge to the future fiscal stability of the Medicare program, and new health care technology is the leading cause of health care cost increases. This project will examine in detail how new technology increases health care costs, and it will investigate how cost growth due to new technology is influenced by conditions in local health care markets as well as Medicare's coverage policies. 08/02/2010 link unspecified other health technology, procedure
AHRQ TOOLS TO REDUCE INFANT RSV MORBIDITY AND ASTHMA: USE, ADHERENCE AND EFFECTIVENESS VANDERBILT UNIVERSITY $0 The objectives of this study are to determine the disparities in use, adherence and "real-world" effectiveness, and whether there are any important long-term protective effects on preventing diseases such as asthma, of a medication to prevent severe infant viral respiratory tract infections from a virus known as RSV. While there have been a number of clinical trials that have enrolled very select populations that have established "efficacy" (can it work?), the "effectiveness" (does it work?) data are limited and conflicting. We need to understand who gets this highly costly medication, who doesn't, does it work in the real-world, and can it prevent childhood asthma. 08/02/2010 link respiratory pharmaceutical only
AHRQ COMPARATIVE EFFECTIVENESS AND SAFETY OF DEPRESSION TREATMENTS DURING PREGNANCY HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) $0 Given the high prevalence of depression in pregnant women, the potential toxicity of antidepressant medications for the fetus, and the risk of relapse of major depression if untreated, it is critical to quantify the risks and benefits of alternative approaches used to manage depression during pregnancy. We propose to compare the effectiveness and safety of 1) specific selective serotonin reuptake inhibitors (SSRIs) and 2) continuing and discontinuing the medication for depression during pregnancy. 08/02/2010 link mental health pharmaceutical only
AHRQ MEASURING PEDIATRIC INPATIENT MEDICATION USE UNIVERSITY OF RHODE ISLAND $0 An analysis of the Premier, Inc. database has the potential to produce estimates of inpatient use, and variation in patterns by hospital. These analyses will lay the basis for future studies of comparative effectiveness, may contribute to planning and design of observational and clinical studies, and can also be used in future studies to measure and reduce medical errors, improve quality of care, and describe off-label medication use in hospitalized children. These can in turn inform the full range of policy and practice decisions, including drug labeling, warnings, and removal from the market, which require an understanding of the number of children affected, their ages, and other patterns of use. 06/23/2010 link unspecified
AHRQ RANDOMIZED ACTIVESTEP COMPARATIVE EFFECTIVENESS TRIAL DARTMOUTH COLLEGE $0 Falls are the leading cause of fatal and non-fatal injuries in the elderly. Each year an estimated 1/3 of older adults fall and by the year 2020, the total cost of fall related injuries is estimated to be approximately $54.9 billion. The proposed randomized comparative effectiveness trial will evaluate a newly approved fall prevention program (ActiveStep(R) training system) compared to a traditional physical therapy program for reducing the incidence and severity of falls in a geriatric population. 08/02/2010 link other other health technology, procedure
AHRQ SPECIFIC BIRTH DEFECTS AND ASTHMA MEDICATIONS IN PREGNANCY: DEMONSTRATION PROJECT BOSTON UNIVERSITY MEDICAL CAMPUS $0 To judge the comparative effectiveness of medications taken by pregnant women, both prescribers and patients need to know the comparative risks as well as the benefits. No comprehensive system exists to gather such information. Using a well-established study, we will demonstrate the feasibility of learning the risks of specific birth defects in relation to specific asthma medications most commonly used by pregnant women, and in collaboration with others, including an Independent Advisory Committee, demonstrate the feasibility of establishing an ongoing system for studying various adverse pregnancy outcomes in relation to the wide range of medications used in pregnancy, including prescription, over-the-counter, and herbal products. 08/02/2010 link respiratory pharmaceutical only
