Monday, February 27, 2017

Dr. Michael LaMantia on VPR'S Vermont Edition tomorrow 2/28/17

For anyone who has access to a radio tomorrow (Tuesday, Feb 28) at noon (or can catch the rebroadcast at 7pm), Dr. Michael LaMantia, Associate Professor of Medicine and Section Head of Geriatric Medicine, Department of Medicine is going to be a guest on VPR’s Vermont Edition with Jane Lindholm.  He will be talking about difficult conversations that adult children face with their aging parents and will be offering advice on how these conversations can be handled better.  Please tune in if you have the time --- this is part of an effort, supported by UVM, for the geriatrics team to do outreach to people across the state around issues in aging.

Friday, February 24, 2017

Congratulations Dr. Kairn Kelley, PhD

We would like to congratulate Kairn Kelley on her successful dissertation defense on January 27, 2017. Kairn has submitted her final manuscript "Dichotic Listening Test Performance in Children" and has fulfilled all requirements for the Ph.D. in Clinical and Translational Science.  She will be awarded the degree at the upcoming Commencement in May 2017.

Congratulations Dr. Kelley!  We are all very proud of your achievement.

Wednesday, February 22, 2017

What is the new Medicaid ACO in Vermont about?

Hamilton Davis, who knows an awful lot about health policy in Vermont and elsewhere, has written a very useful blog post on the new deal that the state of Vermont has made with OneCare to provide care to 30,000 Medicaid patients.

A Big First Step for Vermont Health Care Reform

Thursday, February 16, 2017

An excellent source of secondary data

This is an excellent source of secondary data from the Census, the National Health Interview Study, the American Time Use Survey and other cool databases going back forever. It is all available in Stata-ready files, too.

- Ben Littenberg
IPUMS NHGIS Logo

Exciting changes are coming to NHGIS. Over the next week, we will be launching a new look for the site along with a new name: IPUMS NHGIS.

NHGIS has always been part of the IPUMS family of projects. NHGIS, like other IPUMS projects, provides census and survey data integrated across time and space. Our updates next week will bring NHGIS together with our other IPUMS projects to provide unique types of integrated data with a consistent look.

Don’t be confused by the new name and the new look: we’re still offering the same free data and data tools. Website navigation and the data finder remain the same.

If you have not used our other IPUMS projects, we recommend you visit the new ipums.org. We have made it easier to access all our data projects and to find video tutorials, online learning modules, and assistance from IPUMS staff. You will also find information on events and workshops, a blog feed, and social links to make it easier for you to stay connected with IPUMS.

We look forward to introducing you to the new IPUMS NHGIS, and all our new sites, and we welcome your feedback.

Sincerely,

Steve Ruggles and the IPUMS Team

Copyright © 2017 University of Minnesota, All rights reserved.

Our mailing address is:
  • IPUMS
    225 19th Ave South
    Minneapolis, MN 55455

Tuesday, February 14, 2017

Notes from CROW Meeting 2/10/17



Clinical Research Oriented Workshop (CROW) Meeting: February 10, 2017
Present: Marianne Burke, Justine Dee, Juvena Hitt, Liliane Savard, Michael LaMantia, Kairn Kelley

  1. Liliane shared a fictional case report that will be used as part of an article about inter-professional practice(IPP) in the care of children with autism. The audience is speech and language therapists.  Constructive critique and next steps were provided.
  2. We went around the table introducing ourselves, our current roles, and what that means (i.e., what do we each do all day?). Very interesting! 
  3. Next Workshop Meeting(s): Fridays, 2:00 p.m. – 3:15 p.m., at Given Courtyard South Level 4
  • 2/17 – Kairn: Finding the way as a new investigator
  • 2/24 – Marianne: Manuscript draft
  • 3/3 – Gail: SBM Prep?
  • 3/10 – (Mike manuscript? Juvena data management?)
  • 3/17 –
  • 3/24 –

Tuesday, February 7, 2017

Position available: Research Specialist (staff position)

I am hiring a Research Specialist (staff position). I am hoping you can share this posting widely across your networks to attract top candidates with data experience. This person would join my Health Services Research Team at VCHIP.
Thanks! Valerie


