Youtube with a unique way to display data visually

I looked at this Youtube and saw data points making order out of chaos. See what you think:

http://www.youtube.com/watch?v=yVkdfJ9PkRQ&feature=player_embedded

Fifteen uncoupled simple pendulums of monotonically increasing lengths dance together to produce visual traveling waves, standing waves, beating, and (seemingly) random motion

Clinical Research Oriented Workshop (CROW) Meeting: July 21, 2011

Present: Amanda Kennedy, Rodger Kessler, Connie van Eeghen

1. Check in: Newly available – policies for the CTS PhD program; see Amanda if interested.

2. Rodger: R01 redesign

a. Note – this is part of two projects underdevelopment, the other of which is an R03 that Connie is working on. Partners for the R01 (likely to be submitted to NIMH) besides Rodger: Ben, Connie, and others, possibly including Amanda. There are other strategies (besides an R01) to consider whether other grant mechanisms and institutes are appropriate but as an R01, it needs external (to VT) partners, of which Rodger has two candidates (NJ and San Diego).

b. The R01 announcement is not about improving clinical care but about evaluation and research, testing, for example, the consistency of implementation across settings, staff, and time. It is also about studying dissemination and implementation; it does not require a RCT design.

c. Scope needs to be narrowed from original plan. Rodger’s study goal is to compare the effectiveness of a set of alternatives in collaborative care, not to prove causality, but to evaluate how they stand with respect to RE-AIM criteria and to explore variation. The design to support this question may be cross-sectional (no time series) or cohort (over time). Choices from Rodger’s handout were reviewed (see below, with discussion notes interspersed).

i. Possibility 1 Q: Does a systematically developed and implemented collaborative care intervention improve clinical, organizational and financial processes and outcomes compared to regular care? Not really novel, does not have much chance of considerably impacting on the field. Not personally exciting to Rodger.

ii. Possibility 2 Q Does systematically defined and implemented collaborative care improve clinical, organizational and financial processes and outcomes compared to practices that have implemented cc with no attention to formal intervention design or implementation? More interesting - could impact the field moderately - not sure that study section will get it. May be difficult to recruit.

iii. Possibility 3 Q Does systematically defined and implemented collaborative care (to be relabeld ~integrated care) in a set of primary care practices including FA PC practices and outside of Vermont practices who are interested in but have not yet moved to implementing collaborative care who agree to implement the FA PCBH intervention- improve clinical, organizational and financial processes and outcomes compared to practices that have adopted the Katon/Unutzer IMPACT nurse care manager with psychiatric oversight model of primary care treatment of psychiatric conditions (the gold standard in research but which, so far, has low uptake). Novel, Interesting, feasible large impact on field- Not sure it is implementation research- rather comparative effectiveness.

1. Not randomized: leaves open the question of bias; a design issue related to subject selection. May need to collect an “interest cluster” and randomize within the cluster.

2. Timing of grant implies a 2012 start or later. Likely, the projects will start before the grant is approved using EMR data retrospectively and prospectively, sampled repeatedly over time.

3. Consider a pre/post design; each subject serves as their own control. Start ups can be staggered.

3. Next Workshop Meeting(s): Thursday, 9:30 a.m. – 11:00 a.m., at Given Courtyard Level 4

a. July 28: cancelled (No Ben, Abby, Rodger)

b. Aug 4: Rodger: Implementation planning for next Integrated BH site at FA (No Abby)

c. Ben is on vacation July 16 – 30 and out Aug 4; Abby is on vacation August; Amanda is teaching Tues & Thurs 1 – 4 from July 1 – Aug 26

d. 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: C. van Eeghen

Clinical Research Oriented Workshop (CROW) Meeting: July 7, 2011

Present: Sarah Gillett, Kairn Kelley, Amanda Kennedy, Rodger Kessler, Ben Littenberg, Connie van Eeghen

1. Check in: What do we really know about the population of people eligible for SA therapy involving bupenorphine? Rodger has interest in an R01 grant submission opportunity related to behavioral therapy; Charlie and Rich are involved in supporting opiod prescribing for providers as part of the academic detailing program. Rodger to follow up.

2. Rodger and Connie: R03 Goal Statement

a. Connie reviewed the purpose of this response to a RFA: create a manual to integrate behavioral health (BH) services into primary care practices. The manual offers options in how to integrate and a prescriptive method to conduct the quality improvement (QI) process.

i. The group maintained a debate throughout the presentation about whether “a manual” is the real purpose of this proposal. The purpose is to implement and disseminate BH services in primary care; the QI method and the tools needed to do are background technical requirements that are essential but not the purpose of this effort.

ii. The language of the proposal must mirror the R03 announcement.

b. Audience: leaders of primary care practices. The group tested the “marketability” of the resulting “tool kit” (or manual, process, hyperlinked document, or other products of this work). They questioned whether the proposal underway already had answers for:

i. What aspects of BH are wanted by primary care clinicians and leaders?

ii. What is the most effective way to implement those aspects (recruitment, training…)?

c. The group confirmed that this proposal is pre-alpha phase; Connie will be the “user” of the tool kit before it is trialed on a practice. Furthermore, the alpha phase of testing may be a virtual test, around a table with clinicians to see if they understand and can visualize using it. Measures of success may be based on the evaluation of outside observers on completeness, consistency, and comprehensibility.

d. The aims of the proposal do not state all of the expectations above.