AHRQ DEEP SOUTH MUSCULOSKELETAL (DSM) CERTS UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 1) Improve safety and effectiveness of MSD therapeutics through four demonstration projects that effectively build on our major research domains of safety and effectiveness evidence generation and translating research into practice: (a) The Alabama NSAID Patient Safety Study, Phase II: Reducing Disparities in Risk Assessment and Communication; (b) Improving Osteoporosis Care for High-Risk Home Health Patients by a High-intensity Intervention; (c) Defining Serious Adverse Events from Biologic Therapies; and (d) Osteonecrosis of the Jaw: An Emerging Threat for Bisphosphonate Users; 2) Educate health care practitioners, insurers, and policy makers while broadening the public health impact of our research and educational portfolio about musculoskeletal therapeutics; and 3) In cooperation with AHRQ, other CERTs, and our network of partners, and building upon the themes, experience, and investigator talent pool of our CERTs, develop seed projects into full proposals that will be submitted to external funding agencies for peer review. 09/02/2010 link arthritis pharmaceutical only
AHRQ TRANSLATING INFORMATION ON COMPARATIVE EFFECTIVENESS INTO PRACTICE MAYO CLINIC COLL OF MEDICINE, ROCHESTER $0 In this study, we propose to study how using a decision aid during a patient office visit - a tool that helps patients understand the benefits and side-effects of each of the medications - can help patients make a decision and stick to their decision. We will also study what community-based practices need to do to effectively use these decision aids as part of their routine, and what factors affect the integration of the medication choice into patients' daily lives. 08/02/2010 link diabetes
AHRQ COMPARATIVE SAFETY AND EFFECTIVENESS OF STIMULANTS IN MEDICAID YOUTH WITH ADHD UNIVERSITY OF FLORIDA $0 Propose to expand our previous research with a retrospective cohort study of more than 500,000 youth with ADHD eligible for Medicaid benefits in 14 large states (representing 16 million youth and 70% of the entire pediatric Medicaid population) between 1999 - 2006 to: (1) evaluate the cardiac risk of stimulants overall, and of mixed amphetamine salts (MAS) versus methylphenidate (MPH) individually, on fatal or severe cardiovascular events; (2) assess whether stimulant risk is modified when used concomitantly with antipsychotics, antidepressants, or clonidine; (3) evaluate stimulant effectiveness overall, and between MAS versus MPH individually, on reduced risk for traffic citations and crashes. 10/01/2010 link developmental delays, ADHD, autism pharmaceutical only
AHRQ POST-ACUTE CARE IN ELDERLY TRAUMA PATIENTS: USE, OUTCOMES AND COSTS JOHNS HOPKINS UNIVERSITY $0 The broad research goals of this study are to understand what factors influence who and where elderly receive post-acute care after a major trauma, to determine what types of post- acute care settings lead to improved functional outcomes, and to identify patterns of post- acute care utilization and costs. The specific aims of this research study are: (1) to identify factors that influence initial post-acute care receipt and setting, specifically a) patient-level factors, b) health system-level and post-acute care geographic supply factors, (2) to determine the impact of post-acute care receipt and type of setting on short and long-term functional outcomes in elderly trauma patients, and on nursing home residence one year post-trauma; and (3) to identify common post-acute care utilization patterns, their effects on re-hospitalizations and costs to Medicare, as well as to patients and their caregivers. 10/02/2010 link unspecified health system
AHRQ Comparative Effectiveness of Medication vs. CBT in Depressed Low-Income Women NORTHWESTERN UNIVERSITY $0 This project will estimate the different trajectories that participants follow in response to treatment for depression and the socioeconomic and clinical features associated with these trajectories The comparative effectiveness of antidepressant medication versus cognitive behavioral therapy will be estimated within trajectories The overall goal is to contribute to the development of personalized depression interventions for disadvantaged populations 04/02/2011 link mental health
AHRQ Teamwork, Communication and Decision-Making: An Assessment Program Using Simulation Crises WASHINGTON UNIVERSITY $0 Two types of crisis medical teams will engage in simulation scenarios to determine what constitutes effective communication and decision-making processes and to determine how teams may avoid heuristics-driven diagnostic mistakes. Results will lead to better patient care nation-wide, as we aim to develop data-driven assessment and training procedures for future medical team members. 03/02/2011 link unspecified
