Clinical Research Oriented Workshop (CROW) Meeting: February 20, 2014

Present:  Marianne Burke, Kairn Kelley, Rodger Kessler, Ben Littenberg, Connie van Eeghen

Start Up: Good places to eat in Old San Juan – check with Ben and Rodger.  Also, there are 550,000 VT driver license records with zip code, state, age, height, and weight being – data analysis jeopardy awaits!  Analysis focused on building density and BMI to test walking vs. non-walking hypotheses on body size.

1.                  Discussion: SBIRT (Screening, Brief Intervention, Referral & Treatment) Training Grant – Research Questions and Aims – Rodger & Connie

a.       This training grant broadly focuses on substance abuse (SA), with the goal of training 3 cohorts of students, IM residents, FM residents, advance practice nursing, counseling, and social work to use team based interventions in a primary care setting.  The training program recognizes that not everything can be done to meet the SA needs of patients in a 15 minute period and brings together a team of providers working at the top end of their licenses.

b.      The training grant includes evaluation, with required reports.  This discussion is intended to think about the research value of this work, starting with research question and aims.  Clarifications:

                                                  i.      Students will enter the project over three years, and followed for the remaining period of the grant.

                                                ii.      Less than a dozen faculty are involved that were themselves trained in the key components of SBIRT (4 modules) and 2 sets of experiential trainings (including standardized patients).  In some departments, faculty act as preceptors (Rich Pinckney for IM – with additional didactic added; John King for FM).

                                              iii.      At this time, the students have started the didactic training.

c.       The research question currently: Does access to SBIRT have an effect on evidence-supported, team-based, behavioral intervention skills and implementation in practice?  Possible measures:

                                                  i.      Student knowledge, attitudes, and skills

1.      Perceived by students

2.      Perceived by preceptors

                                                ii.      Observable data (consider selective, convenience sampling)

1.      Patient encounters – preceptor structured questionnaire

a.       Residents many have clinical experience prior to training

b.      Other students may need a different data collection plan

2.      Referrals (may be too difficult)

3.      Prescriptions

                                              iii.      Pilot the data collection process on cohort 1

1.      Cohort 2: pre- and post- data collection as similar as possible

2.      Cohort 3: pre- and ???post-data collection

d.      Data collection

                                                  i.      Knowledge: prescribed by the SBIRT modules; content from didactic (memorized facts)

                                                ii.      Attitudes:

1.      Medical problem; requires support and continuity; also prescribed by SBIRT

2.      Attitude about self-efficacy (how hopeless is the patient’s condition or the provider’s ability to act on it)

3.      Other…

                                              iii.      Skills: Using a case scenario to demonstrate application (cognitive skills)

1.      Screening

2.      Brief Intervention

3.      Referral

4.      Treatment

                                              iv.      Skills: (practical skills) observed by preceptor (see above)

                                                v.      Post-only, evaluation by students (opinions)

1.      Value of the program in terms of new knowledge, helpfulness, novelty, perceived value (ease, relevance, usability)

e.       Does this program have measurable impact on Knowledge, Attitudes, and skills relative to SBIRT

f.       Does this program influence the chronic structure of service delivery

                                                  i.      After grant based training program is done, did the SBIRT curricular training program get adopted in the UVM programs

                                                ii.      How much SBIRT activity is taking place before, during, and after the training program

1.      Structured screening program

2.      Use of Brief interventions

                                              iii.      Trainees evaluate their clinics

1.      At start up

2.      Part way through

3.      At end

                                              iv.      Alumni evaluations post-training

g.      Next steps:

                                                  i.      Rodger to ask SAMHSA for tools and examples

                                                ii.      SBIRT Evaluation Meeting to refine

                                              iii.      Return to CROW in a month (March 27)

2.                  Next Workshop Meeting(s): Thursdays, 11:30 a.m. – 12:45 p.m., at Given Courtyard South Level 4.   Remember: the first 15 minutes are for checking in with each other.

a.       February 27: Cancelled

b.      March 6: Marianne Burke

c.       March 13:

d.      March 20:

e.       March 27: Rodger and Connie on SBIRT plan

Recorder: Connie van Eeghen

Scott Hipko to present at International Meeting

Scott Hipko, candidate for the MS in CTS with a concentration in Research Management, will be presenting his original research on "T1-Rho Imaging of Brain Tumors: A Novel Method to Predict Histology of Intracranial Masses" at the American Society for Neuroradiology in Montreal this May. Scott worked on this project as part of his MS course work. Many congratulations, Scott!

Clinical Research Oriented Workshop (CROW) Meeting: February 6, 2014

Present:  Marianne Burke, Sylvie Frisbie, Kairn Kelley, Rodger Kessler, Connie van Eeghen

Guest:     Diantha Howard

Start Up: RedCap is about to go through an upgrade in just a few weeks – stay tuned!

1.                  Discussion: How to use REDCap for data collection and analysis, with Kairn’s dissertation data collection process as a model for exploration

a.       REDCap is more than a survey; it is a data base that can produce outputs easily transferable to Stata and other analytical software

b.      Kairn is using a survey to collect data from parents (from paper forms) and from child subjects (directly into REDCap)

c.       An online designer automatically creates a data dictionary, while designing the survey

                                                  i.      However, the view of the data dictionary variables allows faster editing and additions, once the structure is understood

                                                ii.      A project has one data dictionary, which may support multiple forms

d.      For this project, each of 60 children will take this test twice.  The goal is to find out how much the scores changed for the left ear and (separately) the right ear. 

                                                  i.      At project setup, indicate that the study is longitudinal.  REDCap then provides repeated events. (See “Add new event” button function).  (We later decided to un-do this.)

                                                ii.      REDCap can track subject ID to connect longitudinal responses on a paired basis.

                                              iii.      The randomized ordering of the tests (the questions of which are part of the form, including all three tests) cannot be tracked by REDCap but can be identified as a field with a coded randomization order (for three tests, that can be randomized into 6 alternatives).  Although REDCap has a randomization function to assign a subject to a particular randomized alternative, it cannot change the presentation of the questions to match that alternative.

                                              iv.      The first form in the project should always be the subject identification variables, such as age, gender, and unique ID (which REDCap can also generate) etc.

1.      Changes to data are tracked in a history record

2.      Notes are for data management purposes; they do not export to analysis

                                                v.      Exports include all data; the analysis software has to do the work of selecting which data to analyze

e.       Once the data are in for the two different trials (or events), exported data take the appearance of two rows of data for each subject

                                                  i.      To create an exported file with all subject data on a single row, do NOT create a longitudinal study and duplicate all forms with new variable names identifying the different trials

f.       Calculated fields in REDCap are important for this project in order to immediately create an individual report for each child upon completion of the second trial.

                                                  i.      Example: how to calculate age using the birthdate (in the data file) and “today’s” date.  Calculated field come with a good “help” window to guide syntax.

g.      Kairn’s data reside on REDCap on a FAHC server, because she is collecting PHI.  Access requires an M number and, if offsite, the FAHC remote access portal.  If the project does not have PHI, the data can be stored on a UVM server hosting REDCap. 

h.      Use of REDCap is usually based on an IRB approved project.  However, education and quality improvement projects can use REDCap but need individual approval.

i.        Excellent for planning and organizing the data that support a project.

2.                  Next Workshop Meeting(s): Thursdays, 11:30 a.m. – 12:45 p.m., at Given Courtyard South Level 4.   Remember: the first 15 minutes are for checking in with each other.

a.       February 13: TBD

b.      February 20: Rodger & Connie?

c.       February 27:

d.      March 6:

Recorder: Connie van Eeghen