Institute’s focus: How research is changing in the ACA era

That the Patient Centered Outcomes Research Institute (PCORI) awards follow such patient-centric guidelines shouldn’t come as much of a shock; it’s in the organization’s name, after all.

But what may come as a surprise to unfamiliar researchers is that a patient is actually on the other end of their funding application, reviewing their submission and helping to decide who gets funded.

Tom Fogg, M.S., M.P.H.

Tom Fogg, M.S., M.P.H.

“A patient’s score counts just as much as a scientist’s,” said Tom Fogg, M.S., M.P.H., director of operations for the CTSI.  “It has a lot of implications for the way the application should be written.  It can’t be totally impenetrable – it has to be composed in a way that a general reader can understand it.”

Spawned by the Affordable Care Act (ACA), PCORI is just one of several funding sources that have been shifting their focus toward patient-centered outcomes.

At the Mini Summer Research Institute, which takes place on June 19, researchers, clinicians, and trainees can learn more about how the ACA has affected the funding landscape, and learn from colleagues who have had success navigating the still-being-charted waters.

Designed around a series of rapid-fire presentations, the day-long institute will provide attendees with targeted synopses on a wide variety of topics.  No individual presentation spans longer than half an hour — most, such as Fogg’s, which is on the PCORI review process, will only last 10-15 minutes.

Harriet Kitzman, Ph.D.

Harriet Kitzman, Ph.D.

Instead, the event will devote large portions of time to a series of panels and Q&As that allow attendees to dig deeper into whatever topic they are interested in.

“I think it will be helpful even for the established R01 investigators to get a sense of what the new directions are,” said Harriet Kitzman, Ph.D., co-director of the CTSI and director of the Center for Research Implementation and Translation, which is hosting the institute.  “We have a great panel in the afternoon to talk about the three major areas here in regards to the Affordable Care Act, and the research questions that are emerging from it.”

Among those questions: how to go about quality improvement research, which Kevin Fiscella, M.D., M.P.H., has been working on.

Kevin Fiscella, M.D., M.P.H.

Kevin Fiscella, M.D., M.P.H.

Fiscella will discuss the learning health care system, and will use several examples from his own research, including a recent study in which the IRB waived the consent process when his team was attempting to measure the effectiveness of cancer screening reminders.

“If you go out and find unscreened people and say ‘I want to enroll you in a controlled study of cancer screening,’ it immediately taints the whole study,” said Fiscella.  “So I think our IRB has taken an enlightened approach on some of these things.”

To register for the Mini Summer Research Institute, or to see the full list of presentations, click here.

CTSI co-director Harriet Kitzman receives Hutchison Medal

Harriet Kitzman was overwhelmed and appreciative, to be sure.

She was the first School of Nursing graduate — and only the fourth active faculty member — to receive the Charles Force Hutchison and Marjorie Smith Hutchison Medal, the university’s highest recognition of personal achievement.

HarrietKitzman

Harriet Kitzman, Ph.D.

But for Kitzman, the full magnitude of the honor didn’t quite sink in until her inbox began to fill with emails from all over the world.

“It was people that I’d mentored, that I’d worked with over time, and they’d come from all kinds of different places,” said Kitzman, senior associate dean for research at the School of Nursing. “It allowed me to make connections with people I hadn’t seen in decades. That was really rewarding.”

Kitzman, ’61W (MS), ‘84N (Ph.D.), who was presented with the Hutchison Medal by university president Joel Seligman at the School of Nursing Commencement Ceremony on May 16, was honored for her decades of research on the benefits of home nurse visitations for new mothers and infants.

Focusing on the economically disadvantaged, her research showed that these interventions lead to a broad range of positive outcomes for both mother and child, and her studies paved the way for shifts in health care policy nationally and internationally.

She was also recognized for her contributions as a mentor and role model in the School of Nursing, and as an inspiration to health care professionals around the world.

