Medical Panel Expenditure Survey

AHRQ released new Medical Panel Expenditure Survey (MEPS) data.

MEPS HC-114: MEPS Panel 11 Longitudinal Data File
Release date: December 2009

This file is a two-year longitudinal file derived from the respondents to the MEPS Panel 11 sample. The persons on this data set represent those who were in the MEPS population (U.S. civilian noninstitutionalized) for all or part of the 2006-2007 period.

 I took an hour or so and downloaded the file. I was able to quickly demonstrate that patients with diabetes spent $2643 per year more than others on prescription meds, that diabetes is more common in rural areas (even correcting for age, sex, race and ethnicity), that diabetes is LESS common in Hispanic subjects than non-Hispanics, but is MORE common in Puerto Ricans than either non-Hispanics or non-Puerto Rican Hispanics, and that rural subjects spent $118 per year more on prescriptions even controlling for age, sex, race, ethnicity and the presence of diabetes.

If you want to learn data analysis, this is a good place to start.

FW: Potential Candidates for Post-Doc Training Grant

On Behalf of Martin M. LeWinter, M.D.

I want to alert you to the fact that we will have an unusually large number of open slots coming come. Two slots will open up July, 2010 and one slot on August 1, 2010. If you have potential candidates, please let me know. Also, don't hesitate to speak to potential candidates at meetings (e.g., Biophysics) or solicit external applications. I will be also be doing some advertising via e mails, journals, etc., if we do not identify candidates quickly.
Happy New Year,
ML

Candidates must have a doctoral degree and be studying some aspect of heart or vascular disease.

Ben

NIH Exploratory/Developmental Research Grant Program (Parent R21)

This RFA is one to consider for new investigators or when there is not much preliminary work.

Title:  NIH Exploratory/Developmental Research Grant Program (Parent R21)

Program Announcement (PA) Number: PA-10-069

• Purpose.  ... The Exploratory/Developmental Grant (R21) mechanism is intended to encourage exploratory and developmental research projects by providing support for the early and conceptual stages of these projects. These studies may involve considerable risk but may lead to a breakthrough in a particular area, or to the development of novel techniques, agents, methodologies, models, or applications that could have a major impact on a field of biomedical, behavioral, or clinical research.
• Budget and Project Period.  The total project period for an application submitted in response to this funding opportunity may not exceed two years. Direct costs are limited to $275,000 over an R21 two-year period, with no more than $200,000 in direct costs allowed in any single year.
• Application Research Strategy Length: The R21 application Research Strategy section of the PHS398 may not exceed 6 pages, including tables, graphs, figures, diagrams, and charts.

I'm reading: Why do ineffective treatments seem helpful? A brief review

This article quotes both Clem McDonald and Paul Simon - what could be bad?

 Why do ineffective treatments seem helpful? A brief review

Steve E Hartman

Department of Anatomy, College of Osteopathic Medicine, University of New England, Biddeford, Maine 04005, USA

author email corresponding author email
Chiropractic & Osteopathy 2009, 17:10doi:10.1186/1746-1340-17-10

Published:	12 October 2009

Abstract

After any therapy, when symptoms improve, healthcare providers (and patients) are tempted to award credit to treatment. Over time, a particular treatment can seem so undeniably helpful that scientific verification of efficacy is judged an inconvenient waste of time and resources. Unfortunately, practitioners' accumulated, day-to-day, informal impressions of diagnostic reliability and clinical efficacy are of limited value. To help clarify why even treatments entirely lacking in direct effect can seem helpful, I will explain why real signs and symptoms often improve, independent of treatment. Then, I will detail quirks of human perception, interpretation, and memory that often make symptoms seem improved, when they are not. I conclude that healthcare will grow to full potential only when judgments of clinical efficacy routinely are based in properly scientific, placebo-controlled, outcome analysis.

Full text available here.

Jen Otten's media steamroller keeps on going

CTS alumna Jennifer Otten's paper on the effects of limiting TV viewing on caloric balance came out in the same issue of the Archives of Internal Medicine as a major paper on the cancer-causing effects of CT scans. The CT paper diverted media attention and stole a lot of the immediate thunder from Jen's work. Nonetheless, Jen's work has slowly been getting more and more attention in the media and the blogosphere. Most stories about newly published research fizzle out pretty quickly, but this one still has legs. For instance, the New York Times has published a second article about it!  That's pretty unusual and a testimony to the importance of her work.

The original work is here:

Otten J, Harvey-Berino J, Jones K, Littenberg B. Effects of a Television Viewing Reduction on Energy Intake and Expenditure in Overweight and Obese Adults: A Randomized Controlled Trial. Arch Intern Med 2009; 169(22):2109-2115.

UVM will be issuing its own press release on the story soon.

The competition is tough in research....

And the winner is...

Rich!

Jennifer Otten is famous!

Rumur has it that our own Jen Otten will be interviewed about the role of TV in obesity in Tuesday's New York Times!

Peter presents a poster!

Congratulations to Peter Durda. His poster on Strategies for Maximizing Variation Coverage of the Human Genome has been accepted for presentation at the Joint Conference - 50th Cardiovascular Disease Epidemiology and Prevention - and - Nutrition, Physical Activity and Metabolism Conference, scheduled March 2-5, 2010 at the Hilton San Francisco Union Square, San Francisco, California.

CTS Workshop 12/18/09 Notes

Present: Amanda, Ben, Abby, Kairn, and Rodger

Abby Crocker lead discussion on the article: "A Comparison of the General Linear Mixed Model and Repeated Measures ANOVA Using a Dataset with Multiple Mission Data Points."

In her work, Abby had been looking for an article that answered questions about how, why, and when to use General Linear Mixed Model (GLMM) measures and found a hole in the literature. She is considering writing a tutorial article for clinician researchers. She also wonders if GLMM, which appears to work for any kind of data, is “too good to be true.”

Here were some questions proposed and discussed:
-What are the advantages and disadvantages of GLMM?
-If you have a complete dataset, when does it make sense to use GLMM? When not?
-When is GLMM better than repeated measures ANOVA?

