Monday, March 14, 2011

Clinical Research Oriented Workshop (CROW) Meeting: March 10, 2011

Present: Abby Crocker, Amanda Kennedy, Ben Littenberg, Charlie MacLean, Connie van Eeghen

1. Check In:

a. Consumer testing new health care names – we like “P1 Works!” (Careful, though; it has an odd acronym.)

b. Ben showed off his Galaxy 1 (an Android phone without the phone); designed to fit into a suit pocket but is large enough to see and type on (think of it as “Mama Bear”)

2. Abby’s Update: Plan for tomorrow’s presentation

a. Research domain: substance abuse during pregnancy; treatment of newborns; many issues; hard to pick one focus

i. Keep candidate “new ideas” for later harvesting

ii. Balance number and focus of questions with ability to derive a response

iii. Future data sources: primary chart review (500 paper only records to collect the actual NAS scores and total dose of Methadone administered to infants; may currently be found in EPIC for past 2 years); Medicaid claims

iv. Other data desired: other illicit substances, clinical dose of therapeutic treatment, infant head circumference

v. “What is the effect of opiod management in pregnant women?” Many ways to answer this question; it is not possible to take every angle. OK to identify which will be taken and which not, or may be taken in the future.

b. Goal for tomorrow:

i. Present PhD objectives, domain, mentors, initial overview, literature synopsis, and initial question

1. “An Exploratory Analysis: Predictors of medication required for NAS symptoms in infants born to mothers treated with Methadone or Buprenorphine during pregnancy at FAHC (2006-10)” (with no hypothesis presented)

2. Univariate results of four variables in handout where p value is <= .10:

a. Birth weight, z-score

b. Maternal age at delivery

c. Maternal treatment = Buprenorphine %

d. Estimated Gestational Age at initial Ante Partum Visit

3. Include NAS definition, how determined, and inclusion details

4. This study does not include mothers whose treatment program was unknown and mothers not in a treatment program (70 people in total) but these are clinically relevant populations to study

ii. Plan for next steps:

1. Complete data collection

2. Conduct multi-variate regression

3. Goal: develop a model of what drives NAS

a. Develop a predictive scoring system

b. Test via a RCT or against another data set

3. Next Workshop Meeting(s): Thursday, 2:30 p.m. – 4:00 p.m., at Given Courtyard Level 4

a. March 17: John Senders - engineer and psychologist with deep expertise in human error and an international authority on medical errors; Ben as host

b. March 24: Rodger: NCQA survey data (no Connie)

c. March 31: Rodger: State wide mental health in Blueprint evaluation design (no Amanda)

d. April 7: (no Connie)

e. April 14: (no Connie)

f. zz: Rodger - discuss a research design for evaluating mental health contribution in BP PCMH practices; Craig Jones and Beth Tanzman (new member of his team) will be guests

g. Future agenda to consider:

i. Rodger: Mixed methods article; article on Behavior’s Influence on Medical Conditions (unpublished)

ii. 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)

Recorder: Connie van Eeghen

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