Tuesday, February 5, 2013

Clinical Research Oriented Workshop (CROW) Meeting: Jan 31, 2013

Present: Abby Crocker, Kairn Kelley, Amanda Kennedy, Ben Littenberg, Connie van Eeghen

1.                  Start Up:    Review of our lunch time speaker: great background; a good fit for our organization?

2.                  Presentation: Kairn’s application for F31 to Deafness and Communications Disorders  Due end of March; coming along.  Progress made and continued during our session:
a.       Pediatric practice support in rural central VT: enthusiastic!  Consider asking Joe Hagan or other pediatricians for letters of support as well.
b.      Audiologist support: still working on this.  Want to develop a clear research statement first.
c.       Planning to attend American Audiological Society conference in March, Phoenix AZ (and, decide when to visit the Grand Canyon?)
d.      Lit Review-based opportunities discovered:
                                                  i.      Develop tests with good internal controls (i.e. sensitive to APD in a setting of ADHD: able to determine if the subject stops trying to achieve on the test, and starts to respond randomly). 
                                                ii.      Do rewards change the results of the test – and can they help distinguish among children who have motivation issues versus APD concerns? 
                                              iii.      Are there other ways to design tests to identify APD regardless of motivation and normal “ants in the pants” issues?
1.      For example: are there markers for lack of good attendance, e.g. delays in response or other measurable behaviors?
2.      Consider a “gold standard” of word pairs, with known relative “ease” or “hard” to test for attention
3.      Consider changing volume to make words easy or hard to identify, testing for attention
                                              iv.      What is the role of subject attentiveness in APD tests? Can we measure it?  Does it vary?
1.      ADHD kids are on one end of this scale.  Is the scale big enough to include non-ADHD, attention-challenged children?
2.      Are there other scales of attentiveness?
3.      Can you make a test for attentiveness? Ask a child psychologist.
4.      Does the length of the test matter?
5.      Does the beginning or ending of a test produce different results?
6.      Do incentives, after poor performance, make a difference?
7.      For these questions, the interesting scores are those that fail first, and then get tested again.
                                                v.      Is attentiveness a threat to APD testing?
e.       Focus the package of questions next.  Reference own strengths relative to the domain of the questions.  Keep:
                                                  i.      Test-retest model of collecting data to assess tests
                                                ii.      Inter-rater reliability
                                              iii.      Aim 1: Test standard, clinically available tests with no test/retest data – something useful in the clinical world.  (This is a technology assessment question, with a classic set of steps to address.) Not about accuracy; this is about reliability.  Collect additional data about the kids to support other research questions (IQ…)  This Aim needs a large sample size. Use this to draw the progression of questions that leads to a K award.
1.      Consider the recruitment/selection process: purposefully selected children, everyone who comes to the pediatrician’s office (like a population survey), only those referred to audiology screening, only those referred with suspicion of APD, or …
                                              iv.      Aim 2: create a registry to be able to look for patterns
                                                v.      Sub-groups of interest
1.      Age of child (younger children more variable?)
2.      Diagnoses (ADHD)
3.      Foster or adopted kids
4.      Kids with IEP
                                              vi.      Interventions that might make a difference (see d- iii and iv above)
                                            vii.      Test modifications (this is a risky question)
f.       Complete the professional development part of the application.

3.                  Next Workshop Meeting(s): Thursday, 2:00 p.m. – 3:30 p.m., at Given Courtyard South Level 4. 
a.       Feb 7: Steve Kappel: Understanding/using VHCURES
b.      Feb 14: Abby: Breastfeeding manuscript (no Ben)
c.       Feb 21: Kairn: F31 (no Amanda)
d.      Feb 28: (no Connie, no Kairn)
e.       Mar 7: (no Ben, no Kairn)
f.       Future agenda to consider:
                                                  i.      Christina Cruz, 3rd year FM resident with questionnaire for mild serotonin withdrawal syndrome?
                                                ii.      Peter Callas or other faculty on multi-level modeling

Recorder: Connie van Eeghen

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