Ways to make a GLMM tutorial more understandable to clinicians may be:
-Use clinical rather than statistical terms in the bulk of the article
-Create visual examples of GLMM
-Use clinically interesting data
-Don’t compare to ANOVA
-Presenting an algorithm for when to use GLMM (Predictors: time, any data type; Outcomes: Any, except maybe nominal; Assumptions: some missing data OK, sample size limitations uncertain, must assert type of relationship such as linear or quadratic)

Next session: Jan 8.
I was called out of the room as the time ended. It is not clear if future topics were discussed.

Kairn Kelley

Happy Holidays

Hi everyone,
This is a reminder that there is no seminar next week.
Happy Holidays
Amanda

p.s. This is also a test of my posting abilities (Ben is standing next to me)

OBSSR/NIH Summer Institute on Design and Conduct of Randomized Clinical Trials Involving Behavioral Interventions

Applications Due January 15, 2010

OBSSR/NIH Summer Institute on Design and Conduct of Randomized Clinical Trials Involving Behavioral Interventions

July 11-23, 2010

Objective

To provide a thorough grounding in the conduct of randomized clinical trials to researchers and health professionals interested in developing competence in the planning, design, and execution of randomized clinical trials involving behavioral interventions. The curriculum will enable participants to:

    * Describe the principles underlying the conduct of unbiased clinical trials.
    * Identify the unique challenges posed by behavioral randomized clinical trials (RCTs).
    * Evaluate alternative RCT designs in terms of their appropriateness to scientific and clinical goals.
    * Select appropriate strategies for enrollment, randomization, and retention of participants.
    * Understand methods for monitoring, coordinating, and conducting RCTs.
    * Develop strategies for appropriate statistical analyses of RCT data.
    * Evaluate the quality of behavioral RCTs and interpret their results.
    * Design a RCT research project in collaboration with a scientific team.

Eligibility Requirements for Summer Fellows

Priority will be given to individuals who have received their PhD or MD (or equivalent degrees) not later than July 2008. Applicants must have at least two years of subsequent research experience. Applicants should not yet have achieved a tenured position at their institution. (The typical past participant has had 4-5 years of research experience.) Beyond these eligibility criteria we are seeking researchers who have demonstrated research potential and experience and who will clearly benefit from behavioral randomized controlled trial training. The ideal candidate will have prior experience, and will be actively pursuing an independent research career, in behavioral randomized clinical trials.

Further, those who have extensive research experience will only be considered after more junior investigators have been evaluated. Preference is also given to individuals who are not employees of NIH. While we will consider and may even accept exceptional applicants who do not meet the above criteria, priority will go to those who do.

Due to the limited number of spaces in the course, applicants must be citizens or non-citizen nationals of the United States, or must have been lawfully admitted to the United States for permanent residence (i.e., possess a currently valid Alien Registration Receipt Card I-551, or other legal verification of such status). Women, minorities, and individuals with disabilities are encouraged to apply.

Reasonable Accommodations for Disabilities: If you are accepted to attend the summer institute and require reasonable accommodations for disabilities to participate in this activity, at least 60 business days before the course begins please contact Ms. Sidnitra Bates at 301.577.0244, extension 64 or sbates@blseamon.com.

Costs and Stipends

The Office of Behavioral and Social Sciences Research, NIH, will pay for domestic (USA) travel to and from the Summer Institute site, room and board, and for course materials. Family members may accompany participants at their own costs.

Application Procedures

All application materials must be submitted online. Instructions and the application form are posted athttp://blsweb.net/obssrapp2attend2010/.

AHRQ Funding for Students and Fellows

This web site has links to various opportunities for US Agency for Healthcare Research and Quality grants to support pre- and post-doctoral students in clinical or outcomes research.

New publicaion by recent alumna

Jennifer Otten, PhD, and a recent graduate of UVM, just had this major publication:

Effects of Television Viewing Reduction on Energy Intake and Expenditure in Overweight and Obese Adults
A Randomized Controlled Trial
Jennifer J. Otten, PhD, RD; Katherine E. Jones, MS; Benjamin Littenberg, MD; Jean Harvey-Berino, PhD, RD

Arch Intern Med. 2009;169(22):2109-2115. 

The bottom line: cutting back on TV viewing did good things for people's calorie intake and activity.

The article got some nice press attention, such as Science Daily, and US News and World Report.

Biodiversity Loss Affects Global Disease Ecology

Check out this UVM authored paper http://www.uvm.edu/giee/publications/Pongsiri_Roman%20et%20al.pdf about how human activity affects biodiversity which then impacts the rates of infectious disease. Implications for health monitoring and conservation planning are discussed. From the article,

"Effectively addressing emerging diseases
requires adequate health infrastructure that recognizes
the environmental, epidemiological, and social drivers of
disease transmission."

Great topic for seminar.

Clinical Research Oriented Workshop (CROW) Meeting: Dec 11, 2009

Clinical Research Oriented Workshop (CROW) Meeting: Dec 11, 2009

Present: Abby Crocker, Kairn Kelley, Rodger Kessler, Ben Littenberg, Connie van Eeghen
Absent: Matt Bovee, Liz Chen, Kim Dittus, Amanda Kennedy, Charlie MacLean, Maria Ramos, Alan Rubin

1. Start up: Brrrr! OK, winter is here; I’ll stop whining.

2. Roundtable, with update, short term goals, long term goals
a. Ben: Demo on how to access and update the blog. These instructions will be presented here and these notes will be copied only to the blog, after this update. So pay attention:
i. Go to http://uvmcts.blogspot.com/
You will see the contents of the blog and you can read it without signing in. If you would like to sign in, click “Sign In” in the top right hand corner and enter your e-mail address and password. Next:
ii. Click on “New Post” and add your thoughts.
This is as informal as having a hallway bulletin board or a white board on which we leave each other notes. Make the blogspot a favorite (or even your home page) and we’ll all be able to ‘find each other’ easily and quickly.