AHRQ COMPARATIVE SAFETY OF ANTIRETROVIRALS AMONG HIV-INFECTED PATIENTS: MINIMIZING COR UNIVERSITY OF NORTH CAROLINA CHAPEL HILL $0 Propose to conduct analyses of the comparative safety and effectiveness of recent and long-term antiretroviral therapy on CHD morbidity and mortality, relying on a large HIV clinical cohort in the Southeastern United States (the UNC CFAR HIV Clinical Cohort) as well as the Medicaid and Medicare claims databases. 04/02/2011 link HIV/AIDS
AHRQ IMPROVING TRAUMA OUTCOMES USING HOSPITAL PERFORMANCE REPORTS UNIVERSITY OF ROCHESTER $0 The primary hypothesis to be tested is that providing trauma hospitals with information on their risk-adjusted outcomes will lead to improved outcomes. Trauma hospitals will be randomized to either receive or not to receive feedback on their comparative performance, and the effect of providing hospitals with benchmarking information will be analyzed. The proposed work will also determine whether "best practices" identified by surveying high-performance hospitals are associated with improved outcomes after controlling for patient risk and hospital quality. 04/02/2011 link unspecified
AHRQ IMPROVING END-OF-LIFE CARE FOR CANCER PATIENTS WITH VIDEO DECISION AIDS MASSACHUSETTS GENERAL HOSPITAL $0 Explore the use of video decision aids in assisting discussions between older patients with advanced cancer and their physicians. The present work of using video decision aids in end-of-life discussions in the context of cancer will serve as a prototype for other common diseases that involve difficult decisions. 03/02/2011 link cancer
AHRQ IMPACT OF COGNITIVE TRAINING ON BALANCE AND GAIT IN OLDER ADULTS UNIVERSITY OF ILLINOIS AT CHICAGO $0 This pilot study builds on the literature by testing the ability of exposure to cognitive training on executive function tasks over 10-weeks to improve outcomes related to gait and balance in a population of older adults. 02/02/2011 link dementia, Alzheimer's
AHRQ COST EFFECTIVENESS OF ANTICOAGULATION VERSUS GENETIC TESTING OF CYP2C9 & VKORC1 G HOWARD UNIVERSITY $0 This study proposes using a simulation model of the natural history of VTE to determine the cost-effectiveness of genetic testing for CYP2C9 and VKORC1 genes to guide long-term use of warfarin anticoagulation from the societal perspective. Methodology: A decision analysis using discrete event simulation will be developed to construct an economic model depicting the health states of a cohort of patients as the disease evolves over time. Associated costs and quality of life traits (utilities) of the complications will be captured. 08/02/2010 link other
AHRQ PREGNANCY OUTCOMES AND ASTHMA MEDICATIONS IN PREGNANCY: A DEMONSTRATION PROJECT UNIVERSITY OF CALIFORNIA SAN DIEGO $0 The OTIS Collaborative Research Group proposes in this demonstration project to test the feasibility of such a system by conducting a cohort study of 600 pregnancies comparing outcomes among asthmatic women who take the newly marketed long-acting beta2 agonists with or without inhaled corticosteroids to asthmatic women who are treated only with the older short-acting beta2 agonists as well as non- asthmatic women who take no such medication. 08/02/2010 link respiratory
AHRQ MOTOR VEHICLE COLLISION PREVENTION VIA EARLIER CATARACT SURGERY UNIVERSITY OF ALABAMA AT BIRMINGHAM $0 Simulation modeling will be used to examine how many motor vehicle collisions and deaths might be avoided if a threshold measure of vision, contrast sensitivity, were used to determine when cataract surgery ought to be performed and a draft guideline for earlier cataract surgery based on model findings will be developed and circulated for comment. 10/01/2010 link other
AHRQ COMPARATIVE EFFECTIVENESS OF ACE INHIBITORS FOR AFRICAN AMERICANS NEW YORK UNIVERSITY SCHOOL OF MEDICINE $0 Despite their proven efficacy in lowering blood pressure, ACE inhibitors may not provide the same benefits in African Americans as in Caucasians. The proposed study will examine the safety and clinical effectiveness of ACE inhibitor for African Americans relative to Caucasians, as well as the cost effectiveness of ACE inhibitors relative to other classes of antihypertensive medications for African Americans. 08/02/2010 link cardiovascular