i. Aim 2: Provide instructions on the process necessary for the clinic to develop a strategy to be able to choose a menu option

ii. Aim 4 (new): Pilot test and evaluate the tool kit to meet the goals of an R18 project with a broader population.

e. Support needed:

i. Out of state physician support: contact nancy Morris, Springfield, MA at Bay State

ii. UVM physician collaborator (Ben)

iii. Primary care provider advisory board

3. Sarah: Poster Presentation

a. Sarah is heading to Japan in two weeks with a poster on “Inflammation and Decline in Learning and Memory Function in the Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study”

i. CRP, a stroke risk marker, may be associated with cognitive decline learning, memory, and executive function

ii. CRP may mediate racial differences in decline

b. International Society of Thrombosis and Hemostatis; focus is on biology but as member of grant, Jennifer received funding for peer review from scholarship (acknowledge at bottom)

c. Poster sessions are for developing collaborators, friends, and new insight into pilot studies

d. Travel expense forms, by the way, are getting more complex.

4. Next Workshop Meeting(s): Thursday, 9:30 a.m. – 11:00 a.m., at Given Courtyard Level 4

a. July 14: Abby (No Rodger)

b. July 21: Rodger (No Ben)

c. July 28: Connie (No Ben)

d. Aug 4: (No Abby)

e. Change to new time for our meetings for July and August: Thursday morning 9:30 – 11:00

f. Ben is on vacation July 16 – 30 and out Aug 4; Abby is on vacation August; Amanda is teaching Tues & Thurs 1 – 4 from July 1 – Aug 26

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: C. van Eeghen

Clinical Research Oriented Workshop (CROW) Meeting: June 30, 2011

Present: Abby Crocker, Kairn Kelley, Amanda Kennedy, Rodger Kessler, Jennifer Libous, Ben Littenberg, Charlie MacLean

1. Abby: Dissertation Plan

a. Abby presented an outline that she will be bringing to her dissertation committee this week. The membership on the committee was discussed, research questions were modified, analytic plan was touched upon. Additional information on the distinction between the dissertation committee, comps committee, and "studies committee" was provided.

2. Amanda: AHRQ Study Section Update

a. Amanda gave an update from her participation in AHRQ study section and the impact of the new scoring system. In short, large grants are being funded at much lower rates than in the past. One interpretation of this is that the new system works to get exceptional proposals to the top of the pile, but many excellent projects are not distinguished from the middle of the pile.

3. Next Workshop Meeting(s): Thursday, 9:30 a.m. – 11:00 a.m., at Given Courtyard Level 4

a. July 7: Connie: R03 Grant Development and Case Study #2 Data Plan

b. July 14: Rodger?

c. July 21: Abby?

d. July 28: Kairn? Or Connie?

e. Change to new time for our meetings for July and August: Thursday morning 9:30 – 11:00

f. Ben is on vacation July 16 – 30 and out Aug 4; Abby is on vacation August; Amanda is teaching Tues & Thurs 1 – 4 from July 1 – Aug 26

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: K. Kelley

A National Agenda for Research in Collaborative Care

Congratulations to Rodger Kessler, PhD, Assistant Professor of Family Medicine, for publishing a series of major policy papers commissioned by AHRQ.  The full papers are available here. A National Agenda for Research in Collaborative Care

Papers from the Collaborative Care Research Network Research Development Conference This collection of three research papers represents the fruits of the AHRQ-funded Collaborative Care Research Network Research Development Conference in Denver in October 2009. At the meeting, participants took steps toward establishing a research agenda for collaborative care among primary care and mental health clinicians. Collaborative care emphasizes the recognition and care of mental health problems in primary care settings and the effective collaboration of primary care and mental health clinicians. Collaborative care is regarded as an important function of the patient-centered medical home (PCMH), and one avenue toward achieving PCMH goals for health, patient experience, and affordability. The three papers are: Establishing a Research Agenda for Collaborative Care (Miller, Kessler, and Peek). A Framework for Collaborative Care Metrics (Kessler and Miller). A Collaborative Care Lexicon for Asking Practice and Research Development Questions (Peek). Select to download print version (PDF File, 800 KB). PDF Help. Investigators: Benjamin F. Miller, Psy. D., University of Colorado School of Medicine Rodger Kessler, Ph. D., ABPP, University of Vermont College of Medicine C.J. Peek, Ph.D., University of Minnesota Medical School Editor: Charlotte Mullican, M.P.H., Agency for Healthcare Research and Quality Contents Overview    The Papers    From Lexicon Definitions to Practical Metrics: The Flow of Concepts in the Papers Establishing the Research Agenda for Collaborative Care    Abstract    Introduction    Methodology    Toward a Collaborative Care Lexicon    The Method for Producing the Research Agenda—The Conference    Results    Financial Research Questions    Summary A Framework For Collaborative Care Metrics    Abstract    Access to Behavioral Care for Medical Patients: Insufficient    Uncertainty about Characteristics of Ideal Care    Discussing Collaborative Care with a Common Consensually Derived Language    The Need for Definition and Measurement    Parameters of Measurement    Collaborative Care Measures and Metrics    Summary A Collaborative Care Lexicon for Asking Practice and Research Development Questions    Abstract    Introduction: A Place in a New Movement for an Old Idea    Consistent Language for research in Collaborative Care    A Method for Creating a Lexicon for Collaborative Care    The Product—A Lexicon for Collaborative Care    Applications for the Lexicon    Conclusion: The Need for Consistently Understood Concepts and Vocabulary in Emerging Fields