Even MORE helpfully, you will get the updated notes (and other CTS updates) automatically by e-mail if, after accessing the blogspot, you click “Click here to subscribe by Email” and enter your email address. You do not need to “sign in” in order to make this work; you just need to visit the blogspot once. This means you don’t have to remember to check the blog to get these wonderful notes. Take note!

BTW: there was a way cool link on the blogspot called: Equator Network, which is right on the home page of the blog in the right hand column providing advice and guidelines on Reporting Health Research. It features RCT and other research guidelines which even includes QI (now you know why I was interested). Sounds like its worth a visit when you get to the blog and have a little time to look around.

b. Abby: state and national datasets for secondary data analysis:
i. There are data sets available for us to browse, understand, and use; we need to view and refresh ourselves on them regularly
ii. www.sgim.org/index... provides a Research tab that lists research data sets for review. Obtaining the data, and understanding how they were put together and should be used, is another task entirely. CTS participants may have the opportunity to become experts for a particular data set; it would be good to know who in our Center has that expertise.
iii. We could work on sample projects, taking a single data set and exploring it for research in areas in which we are already interested.
iv. Students can also pair with a faculty member to explore a data set based on a topic with the goal of a submittable abstract at the end of 28 days.
v. Charlie has designed a course for grad students (special topics) the outcome of which is to understand how research and policy connect with each other. See Charlie for more details.
vi. Our work fits in a model in which our intuition may feed a qualitative study which may lead to quantitative study which may lead to an intervention based control trial which may lead to a dissemination process or change in clinical or institutional policy. This process is not usually linear and it has different levels of success: immediate change or the “anechoic” effect (no echo back). Other choices aside from academic publication: market forces, legislative, judicial, and behavioral economics are other levers for making change. What works, and why, is part of what we need to understand.

c. Kairn: Future workshop meetings in the spring semester: no change to our current day and time. We will continue to meet on Friday mornings, 9:30 a.m. to 11:00 a.m.

3. Next Fellows Meeting(s): Dec 18, 2009 from 9:30 – 11:00 a.m., at Given Courtyard Level 4
a. Dec 18: journal club with Abby Crocker’s article to answer questions about generalized linear mixed models (no Connie – could someone else take notes?)
b. Future agenda to consider:
i. Dec 25: no Workshop
ii. Jan 1: no Workshop
iii. Jan 8: Connie – research update
iv. Skype demo: Connie & Matt? Wait until Amanda K is back. Or do twice?
v. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)
vi. Future: Informed consent QI: Connie to follow up with Nancy Stalnaker, Alan Rubin will follow up with Alan Wortheimer or Rob McCauly
vii. Workshop’s WIP (the history document) – discuss goals and progress, make recommendations, review and modify document, add Fellows’ orientation

4. Fellows document – nothing new this time

Recorder: Connie van Eeghen

FW: CS Grad Students Presentations

________________________________________
From: Kost, Rhonda M.
Sent: Friday, December 11, 2009 5:18 PM
To: Littenberg, Benjamin
Subject: CS Grad Students Presentations

I'll be doing a 20 minute presentation (Assessing Evidence of Diabetic Foot Exam by Natural Language Processing of Unstructured Clinical Notes) on Wednesday. The draft schedule had me listed just before lunch.

In case you would like to attend ....

Wednesday, Dec. 16
9:00 am - 5:00 pm
Perkins 101

CS Research Day 2009

Don't miss this conference of 13 presentations, with a keynote speech by Charles Colbourn of Arizona State University.

Funding to do research in Federal Labs

Dear Department Head:

As you may know, the National Research Council of the National Academies
sponsors a number of awards for graduate, postdoctoral and senior
researchers at federal laboratories and affiliated institutions. These
awards provide generous stipends ($42,000 - $75,000 per year for recent
Ph.D. recipients and higher for additional experience; Master's level
stipends are $38,000 per annum), and the opportunity to do independent
research in some of the best-equipped and staffed laboratories in the
U.S. Research opportunities are open to U.S. citizens, permanent
residents, and for some of the laboratories, foreign nationals.

We ask your assistance in informing students and faculty in your
department of these opportunities by copying this message to each one.

Detailed program information, including instructions on how to apply
online and a list of participating laboratories, is available on the NRC
Research Associateship Programs Web site at:

*www.national-academies.org/rap
<http://pull.xmr3.com/p/1327-533E/82473459/http-www.national-academies.org-rap.html>*

Questions should be directed to the NRC at 202-334-2760 (phone) or
rap@nas.edu <mailto:rap@nas.edu>.

There are four review cycles annually. Deadline dates for 2010 are:

February 1, 2010
May 1, 2010
August 1, 2010
November 1, 2010

Applicants should begin a dialogue with prospective Advisers at the lab
as early as possible, before their anticipated application deadline.

Thank you for your assistance.

Sincerely yours,
H. Ray Gamble
Director of the Fellowship Programs
National Research Council
The National Academies
5000 5th Street NW, Keck 568
Washington, DC 20001

SGIM Research Dataset Compendium

The SGIM Research Dataset Compendium is designed to assist investigators conducting research on existing datasets, with a particular emphasis on health services research, clinical epidemiology, and research on medical education. The detailed information provided by the SGIM compendium distinguishes it from other web-based compendia, which typically provide lists of datasets but give little information about their strengths and weaknesses and the insights of experienced users about making best use of the data. See their list of featured datasets at: http://www.sgim.org/index.cfm?pageId=864

Clinical Research Oriented Workshop Notes of Dec 4 09

Clinical Research Oriented Workshop (CROW) Meeting: Dec 4, 2009

Present: Abby Crocker, Kim Dittus, Amanda Kennedy, Rodger Kessler, Ben Littenberg, Connie van Eeghen
Absent: Matt Bovee, Liz Chen, Kairn Kelley, Charlie MacLean, Maria Ramos, Alan Rubin

