Tuesday, January 15, 2013

Clinical Research Oriented Workshop (CROW) Meeting: Jan 10, 2013

Present: Kairn Kelley, Amanda Kennedy, Rodger Kessler, Ben Littenberg, Charlie MacLean, Connie van Eeghen

1.                  Start Up:  How much money is it possible to spend on a watch?  Try $4.5m, per Rodger.  There is no process that we can think of that quite explains this resource allocation.

2.                  Presentation: Kairn: F31 grant application for career development of pre-doctoral fellows: stipend, research, and tuition for 2-5 years.
a.       The FINER question is “Do symptoms of ADHD affect the reliability of dichotic word tests?”
b.      Aims: recruitment, test administration, data collection (including scoring of ADHD and treatment of children for ADHD), results, relationship between ADHD and test results.  Questions of interest:
                                                  i.      Does ADHD impair the reliability of DWT?
                                                ii.      What is the distribution of DWT scores in an unselected pop?
                                              iii.      What is the test-retest reliability of DWT in unselected pop?
                                              iv.      Do scores differ in ADHD vs. non-ADHD?
                                                v.      Does reliability differ in ADHD vs. non-ADHD.
c.       FINER:
                                                  i.      Feasibility: pending
                                                ii.      Interesting: yes
                                              iii.      Novel: yes; ensure that this study is not duplicative of another researcher known to be at work in this area of the field.
                                              iv.      Ethical: yes, but schools may not want to hear about previously undiagnosed problems, and this does place a burden on kids that may be struggling.  Also, there’s no ability to follow up medically on newly found diagnoses. 
                                                v.      Relevance: feedback from program officer indicated that this was not clear.  Identify whether there is clinical interest and develop a strong statement about:
1.      Tests need to be evaluated
2.      ADHD is an important clinical subgroup
3.      Concerns of reliability could affect patient/student outcomes
4.      Consider estimating the financial impact of administering this test across the country
d.      Design: cross-sectional sample with a follow up test
                                                  i.      Target population: general U.S. school age population, English as first language, ages 6-11, with consistent language patterns with the test and the raters.   
1.      Age as a covariate (older kids score better)
2.      Concern: Is the scope broad enough to attract reviewers/funding?  Consider seeking out collaborators in other states/territories (e.g. Puerto Rico)
                                                ii.      Sample:
1.      VT school children (non-Vermont samples will help the F31 greatly), captured in an unselected way (no differentiation by other diagnoses affecting children)
2.      Pediatric patients, pre- and post-wellness visit
                                              iii.      Measures: ADHD checklist (filled out by parent or teacher), DWT scores, demographic data
1.      Retest: logistic issues include number of days within which the test can be re-taken, preferably within 3 weeks (see Amanda’s suggestion of previous doctoral student’s experience with gaining access to schools across the country).  Retest will be the same words in same order.

3.                  Future CROW Sessions: The group agreed that it is interested in discussing a broad outline of a group research project with roles organized around investigator, analyst, and reviewer.  Access to data may determine some aspects of the project, as IRIS is not quite ready yet.  Rodger noted that another data base source is SafetyNet with Medicaid claims of FAHC and FQHC patients.  These data may not tell the complete story of a patient’s history of treatment, but other sources are also available.  Our goal is to learn more about multi-level modeling through a team-based research study.  For discussion next week. 

4.                  Next Workshop Meeting(s): Thursday, 2:00 p.m. – 3:30 p.m., at Given Courtyard Level 4. 
a.       Jan 10: Kairn: F31 grant application for career development of pre-doctoral fellows: stipend, research, and tuition for 2-5 years.  CROW: review high level plan to study and conduct research using IRIS and multi-level modeling.
b.      Jan 17: CROW research project plan
c.       Jan 24:
d.      Jan 31: Kairn: F31 update
e.       Feb 7:
f.       Future agenda to consider:
                                                  i.      Christina Cruz, 3rd year FM resident with questionnaire for mild serotonin withdrawal syndrome on 12/6 or 12/13
                                                ii.      Peter Callas or other faculty on multi-level modeling

Recorder: Connie van Eeghen

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