“She’s been such an amazing teacher, mentor, collaborator, and she has served the university in so many different roles,” said Madeline Schmitt, Ph.D., professor emeritus in the School of Nursing, who worked closely with Kitzman for much of her career. “I can’t think of anyone who would be better recognized in this way.”

Kitzman, who currently serves as co-director of the CTSI, thinks of her career in four stages, and each stage has helped shape health care in Rochester and throughout the country.

The first was when she led the development of the first graduate nurse practitioner program at the University of Rochester in 1971. Working alongside Loretta Ford, Kitzman worked to partner early nurse practitioners with pediatricians, allowing them to continue their education and obtain master’s degrees. Today, nearly 200,000 nurse practitioners are practicing in the United States.

“I turned to her one day and said ‘What’s it like to have created a program that makes up what we do everywhere now?’” said Nana Bennett, who along with Karl Kieburtz serves as co-director of the CTSI with Kitzman. “She’s just done incredibly important work during her career that really has changed the landscape for children and for parents.”

Kitzman moved on to become the first clinical chief/chair in the School of Nursing’s Unification Model, which brought together the nursing services in the Medical Center with nursing education and research, and became a national model for other nursing schools.

The third piece is her research, including the aforementioned nurse visitation studies.

“Usually when you do an experimental intervention, you get an initial impact, but it tends to diminish over time,” said Schmitt. “What this research program demonstrated — which is amazing — is that the further out you get from the initial intervention, the more powerful the impact.”

And the fourth portion is in her role as co-director of the CTSI.

“She really sees connections that some of us miss,” said Bennett. “We’ll often be discussing something and she’ll say ‘That’s similar to this,’ and very often, whatever the connection was will turn out to be extremely helpful.”

Kitzman, whose research is still ongoing, is a member of the American Academy of Nursing and continues to serve on a number of national and local policy committees.

CTSI welcomes new trainees and scholars

Person showing welcomeThe CTSI welcomes the following scholars and trainees that will begin their funded projects on July 1:

KL2 Scholars

Beau Abar, PhD (Mentor: Manish Shah, MD)
“Enhancing patient access to appropriate medical care across the lifespan, with a particular emphasis on access to substance abuse and other psychiatric treatment”

Suzannah Iadarola, PhD (Mentor: Tristram Smith, PhD)
“Mindfulness-Based Intervention for Parents of Children with Autism Spectrum Disorders”

Megan Lytle, PhD (Mentor: Vincent Silenzio, MD, MPH)
“Lesbian, gay, bisexual, and transgender (LGBT) health disparities/suicide prevention”

CTSI Year Out Trainees

Josef Bartels (Mentor: Ronald Epstein, MD)
“The Qualities of Science”

Michael Geary (Mentor: Regis O’Keefe, MD, PhD)
“Modulation of the prostanoid receptor EP4 to reduce scarring during flexor tendon healing”

Trevor Hansen (Mentor: Howard Langstein, MD)
“Thy1 Expression as a Marker and Therapeutic Target for Scar Formation in Capsular Contracture Following Reconstruction Mammoplasty”

Kelly Makino (Mentor: Anton Porsteinsson, MD)
“Advance Care Planning in Early Dementia Study”

Kyle Rodenbach (Mentor: George Schwartz, MD)
“Cystatin-C-based renal reserve in children with history of hemolytic uremic syndrome-associated acute kidney injury”

Lauren Roussel (Mentor: Howard Langstein, MD)
“Evaluating Upper Extremity Function Following Mastectomy in Reconstructed and Non-Reconstructed Women with Breast Cancer”

Elizabeth Saionz (Mentor: Jeff Bazarian, MD, MPH)
“Post-concussion progesterone decline in female athletes”

Lindsay Wahl (Mentor: Patricia Sime, MD)
“One Protein, Multiple Functions: The Role of Tissue Transglutaminase in Pulmonary Fibrosis”

To learn more about the CTSI Year Out program, click here. To learn more about the KL2 program, click here.