1. Start up: Updates on where we are and what we’re doing next

2. Roundtable, with update, short term goals, long term goals
a. Connie: Spires of Excellence – Public Health Input – resulted in a wide ranging conversation about the strategic purpose of the UVM administration, past processes that were similar, the significance for the CCTS, and the impact on our role as largely independently funded researchers. The outcome is that Connie will submit her letter, primarily as a way of expressing her own interest in public health related research and to share that interest with the community of like-minded researchers and administrative leaders at UVM. (We also talked a lot about how to make the process of sharing our own work, within the CCTS and across UVM, more systematic without killing it with protocols. As with much else about CCTS, this is an unfolding set of answers about this new program.)
b. Connie: AHRQ Informed Consent Toolkit. The toolkit provides advice to:
i. Raise awareness among researchers
ii. Access resources about IC available on the web and through specific agencies
iii. Create mechanisms for change: education – especially around common concerns, advisory councils
iv. Improve the process, addressing:
1. The research culture within an organization
2. The need to train staff
3. Physical environment of consent
4. Plan to promote comprehension: translations, interpreters
5. Process of reading with potential subjects
6. Need for allowing time
7. Verifying understanding through teach-back (process example)
v. The toolkit provides a checklist, a “researcher’s certification tool,” to assist researchers in accomplishing IC. It provides sample forms which conform with regulations re: informed consent and HIPAA.
vi. Suggestions:
1. Use to update educational course materials we currently offer
2. Pass on to IRB for their consideration
3. Explore the possibility of a grant to study our use of IC and the application of ways to improve
vii. Next step: ask Alan Rubin about discussion at a Friday seminar. (He said yes; Connie will follow up with Nancy Stalnaker, Alan will follow up with Alan Wortheimer or Rob McCauly.)

3. Next Fellows Meeting(s): October 23, 2009 from 9:30 – 11:00 a.m., at Given Courtyard Level 4
a. Dec 11: blog seminar (Ben); state and national datasets for secondary data analysis – Abby (no Kim); calendar for next semester (Kairn)
b. Future agenda to consider:
i. Dec 18 (no Connie)
ii. Dec 25: no Workshop
iii. Jan 1: no Workshop
iv. Jan 8: ???
v. Skype demo: Connie & Matt? Wait until Amanda K is back. Or do twice?
vi. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)
vii. Workshop’s WIP (the history document) – discuss goals and progress, make recommendations, review and modify document, add Fellows’ orientation

4. Fellows document – nothing new this time

Recorder: Connie van Eeghen

Video Instructions for the new NIH forms

Here is a useful video describing the recent changes to NIH forms, including the new page limits and required sections. There are big changes to the Research, Biosketch, and Environment sections. Study up!

Faculty Publications

Congratulations to CTS faculty Liz Chen and Neil Sarkar on their recent publication:


Journal of Biomedical Informatics, In Press, Corrected Proof, Available online 20 October 2009
http://dx.doi.org/10.1016/j.jbi.2009.10.003

MeSHing molecular sequences and clinical trials: A feasibility study

Elizabeth S. Chen^a, b, d and Indra Neil Sarkar^{a, c, d, ,} 

^aCenter for Clinical and Translational Science, University of Vermont, Burlington, VT, USA

^bDivision of General Internal Medicine, Department of Medicine, University of Vermont, Burlington, VT, USA

^cDepartment of Microbiology and Molecular Genetics, University of Vermont, Burlington, VT, USA

^dDepartment of Computer Science, University of Vermont, Burlington, VT, USA

Received 3 September 2009.  

Available online 20 October 2009. 

Abstract

The centralized and public availability of molecular sequence and clinical trial data presents an opportunity to identify potentially valuable linkages across the bench-to-bedside “T1” translational barrier. In this study, we sought to leverage keyword metadata (Medical Subject Heading [MeSH] descriptors) to infer relationships between molecular sequences and clinical trials, as indexed by GenBank and ClinicalTrials.gov. The results of this feasibility study found that approximately 30% of sequences in GenBank could be linked to trials and over 90% of trials in ClinicalTrials.gov could be linked to sequences through MeSH descriptors. In a cursory evaluation, we were able to consistently identify meaningful linkages between molecular sequences and clinical trials. Based on our findings, there may be promise in subsequent studies aiming to identify linkages across the T1 translational barrier using existing large repositories.

Tweeting for Health

Recently, I blogged about collecting data from patients via brief text messages (SMS) over their cell phones. Today, we have communication in the opposite direction: sending prompts to patients to encourage certain behavior.

Text-Message Reminders to Improve Sunscreen Use: A Randomized, Controlled Trial Using Electronic Monitoring
April W. Armstrong, MD; Alice J. Watson, MD, MPH; Maryanne Makredes, MD; Jason E. Frangos, MD; Alexandra B. Kimball, MD, MPH; Joseph C. Kvedar, MD
Arch Dermatol. 2009;145(11):1230-1236.

This group sent the local weather report along with a reminder to wear sunscreen to 35 adults via their cell phones. After 6 weeks, sunscreen usage was 56% vs 30% among 35 control subjects (P<.001). The NNT (Number-Needed-to-Text) was a very low 3.8, suggesting that about 1 in 4 subjects responded to the messages. This is remarkably high success rate for such a low cost intervention and suggests that text messages might have broader applicability in health behavior change.

What other areas would benefit from a periodic cell phone reminder?  Where won't it work?

Research Directions in Understanding and Visualizing Rural Health Access and Traffic Safety

"Research Directions in Understanding and Visualizing Rural Health Access and Traffic Safety" Dr. Thomas Horan Associate Professor, Claremont Graduate University & Research Director, Center for Excellence in Rural Safety, University of Minnesota (UVM Class of '81) Monday, December 7th 10:00 to 11:00 a.m. Decision Theater, Farrell Hall UVM Trinity Campus (Directions) Please join us if you can. For more information, you may contact Richard Watts at RWatts@uvm.edu Metered parking, bike parking and CCTA bus service are all available. The Davis Center and Farrell Hall are wheelchair accessible.