AHRQ COST-EFFECTIVENESS OF WEIGHT LOSS PREVENTION IN NURSING HOMES: A CONTROLLED TRIAL VANDERBILT UNIVERSITY $0 The purpose of the proposed study is to evaluate the comparative cost-effectiveness of two nutrition interventions for improving daily caloric intake and weight status in long-stay nursing home (NH) residents. A controlled, intervention design will be used to determine the cost-effectiveness of oral liquid nutrition supplements with an alternative nutrition intervention that offers residents a choice between supplements and other foods and fluids between meals in a group of 250 residents across 4 NH sites. Resident outcomes, which will be independently monitored by research staff, include changes in caloric intake, body weight, nutrition and hydration status and quality of life measures. 08/02/2010 link other
AHRQ COMPARATIVE EFFECTIVENESS OF ALTERNATIVE LEVELS OF STROKE UNIVERSITY OF PENNSYLVANIA $0 Propose to compare 2 different levels of inpatient rehabilitation (acute rehabilitation services received while patients are still hospitalized for stroke). The first level is consultation where patients are seen by rehabilitation professionals while remaining on non-rehabilitation bed services within the hospital. The second level is higher intensity specialized. multidiciplinary rehabilitation services which occur when patients are admitted onto a specialized rehabilitation bed unit within the hospital. Primary outcomes will include functional recovery and home discharge from the acute hospital stay. One-year survival, long-term care placement, rehospitalization, and total health care costs will be secondary outcomes. The study is a retrospective observational comparative effectiveness study using data merged from 14 large administrative databases compiled from 153 VA Medical Centers. 08/02/2010 link other
AHRQ COLORECTAL CANCER RISK AFTER COLONOSCOPY IN ELDERLY DIABETES PATIENT AND MEN UNIVERSITY OF PENNSYLVANIA $0 Screening for colorectal cancer can reduce the risk of cancer and cancer-related mortality. Given the increased incidence of CRC in elderly male patients or elderly DM patients, it is important to determine whether the recommended 10-year interval between colonoscopies without polyps offers adequate protection to these high risk groups. Our study will help establish the appropriate time interval for elderly men and elderly DM patients to undergo a second colonoscopy following a negative colonoscopy so that they will not be facing an unacceptably high rate of preventable CRC morbidity and mortality. 08/02/2010 link cancer
AHRQ FUNCTIONAL RECOVERY IN LUMBAR SPINE SURGERY: INFLUENCE OF A BRIEF HEALTH BEHAVIOR JOHNS HOPKINS UNIVERSITY $0 The current proposal seeks to investigate the impact of a brief Health Behavior Change Counseling (HBCC) on patient activation and post-operative health behavior and functional recovery. We plan to enroll two consecutive cohorts of individuals undergoing elective surgery for degenerative disease of the lumbar spine. The first cohort will undergo standard preoperative care. The second cohort will undergo standard pre-operative care with an additional brief HBBC intervention session (a patient-centered directive method for eliciting motivation to change behavior). Both groups will be following for 24 months post-operatively. 08/02/2010 link other
AHRQ DOES SCREENING VARIABILITY MAKE DVT AN UNRELIABLE QUALITY MEASURE OF TRAUMA CARE? JOHNS HOPKINS UNIVERSITY $0 SA#1 will examine the impact of hospital-level ultrasound rates on DVT rates reported after major trauma. SA#2 will determine whether hospital duplex and DVT rates correlate with the presence of a hospital duplex ultrasound screening protocol for high-risk trauma patients. SA#3 will determine if patients are more likely to have DVT diagnosed and reported based on hospital characteristics, controlling for patient-level DVT risk factors using multi-level multiple logistic regression. 07/02/2010 link other other health technology, procedure
AHRQ COMPARATIVE EFFECTIVENESS OF ALTERNATIVE LEVELS OF STROKE UNIVERSITY OF PENNSYLVANIA $0 If successful, the project will develop, disseminate, and translate evidence about the expected outcomes and costs of alternative levels of acute rehabilitation in the care of persons with stroke-related functional limitations and disabilities. This study of the Veterans Health Administration's approach to the organization of acute rehabilitation will be directed not only to improving the care of veterans, but also to serving the Medicare and Medicaid programs by providing a disability management model for acute post-stroke rehabilitation. 08/02/2010 link functional limitations, disability
