Present: Marianne Burke, Kat Cheung, Abby Crocker, Ben
Littenberg, Charlie MacLean, Connie van Eeghen
Guest: Thomas
Joseph visiting from India
Start Up: Next semester’s schedule will
start August 29 on Thursday’s from 11:45 to 12:15. Noted also were the finer points of grant
writing, which includes planning and delivering letters of support – and which also
includes the fine art of diplomacy.
1.
Discussion: Abby
provided an update on a group research project around the Natural History of Opioid
Use, based on the all payor claims data base for VT. The question is: what predictors can we find
that result in long term opioid use. The
original time frame has been adjusted due to access barriers and usability of
the source data.
a. How
to maintain momentum: keep this project going and define a more focused topic
that could move forward more quickly using, for example, another national data
base.
b. Barriers
related to the current project: hardware, software, and political issues
i.
Software: it takes time to use the tools
ii.
Policies: a new IRB-like entity to sort out; similar
process
iii.
Steve is able to do extract (1% of total, but without
medical claims – it just has pharmacy claims); resides on Charlie’s
desktop. Have not yet tackled linking
the data sets.
iv.
Hardware: keep running into size limits. NATIZA hardware does have capacity but cannot
run STATA (SPSS only, which no one uses any more). Limited to IBM based software. Picking the right DB server is really
important; Ben will follow up on this.
v.
Will take a while, but is moving forward.
c. Alternate
plans: YRBSS (Youth Risk Behavior Survey System) or BRFSS (Behavior Risk
Factors Survey System - adults) to use for a group study.
i.
BRFSS includes a county field (FIPS code – 5 digit)
1. Ben
has 3 years downloaded; many more years available
2. Rich
data set; many variables, included SES, employment, income, demographics…
3. No
EtOH or drug taking behavior questions
ii.
YRBSS: consider using to develop a predictive model for
answering “yes” to opioid use.
1. Consider
an explanatory model: what risk factors are related to opioid use
2. Seek
clusters: smoking and other behaviors of concern
3. Key
characteristics: age, sex, region…
4. Changes
over time (assuming stability in the survey question)
5. Some
health questions: asthma (for some states), height and weight
iii.
Cross over study from YRBSS to BRFSS for opioid
patterns?
iv.
State/territory data are only available upon request;
county data in North Carolina and Florida
d. NAMCS:
National Ambulatory Medical Care Survey – a sample of O/P providers, including
private practices, EDs, walk-in centers… asking about the clinic, the
characteristics of the visit, the drugs on the med list. No county, but do have MSA and rural/urban
designation.
i.
The data support time series study
ii.
Abby has already started learning about this source (kid
data is in age categories; low numbers)
iii.
Consider determining prevalence of “starts” vs.
“continued use” by age group. What are
the patient characteristics (diagnosis)?
May look at a time series later.
e. DAWN:
Emergency room visits involving drugs – a sample from selected cities
f. The
group discussed the research question that will support the longer term study
on the natural history of opioid use.
i.
What can we say about opioid users vs. non-opioid
users?
ii.
NAMCS: is available up to 2011; there has been a rising
trend of opioid prescriptions, may now be declining – identify the temporal
trend in opioid prescribing
iii.
Where does opioid prescribing start? What setting and how does it change?
g. Next
steps
i.
Look at NAMCS data – what variables do we have?
ii.
Literature review – now novel?
iii.
Develop a FINER research question
h. Addendum:
After the close of the meeting, Kat circulated a link to a recent NEJM
“Perspectives” article entitled: “Abusive Prescribing of Controlled Substances
— A Pharmacy View” by Betses and Brennan (Aug 21, 2013), describing a CVS-based
program to identify prescribers with abusive prescribing habits, resulting in a
policy of refusing to fill the controlled substance prescriptions of selected
providers. Very interesting - to view
the article, go to: http://www.nejm.org/doi/full/10.1056/NEJMp1308222. Thank you Kat!
2.
Next Workshop Meeting(s): Starting next week: Thursday, 11:45 a.m. – 1:15 p.m., at Given Courtyard
South Level 4.
a. Thursday,
August 29, from 11:45 – 1:15?: Rodger: Review of Lexicon Checklist
b. September
5: Abby – Natural History of Opioids projects
c. September
12:
d.
Future agenda to consider:
i.
Peter Callas or other faculty on multi-level modeling
ii.
Charlie MacLean: demonstration of Tableau; or Rodger’s
examples of Prezi
iii.
Journal article: Gomes, 2013, Opioid Dose and MVA in
Canada (Charlie)
iv.
Ben: Tukey chapter reading assignments, or other book
of general interest
v.
Summer plan: each week, one person will send out an
article or prezi ahead for review or discussion by all. Alternatively,
if a participant is working on a key document for their professional
development, this is also welcome (e.g. K awards, F awards, etc.)
Posts
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.