Free, Public Use data from AHRQ

Lots of new data available from Uncle Sam for investigators to work with:

AHRQ is pleased to announce the recent release of the following data products and publications:
MEPS Data:
MEPS HC-113: 2007 Full Year Consolidated Data File
Release Date: November 2009
Released as an ASCII file (with related SAS and SPSS programming statements) and a SAS transport dataset, this public use file provides information collected on a nationally representative sample of the civilian non-institutionalized population of the United States for calendar year 2007. This file consists of MEPS survey data obtained in Rounds 3, 4, and 5 of Panel 11 and Rounds 1, 2, and 3 of Panel 12 (i.e., the rounds for the MEPS panels covering calendar year 2007) and consolidates all of the final 2007 person-level variables onto one file. This file contains the following variables previously released on HC-107: survey administration, language of interview variable, demographics, parent identifiers, health status, disability days variables, access to care, employment, quality of care, patient satisfaction, health insurance and use variables. The HC-113 file also includes these variables: income variables and expenditure variables. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-113
MEPS HC-112: 2007 Medical Conditions File
Release Date: November 2009
This public use data file provides information on household-reported medical conditions collected on a nationally representative sample of the civilian noninstitutionalized population of the United States for the 2007 MEPS Household Component. Released as an ASCII file (with SAS and SPSS programming statements, and also in SAS transport format), this public use file provides information on the household-reported medical conditions reported in the 2007 portion of Round 3 and Rounds 4 and 5 for Panel 11, as well as Rounds 1 and 2 and the 2007 portion of Round 3 for Panel 12 (i.e., rounds for MEPS panels covering calendar year 2007). ICD-9 and Clinical Classification Codes are provided. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-112
MEPS HC-110I: Appendix to MEPS 2007 Event Files
Release Date: November 2009
This public use release is one in a series of public use event files drawn from the 2007 Medical Expenditure Panel Survey (MEPS) Household (HC) and Medical Provider Components (MPC). This release contains 2 data files each of which is provided as an ASCII file with SAS and SPSS programming statements and as a SAS transport file. File 1 is used for linking the MEPS 2007 condition file (HC-112) with the MEPS 2007 event files (HC-110A through HC-110H); File 2 is used for linking the MEPS 2007 prescribed medicines event file (HC-110A) with other 2007 event files. This release also includes two tables provided as PDF files: Table 1, the "MEPS 2007 Condition-Event Frequency" table contains unweighted and weighted counts of records on the MEPS 2007 event files for each of the condition, procedure and clinical classification codes on the MEPS 2007 condition file; Table 2, the "MEPS 2007 Utilization and Expenditures Summary" table contains statistics for all of the utilization and expenditure variables contained on the MEPS 2007 person-level and event-level files. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-110I
MEPS HC-036: MEPS 1996-2007 Pooled Estimation Linkage File
Release Date: November 2009
This file is provided for use with pooled data from the MEPS FY 1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, and 2007 public use files (HC-012, HC-020, HC-028, HC-038, HC-050, HC-060, HC-070, HC-079, HC-089, HC-097, HC105, and HC-113 respectively). Released as an ASCII file (with SAS programming statements) and in SAS transport format, this person-level file contains 1996-2007 combined variance stratum and PSU variables, along with the standard MEPS person ID variables for linking with the 1996-2007 MEPS person-level public use files. There is one record for each of the 202,468 persons who are on the MEPS FY 1996-2007 public use files. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-036
MEPS HC-036BRR: MEPS 1996-2007 Replicates for Calculating Variances File
Release Date: November 2009
This file is provided for use with pooled or individual year data from the MEPS FY 1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, and 2007 public use files (HC-012, HC-020, HC-028, HC-038, HC-050, HC-060, HC-070, HC-079, HC-089, HC-097, HC-105, and HC-113 respectively). Released as an ASCII file (with SAS programming statements) and in SAS transport format, this person-level file contains the standard MEPS person ID variables for linking with the 1996-2007 MEPS person-level public use files and a set of 128 half sample indicators enabling the user to perform a balanced repeated replication (BRR) to calculate standard errors. There is one record for each of the 202,468 persons who are on the MEPS FY 1996-2007 public use files. The 1996-2007 combined variance stratum and PSU variables are released on HC-036. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-036BRR
Tabular Data:
2007 New MEPS Household Prescribed Drug Estimates: Top Prescribed Drugs by Total Expenditures and Top Prescribed Drugs by Total Purchases
Release Date: November 2009
The tables are available on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/quick_tables_results.jsp?component=1&subcomponent=0&year=2007&tableSeries=5&searchText=%251.%25&searchMethod=1

2007 New MEPS Household Prescribed Drug Estimates: Top Therapeutic Classes, by Total Expenditures and Total Purchases
Release Date: November 2009
The tables are available on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb//data_stats/quick_tables_results.jsp?component=1&subcomponent=0&year=2007&tableSeries=5&searchText=%252.%25&searchMethod=1
Tables of Insurance Component National-Level Summary for Series III and IV from the 2008 MEPS Insurance Component Survey
Release Date: November 2009
The tables are available on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/quick_tables_results.jsp?component=2&subcomponent=1&year=2008&tableSeries=-1&tableSubSeries=&searchText=%25IV.%25%2C%25III.%25%2CIII%2CIV&searchMethod=3&Action=Search
MEPS Publications:
Statistical Brief #269: Diabetes Management: Tests and Treatments among the Adult U.S. Civilian Noninstitutionalized Population, 2007
Release Date: November 2009   
This Statistical Brief uses data from the Household Component of the 2007 Medical Expenditure Panel Survey (MEPS-HC) to estimate the health status, preventive health practices, and treatment regimens of adults who reported having been diagnosed with diabetes. Rates at which persons with diabetes obtain preventive medical care and recommended tests are presented. The full Statistical Brief is available on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Statistical%20Brief&opt=2&id=934
 