Scholar Spotlight: Jarrod Bogue

Jarrod Bogue, CTSI Year-Out Trainee, shares his research on bacteria riboswitches and the creation of new antibiotics. Check out a poster of Jarrod’s work in the atrium of the Saunders Research Building.


If you’d like to see your research featured in the CTSI blog, email Sean_Dobbin@urmc.rochester.edu.

“Synergy” not just a buzzword for UNYTE Translational Research Network

Fish oil and aspirin work pretty well together — better, actually, than the sum of their parts.

And as it turns out, the same can be true of clinical researchers and basic scientists.

BobBlock

Bob Block, M.D.

For the past four years, Bob Block, M.D., MPH, of the University of Rochester Medical Center; Tom Brenna, Ph.D., of Cornell University; and Shaker Mousa, Ph.D., MBA, of the Albany College of Pharmacology and Health Sciences have worked together to advance research on the interaction of fish oil and aspirin.

They’ve captured a handful of grants and have published nine peer-reviewed articles in leading journals.

And they all say that none of them would have been able to do it on their own.

The UNYTE Translational Research Network exists to promote collaborations such as this one, and on May 16, neuroscience researchers are invited to attend a free, half-day UNYTE program at the University of Rochester Medical Center, where attendees from universities across the region will meet to share expertise and knowledge with one another.

ShakerMousa

Shaker Mousa, Ph.D.

Collaborations

The word ‘synergy,’ corporatized and beaten to cliché, can draw eyerolls when used in conversation.  But there isn’t a better word to describe what UNYTE has been working towards since its inception: bringing researchers together to share expertise and capabilities in the hopes of producing stronger results than any collaborator could achieve on their own.

When Block, Brenna, and Mousa met several years ago — through an early collaborative network that preceded UNYTE — they realized that they each had something to contribute to a study on the effects of fish oil and aspirin in patients.

TomBrenna

Tom Brenna, Ph.D.

The University of Rochester Medical Center, where Block works as a clinician and researcher, has one of the best clinical centers in the state.  Here, subjects could be tested.  But when it came to the basic science necessary for the research — specifically, the analysis of the metabolites present in the patients after taking their doses of aspirin and fish oil — Brenna’s lab at Cornell was better equipped.

“We’re really one of the great places for studying woodchuck biology, but maybe not humans as much, so being connected to the clinical center in Rochester was important,” said Brenna.  “I certainly couldn’t have done those studies here.”

Mousa, meanwhile, had a lab set up in Albany that was adept with analysis of Omega-3 fatty acids.

“It’s not 1 plus 1 plus 1 equals 3,” said Mousa.  “It’s 1 plus 1 plus 1 equals thousands.”

Thousands of dollars in grant support, that is.

As the research progressed, the coalition showed that fish oil and aspirin could interact in ways that reduced platelet function — important for those who are fighting cardiovascular disease.  Their early work was published in several journals, spawning additional support, and most recently, Block, Brenna, and Mousa were awarded a $275,000 R21 grant from the National Institutes of Health to further their studies.  Next, they’re hoping to file for a joint R01 grant.

Event

In addition to the lab capabilities brought by each collaborator, Block, Brenna, and Mousa were able to bounce ideas off one another throughout the length of the research.

“For the R21 study, we gave patients fish oil, aspirin, and both, and Dr. Brenna was saying that we should really measure blood levels for the Omega 3s as well,” said Block.  “So we did, and we were really glad we did.  So it’s nice to have different ways of thinking.  That’s where the power is in a collaboration like this.”

At UNYTE’s half-day neuroscience conference, researchers from about a dozen different universities are expected to attend.  Keynote speakers are Jonathan Wolpaw, M.D., and Gerv Schalk, Ph.D., of the Wadsworth Center, the Public Health Laboratory for the NYS Department of Health in Albany.

To register, or for more information, click here.