NIH COMPARATIVE EFFECTIVENESS IN GENOMIC & PERSONALIZED MEDICINE FOR COLON CANCER KAISER FOUNDATION RESEARCH INSTITUTE $1,999,998 Our comprehensive research program in GPM for colorectal cancer will have two main components: 1) secondary data collection through evidence synthesis and cost-effectiveness analysis, and 2) primary data collection through a proof-of-principle study to examine questions about personalized medicine for colorectal cancer. In the proof-of-principle study, we will evaluate the utilization of KRAS and Lynch Syndrome genetic tests within our health systems, and measure the effectiveness of KRAS testing compared with a patient population that does not receive testing. We will also conduct patient and physician interviews to measure psychosocial issues related to KRAS testing, and to help us understand how the genetic test results are used to inform decisions. 09/02/2010 link cancer
NIH COMPARATIVE EFFECTIVENESS OF BIOLOGICS FOR PSORIASIS UNIVERSITY OF PENNSYLVANIA $40,421 Create a highly innovative public-private partnership called CERSDN (pronounced "Sirs-DEN"), the acronym for the comparative effectiveness Research in Skin Disease Network, to rigorously study the comparative effectiveness of biologics for psoriasis. 12/14/3268 link unspecified
NIH RANDOMIZED OBSERVATION STUDY OF BIOLOGIC THERAPY FOR RHEUMATOID ARTHRITIS UNIVERSITY OF PITTSBURGH AT PITTSBURGH $40,421 we will obtain CCE data from collaborators at Harvard and also from the UPMC RACER. The UPMC RACER system will utilize a large network of UPMC rheumatologists that are already linked by an electronic medical record (EMR) system; the EMR will be used to identify RA patients and to capture information on treatment, medical costs and clinical laboratory data. goal of establishing the systems in order to effectively perform real-world cost-effectiveness research in patients with RA 05/27/5570 link arthritis
AHRQ Postmarketing Surveillance of Toxicities Associated with Cancer Chemotherapy UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON $0 link cancer
AHRQ DOES SCREENING VARIABILITY MAKE DVT AN UNRELIABLE QUALITY MEASURE OF TRAUMA CARE? JOHNS HOPKINS UNIVERSITY $0 SA#1 will examine the impact of hospital-level ultrasound rates on DVT rates reported after major trauma. SA#2 will determine whether hospital duplex and DVT rates correlate with the presence of a hospital duplex ultrasound screening protocol for high-risk trauma patients. SA#3 will determine if patients are more likely to have DVT diagnosed and reported based on hospital characteristics, controlling for patient-level DVT risk factors using multi-level multiple logistic regression. 07/02/2010 link unspecified
AHRQ RACE AND CARDIAC CATHETERIZATION USE IN THE SETTING OF ACUTE MYOCARDIAL INFARCTION YALE UNIVERSITY $0 The proposed work, an investigation of racial variations in the use of cardiac catheterization in patients with myocardial infarction, is consonant with AHRQ's research mission of understanding factors influencing access to quality health care, and addresses two priority populations, minority groups and the elderly. The proposal's three projects - rigorously evaluating the quality of race data reporting in administrative data and medical records; determining whether racial variations in cardiac catheterization use reflect overtreatment of white patients, undertreatment of black patients, or a combination of processes; and the impact of racial differences in cardiac catheterization use on long-term survival - will help inform current efforts to address racial disparities in health and health care use. 12/02/2010 link cardiovascular
AHRQ ADHERENCE WITH SLEEP APNEA TREATMENTS: A META-ANALYSIS VETERANS MEDICAL RESEARCH FDN/SAN DIEGO $0 This project will systematically search the PubMed database (supplemented by PsyInfo and the Cochrane Central Register of Controlled Trials) and use the techniques of meta-analysis to organize, quantitatively summarize, and statistically integrate the results of all published empirical research analyzing all correlates, determinants, and consequences of patient adherence (compliance) to interventions for SRBD that are given by healthcare providers. 07/02/2010 link other