The Quality of Behavioral Healthcare

Please disseminate throughout your organization! Time is Running Out! Don't miss out on your chance to present your work to a nationwide audience of professionals like you in a warm, beautiful beach environment. The deadline for submissions is 5PM EST on Monday, December 7, 2009. Call for Abstracts The gaps between research, practice and policy, in all configurations, significantly impair the rapidity of progress for improving health care quality. Given the tremendous disease burdens associated with drug abuse, problem alcohol and mental health conditions, and the impact of these conditions on other medical disorders, greater research focus is needed to align consumer preferences and values in care, improved care coordination across providers and service sectors, implementation strategies and workforce development to accelerate the adoption of evidence-based practices, and approaches highlighting how purchasers and employers might encourage delivery of high-quality behavioral healthcare. This scientific conference will encourage linkages between these often separate areas of behavioral services research into a more integrative behavioral health services research (BHSR) platform. This second year of a 3-year NIDA R13 scientific conference grant (with additional support provided by NIMH and NIAAA), continues the effort to 1) develop a collaborative and strategic research agenda to improve the quality of behavioral healthcare to people (across the life span) who suffer from drug abuse, problematic alcohol use, and mental health problems, and, 2) engage and partner researchers and other key stakeholders such as afflicted individuals, families, providers, policymakers, and communities to contribute to and implement a quality improvement agenda. A 'virtual collaboratory' will also be used to connect conference participants and to encourage and support the development of new research teams. Currently there is no one place for addictions, mental health and alcohol services researchers to meet exclusively and at one time on shared priority topics germane to behavioral health services research (BHSR). No professional group or association for BHSR exists. Common problems abound and often work does not cross the disciplines, so this 2010 scientific conference will highlight innovative strategies to improve the quality of behavioral healthcare focusing on a broad range of research examining issues of access to care and care coordination, the implementation of evidence-based practices, improvements in the measurement of quality outcomes, and, financing methods and systems change focused on improving care quality. The conference will be held on Clearwater Beach (FL) on April 13-14, 2010, with preconference methods workshops taking place on the afternoon of April 12th. The Sandpearl Resort (www.sandpearl.com) will be the setting for this year's meeting. Individual paper, poster, think tank and symposia abstracts are being solicited. Please consider submitting an abstract to the conference through our website athttp://bhsr.fmhi.usf.edu All abstract submissions must be received by December 7, 2009 at 5pm EST. Visit us at http://bhsr.fmhi.usf.edu Confirmed Pre-Conference Workshops: John Skvoretz, PhD, Department of Sociology, University of South Florida Nothing But Net(works): Basic Methods Hendricks Brown, PhD, University of Miami Miller School of Medicine Designing the Next Stage of Effectiveness and Implementation Research to Meet the Needs of Communities and Institutions Confirmed Plenary Presenters: Carolyn M. Clancy, MD, Director, AHRQ, DHHS Wilson Compton, MD, Director, DESPR, NIDA Invited Plenary Presenters: Richard Frank, PhD, Deputy Assistant Secretary, Assistant Secretary for Planning & Evaluation, DHHS Mark Willenbring, MD, Director, Division of Treatment and Recovery Research, NIAAA Redonna Chandler, PhD, Branch Chief, NIDA Services Research Branch David Chambers, PhD, Branch Chief, NIMH Division of Services and Intervention Research Sincerely, Alex Harris, Ph.D. Scientific Conference Co-Chair, Center for Health Care Evaluation, VA Palo Alto Health Care System Enola Proctor, Ph.D. Scientific Conference Co-Chair, School of Social Work, Washington University Junius Gonzales, M.D., M.B.A. University of South Florida, R13 Principal Investigator

Transdisciplinary Research in Energetics and Cancer (U54)

Transdisciplinary Research in Energetics and Cancer (U54)
(RFA-CA-10-006)
National Cancer Institute
Application Receipt Date(s): February 26, 2010
http://grants.nih.gov/grants/guide/rfa-files/RFA-CA-10-006.html

The National Cancer Institute (NCI) solicits applications for the centers for Transdisciplinary Research on Energetics and Cancer (TREC) in nutrition, physical activity, energy balance, obesity, and cancer. The TREC initiative (http://cancercontrol.cancer.gov/trec/) is designed to foster collaboration across multiple disciplines and encompasses projects that cover the biology, genomics, and genetics of energy balance to behavioral, socio-cultural, and environmental influences upon nutrition, physical activity, weight, energetics, and cancer risk. This initiative is open to all qualified candidates regardless of whether or not they participated in the previous issuance of the TREC Program. Applicants responding to this FOA should establish transdisciplinary research teams with the appropriate breadth of expertise. TREC has two main goals, which are: (1) to enhance knowledge of the current mechanisms underlying the association between energy balance and carcinogenesis (from cellular, animal or human models to genetics and genomics and across the cancer continuum from causation and prevention); and (2) to explore and integrate the etiology of obesity behavior and relevant health behavior theories, with broad population impact at the social-environmental and policy levels for prevention and control of obesity. Special focus on children, groups at high risk for obesity, and cancer survivors is encouraged. 

Update on the Requirement for Instruction in the Responsible Conduct of Research

The NIH has new guidance for the training of fellows and graduate students on K30 or other programs. Do we meet the requirements?

New NIH forms

It really doesn't get any more confusing than this! From NOT-OD-10-016:

For a period of time between now and early February, applicants must carefully select which version of the FOA and application package (forms and instructions) they should be using. Anyone submitting an application intended for due dates before January 25, 2010 (or before February 7, 2010 for those eligible for continuous submission on AIDS R01, R21, and R34 applications) must use the archived version of the FOA and SF 424 (R&R) ADOBE-FORMS-A application forms and instructions. Anyone eligible for continuous submission who is submitting a non-AIDS application should use the archived version of the FOA and SF 424 (R&R) ADOBE-FORMS-A through January 24, 2010, and use the updated version of the FOA and SF 424 (R&R) ADOBE-FORMS-B application forms and instructions provided with the updated version of the FOA on or after January 25, 2010.

So, pay attention!

What do maple, velveeta and a mug of pizza have in common?

Jean Harvey-Berino, PhD will give the Vogelmann Research Award lecture this Wednesday December 2 at 4 PM. There's a reception starting at 3:30 outside the room (101 Stafford) followed by the lecture form 4-5. 

Highly reccomended!

Goodbye to CRISP; hello, RePORTER

CRISP, the NIH web-based tool for searching funded grants, is no more. The new tool is RePORTER, available now.

Happy searching! 

New Book

Ralistic Evaluation by Ray Pawson and Nick Tilley. Sage, 1997.