AHRQ PREVENTING SUDDEN CARDIAC DEATH: HARNESSING THE POWER OF DECISION ANALYSIS, BAYESIAN STATISTICAL MODEL DUKE UNIVERSITY $0 Recent clinical trials of patients considered at risk for SCD have demonstrated that the implantable cardioverter defibrillator (ICD) is the most effective therapy currently available -- the magnitude of effectiveness of ICD therapy in clinically defined subgroups is unclear. The proposed research will combine patient-level data from 11 clinical trials along with decision analytic methods and Bayesian statistical techniques to explore several unanswered and timely clinical and policy questions related to the prevention of sudden cardiac death. 08/02/2010 link cardiovascular
NIH IMPROVED ESTIMATES OF THE COMPARATIVE TREATMENT EFFECTS OF CABG AND PCI STANFORD UNIVERSITY $499,846 This project will develop methods to use information from electronic medical records to reliably compare treatments for heart disease. Better methods to use electronic data collected in routine practice will help compare the benefits and risks of treatments in routine medical care settings. 08/02/2010 link unspecified
NIH ANALYSES OF REGISTRATION BIPOLAR PROPHYLAXIS TRIALS TO DEVELOP NEW STUDY DESIGNS UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER SAN ANTONIO $381,490 Researchers can conduct analyses of existing databases for systematic benefit/harm analyses or to compare interventions on "real life outcomes" such as level of functioning or acceptability, using meta-analytic methods by means of conducting a rigorous evaluation of the comparative effectiveness and overall impact of 7 different primary drugs employed in maintenance treatment of bipolar disorders. 09/02/2010 link unspecified
AHRQ DEVELOPING TREATMENT POLICIES FOR COMPLEX PATIENTS USING MODELING AND DATA MINING UNIVERSITY OF MINNESOTA TWIN CITIES $0 08/02/2010 link unspecified
AHRQ Realizing the Promise: Evidence-Based, Patient-Centered Care FOUNDATION/INFORMED MED/DECISION/MAKING $0 To identify and present the most promising conceptual frameworks system requirements methodological strategies and outcome measures required for implementing SDM and patient decision aids PtDAs into clinical practice with particular emphasis on: a Underserved populations low literacy low numeracy low income non English speaking rural patients inner city patients ; b Patients with chronic conditions; and c Cross cultural adaptation and dissemination of PtDAs and SDM 2 To examine the regulatory legal and payment policies required to accelerate the wide spread adoption of SDM and PtDAs into clinical practice 3 To identify the best ways to measure the effect of SDM on the quality of decisions and the implications for the quality and costs of care. link unspecified
NIH A COMPREHENSIVE MODEL TO ASSESS THE COST-EFFECTIVENESS OF PATIENT NAVIGATION UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER $357,468 The objective of the proposed study is to develop a comprehensive research framework to assess the cost-effectiveness of a PN program targeted at various points in the continuum of cancer care - screening, diagnosis, and treatment. 09/02/2010 link other
CDC RECOVERY: Comparing the Effectiveness of Traditional Evidence-Based Tobacco Cessation Interventions to Newer and Innovative Interventions Used by Comprehensive Cancer Control Programs Research Triangle Institute $2,546,139 This procurement is to support the development and implementation of a research protocol to: (1) define the most effective strategies to promote tobacco quitline use, and (2) compare the effectiveness of evidence-based traditional quitline interventions, newer web-based cessation interventions, and both interventions together on tobacco cessation 07/18/2010 link cancer
AHRQ COMPARATIVE EFFICACY OF TREATMENTS FOR LUMBAR SPINE UNIVERSITY OF WISCONSIN MADISON $0 We intend to establish a mechanism by which physicians of many specialties can contribute to a prospective database in order to allow for the comparison of outcomes following different treatments for similar disorders. The first step in this process is to agree upon the definitions, outcomes measures, and reporting mechanisms to be used. The proposed conference will be an important step in gathering relevant stakeholders together to work out the components of such a database. This is the first attempt to coordinate input from multiple medical societies, the insurance industry, and government overseers. 10/01/2010