This slim volume presents a paradigm for program evaluation with lots of "how-to" and examples.  Available now in the CTS library on S4.

Encyclopedia of Medical Decision Making

It's here!  The CTS library now has our very own copy of

Kattan MW. Encyclopedia of Medical Decision Making. Sage, 2009.

This is a 2-volume, 1200-page, multi-author work with articles on everthing about decisions from Acceptability Curves to Worldviews.  An excellent resource for those new to this field.  You can see it in the flesh in room S455.

Judge refuses to block lawsuit over patenting genetic tests

An interesting summary article at Ars Technica with links to more background information.

Researchers at the University of Utah identified two genes, BRCA1 and BRCA2, that are mutated in many families that have high incidences of breast and ovarian cancer. The University patented the use of this information for medical testing, and has licensed the patents to Myriad Genetics. The company has since attempted to prevent academic researchers that sequenced these genes in the course of their research from revealing the implications of the results to their patients.

(click on the title of this post to link to the article)

New Public Use Data from AHRQ

Thanks to Uncle Sam, These data are available for investigators to analyze. All you need is a little technical savvy, some statistical know-how, and  plenty of curiosity.

MEPS Data:
MEPS HC-111: 2007 Person Round Plan Public Use file
Release Date: October 2009
This MEPS public use release is one in a series of data releases drawn from the 2007 Medical Expenditure Panel Survey (MEPS) Household Component (HC). This release contains the Person Round Plan (PRPL) file for 2007. This file contains records for persons insured through private establishments providing hospital/physician, medigap, dental, vision or prescription medication coverage and includes variables pertaining to managed care and experiences with plans. These are designed to facilitate research on the sometimes complex and dynamic relationships between consumers and their private insurance. Released as an ASCII file with SAS and SPSS programming statements, and in SAS  transport format, the PRPL file is not a person-level file and linking it to a MEPS full year person-level file requires users making analytic decisions based on understanding the complexity of the PRPL file. The data is on the MEPS Web site at:  http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-111

MEPS HC-110D: 2007 Hospital Inpatient Stays File
Release Date: October 2009
This public use file is one in a series of event-level public use files drawn from the 2007 Medical Expenditure Panel Survey (MEPS) Household Component (HC). Released as an ASCII file with SAS format statements and in SAS transport format, the Hospital Inpatient Stays File provides detailed information on hospital inpatient stays. Data are gathered from a nationally representative sample of the civilian, noninstitutionalized population of the United States and can be used to make estimates of inpatient hospital stay utilization and expenditures for calendar year 2007. Each record represents one, household-reported, inpatient hospital stay reported during the 2007 portion of round 3 and rounds 4 and 5 for Panel 11, as well as rounds 1, 2 and the 2008 portion of round 3 for Panel 12 of the survey (i.e., the rounds for the MEPS panels covering calendar year 2007). The Hospital Inpatient Stays Public Use Data File is an event-level data file containing characteristics associated with the hospital inpatient stay event such as: the date of the hospital inpatient stay, reason for the stay, types of services received, condition(s) and procedure(s) associated with the hospital inpatient stay, whether or not medicines were prescribed and imputed expenditure data. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-110D

MEPS HC-110A: 2007 Prescribed Medicines File
Release Date: October 2009
This file is one in a series of public use event files from the 2007 Medical Expenditure Panel Survey Household Component  (MEPS-HC) and Medical Provider Component (MPC). Released as an ASCII data file and SAS transport file (with SAS and SPSS user statements) this public use file provides detailed information on household-reported prescribed medicines for a nationally representative sample of the civilian noninstitutionalized population of the United States and can be used to make estimates of prescribed medicine utilization and expenditures for calendar year 2007. Each record represents one household-reported prescribed medicine that was purchased during calendar year 2007. These data were collected during the 2007 portion of Round 3 and Rounds 4 and 5 for Panel 11, as well as Rounds 1, 2 and the 2008 portion of Round 3 for Panel 12 of the  MEPS-HC. Each record on this event file represents a unique prescribed medicine event; that is, a prescribed medicine reported as being purchased or otherwise obtained by the household respondent, and includes the following: an identifier for each unique prescribed medicine; detailed characteristics associated with the event (e.g., national drug code (NDC), medicine name, etc.); selected Multum Lexicon variables; conditions, if any, associated with the medicine; the date on which the person first used the medicine; total expenditure and sources of payments; types of pharmacies that filled the household's prescriptions; and a full-year person level weight. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-110A

MEPS HC-110G: 2007 Office-Based Medical Provider Visits File
Release Date: September 2009
This public use data file is one in a series of event-level public use data files drawn from the 2007 Medical Expenditure Panel Survey (MEPS) Household Component (HC). Released as an ASCII file with SAS (and SPSS) program statements and in SAS transport format, the Medical Provider Visits File provides detailed information on office-based medical provider visits. Data are gathered from a nationally representative sample of the civilian, noninstitutionalized population of the United States and can be used to make estimates of office-based medical provider utilization and expenditures for calendar year 2007. Each record represents one household-reported office-based medical provider visit reported during the 2007 portion of round 3 and rounds 4 and 5 for Panel 11, as well as rounds 1, 2, and the 2007 portion of round 3 for Panel 12 of the survey (i.e., the rounds for the MEPS panels covering calendar year 2007). The Office-Based Provider Public Use Data File contains characteristics associated with the office-based visit, such as, date of the visit, time spent with the provider, types of treatment and services received, types of medicine prescribed, condition codes, expenditures, source of payment associated with the visit and imputed expenditure variables. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-110G

MEPS HC-110F: 2007 Outpatient Visits File
Release Date: September 2009
This public use file is one in a series of event-level public use files drawn from the 2007 Medical Expenditure Panel Survey (MEPS) Household Component (HC). Released as an ASCII file with SAS (and SPSS) program statements and in SAS transport format, the Outpatient Visits File provides detailed information on outpatient visits. Data are gathered from a nationally representative sample of the civilian, noninstitutionalized population of the United States and can be used to make estimates of outpatient utilization and expenditures for calendar year 2007. Each record represents one, household-reported, outpatient visit reported during the 2007 portion of round 3 and rounds 4 and 5 for Panel 11, as well as rounds 1, 2 and the 2007 portion of round 3 for Panel 12 of the survey (i.e., the rounds for the MEPS panels covering calendar year 2007). The Outpatient Visits Public Use Data File contains characteristics associated with the outpatient visit and imputed expenditure data such as the date of the visit, whether or not a doctor was seen, type of care received, type of services provided, expenditures and sources of payment, and imputed sources of payment. The data is on the MEPS Web site at: 
http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-110F

MEPS HC-110E: 2007 Emergency Room Visits File
Release Date: September 2009
This public use file is one in a series of event-level public use files drawn from the 2007 Medical Expenditure Panel Survey (MEPS) Household Component (HC). Released as an ASCII file with SAS (and SPSS) program statements and in SAS transport format, the Emergency Room Visits File provides detailed information on emergency room visits. Data are gathered from a nationally representative sample of the civilian, noninstitutionalized population of the United States and can be used to make estimates of emergency room utilization and expenditures for calendar year 2007. Each record represents one, household-reported, emergency room visit reported during the 2007 portion of round 3 and rounds 4 and 5 for Panel 11, as well as rounds 1, 2, and the 2007 portion of round 3 for Panel 12 of the survey (i.e., the rounds for the MEPS panels covering calendar year 2007). The Emergency Room Visits Public Use Data File contains characteristics associated with the emergency room visit, such as, the date of the visit, types of care and services received, types of medicine prescribed during the visit, condition codes, expenditures, and source of payment associated with the visit, and imputed expenditure variables. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-110E

Doctor-patient communication survey

Interested in helping doctors and patients communicate better? We need your help.

We are conducting a NIH-sponsored study comparing five different ways to describe the risks associated with medical tests and treatments to patients

Study participation consists of completing a web-based survey. The time required should be less than 30 minutes. All responses will be kept anonymous.

The study in open to everyone 18 years old or older. It has been approved by the University of Rochester Institutional Review Board.

For more information or to request a survey please visit our website: https://sites.google.com/site/urcmdm/

James Dolan

Associate Professor at University of Rochester

 

Recent Publications from CCTS

Jennifer Otten, PhD (post-doctoral fellow at Stanford and recent aluma of Nutrition and CTS) presented her work at major national meeting last week.

Otten J, Jones K, Littenberg B, Harvey-Berino J. Can Reducing TV Viewing Increase Energy Expenditure in Overweight and Obese Adults? A Randomized Controlled Trial. The Obesity Society Annual Meeting, Washington, DC, October 24-28, 2009. Obesity 2009; 17: S272.

Several CTS faculty were involved in this report of an NIH-funded project:

Maclean CD, Gagnon M, Callas P, Littenberg B. The Vermont Diabetes Information System: A Cluster Randomized Trial of a Population Based Decision Support System. Journal of General Internal Medicine Published online October 27, 2009 http://www.springerlink.com/content/j175384173jhx410/

Congratulations!

Kudos for Rodger Kessler

Rodger Kessler, PhD, Assistant Professor of Family Medicine and CTS Faculty Scholar has been appointed Field Editor for the Society of Behavioral Medicine’s new journal, Translational Behavioral Medicine: Practice, Policy, Research.

Congratulations, Rodger!

New In the CTS Library - Case Study Research

Two new books inaugurate our new section on Qualitative Methods in the CTS library on S4 of the Given Courtyard.

Robert K. Yin.Case Study Research: Design and Methods. 4th edition. Sage, 2009.
Robert K. Yin. Applications of Case Study Research. 2nd edition. Sage, 2003.

Online chat with Whitehouse Senior Advisor on Health care reform

On Monday, November 2nd at 3:30 p.m. EST, Senior Advisor Valerie Jarrett will hold an extended online chat to discuss how health insurance reform will impact minority communities and all Americans. You can submit questions in advance at the below link and also click on the link to get all the details:
http://www.whitehouse.gov/administration/eop/ope/webform/valerie-jarrett-health-insurance-reform-all-americans

Kareem Dale
Special Assistant to the President
The White House
Phone: 202.456.4767
kdale@who.eop.gov

VERMONT CANCER CENTER 2009 Clinical & Translational Research Symposium

 REGISTRATION AND POSTER ABSTRACT DEADLINES  EXTENDED TO OCTOBER 30, 2009

WALK-INS WELCOME!

 VERMONT CANCER CENTER

2009 Clinical & Translational Research Symposium

Environmental Cancers: Risk Factors, Mechanisms and Therapies

 Friday, November 6, 2009

Grand Maple Ballroom

Dudley H. Davis Center

University of Vermont

Burlington, VT

Please join the Vermont Cancer Center, at the University of Vermont and Fletcher Allen Health Care, in collaboration with Dartmouth-Hitchcock Norris Cotton Cancer Center, for a free day-long research symposium featuring presentations focused on clinical and translational research at the Vermont Cancer Center, Norris Cotton Cancer Center, and other cancer research institutions, with particular emphasis on lung cancer/mesothelioma and skin cancers/melanoma.

For symposium agenda, online registration, and poster submission details, visit http://vermontcancer.org/researchsymposium09.

Registration for this event is free, but required by October 30, 2009. 

Please note: This event will focus on Environmental Cancers and not on Genitourinary/Gynecologic Cancers,

as was incorrectly listed on the Registration Page.

*****

CALL FOR SYMPOSIUM POSTER SUBMISSIONS

Participants may present posters on any area of cancer-related research, not only those relating to the symposium topics. Posters may have been presented elsewhere. A $125 award will be given in each of two categories: (1) Pre-doc/Post-doc or (2) Faculty/Staff. Poster abstract deadline extended: October 30, 2009. Space is limited.

This symposium is made possible with support from the Lake Champlain Cancer Research Organization.

For more information, please contact: Kelly O'Malley, Vermont Cancer Center Events Coordinator, 802-656-2176 / kelly.omalley@uvm.edu.