Title: Research Specialist
Job Summary: Maintain, analyze, and report on data gathered from multiple healthcare-related sources (e.g. all-payer claims, primary care practices, specialty care practices, and health and human service organizations) across the state in support of research and evaluation activities conducted by the Vermont Child Health Improvement Program (VCHIP).  Assist in the design and implementation of data management systems in collaboration with program leadership. Export and merge datasets for analyses, ensuring confidentiality of research materials and compliance with applicable regulations. Conduct structured literature searches, and create and maintain an electronic reference manager in support of research efforts and manuscript production. Draft IRB protocols and amendments in collaboration with principal investigator; maintain research compliance binders, maintain comprehensive knowledge of each protocol’s procedures. Conduct descriptive analyses on new and existing data and write detailed reports on evaluation and research methods and results on a monthly, quarterly, and annual basis.
MINIMUM QUALIFICATIONS: Bachelor’s degree in health or social sciences (e.g. biostatistics, psychology, public health, nursing, biology) and 4-5 years of research and data management experience required. Experience with statistical software (SAS, STATA, and/or SPSS), word processing, spreadsheets, and databases required.  Effective project management, organizational, interpersonal, and communication skills required.



Valerie Harder, PhD, MHS
Vermont Child Health Improvement Program (VCHIP)
Director, Health Services Research Team
Assistant Professor of Pediatrics and Psychiatry
Larner College of Medicine, University of Vermont
Office: 802-656-2652

Notes from CROW Meeting: February 3, 2017



Clinical Research Oriented Workshop (CROW) Meeting: February 3, 2017
Present: Marianne Burke, Justine Dee, Nancy Gell, Juvena Hitt, Gail Rose, Liliane Savard, Michael LaMantia, Kairn Kelley
  1. Marianne Burke shared the results of her study in which she compared outcomes of patients with skin conditions whose physicians were asked to consult VisualDx in cases of uncertainty and physicians who were asked not to use VisualDx. Participants provided feedback on how to best present this excellent work.
  2.  Next Workshop Meeting(s): Fridays, 2:00 p.m. – 3:15 p.m., at Given Courtyard South Level 4
  • 2/10 – Lilliane: interdisciplinary practice case study
  • 2/17 – TBD (Gail, Nancy, and Justine are away)
  • 2/24 – Mike: manuscript draft [willing to shift if needed]
  • 3/3 – Gail: SBM Prep
  • 3/10
  • 3/17
  • 3/24

Thursday, February 2, 2017

Graduate Student Senate seeks input

My name is Weiwei Wang and I am the Graduate Student Senate Communications Director.  On Monday, GSS will be holding its first senate meeting of the semester at 4:00pm in HSRF 400, where we will be holding an open discussion with the Dean of the Graduate College, Cynthia Forehand.  I would like to extend an invitation to the graduate students in your program, and encourage them to bring questions about current and future plans the Grad College has in line. 
In addition, there are many open senator and representative positions, and Clinical & Translational Science may not be represented in GSS discussions.  Please encourage your graduate students to join so that the university can better address the needs of the diverse graduate student body and graduate programs across campus. 
Thank you for your time!
Best,
Weiwei Wang
Communications Director | UVM Graduate Student Senate
MS candidate | Community Development and Applied Economics
802-656-0892 (direct)

New article on imaging for kidney stones



Kevan M. Sternberg, MD, Assistant Professor of Urology and Benjamin Littenberg, MD, Professor of Medicine recently published an original research paper in the Journal of Urology. This paper came out of the work Kevan did in the UVM Medical Group course on “Introduction to clinical research using existing data.” Special thanks to instructors Charles D, MacLean, MDCM, Professor of Medicine and Associate Dean for Primary Care, Abigail Crocker, PhD, Assistant Professor of Mathematics and Statistics, Valerie Harder, MHS, PhD, Assistant Professor of Pediatrics and Psychiatry, Thomas Ahearn, PhD, Assistant Professor of Surgery.



Abstract

Purpose

Recent reports support the use of renal ultrasonography (US) as the initial imaging study for the evaluation of patients with suspected renal colic. Urologists, however, often advocate for computed tomography (CT) to better define stone size and location, especially prior to proceeding with endourologic intervention. One concern with using US as the initial imaging study is that CT may be required at a later time, obviating the reduction in costs and radiation gained by using US.

Materials and Methods

Retrospective review of electronic health records of 10,680 episodes of stone disease in 7,659 patients who presented to the emergency department or walk-in-clinic with a chief complaint or visit diagnosis of urolithiasis from 2009-2015 at a single institution. Images obtained during the index encounter and in the following 90 days were recorded.

Results

The index encounter included CT in 47% of episodes, US in 20%, KUB in 12%, and no imaging in 29%. 49% of index visits included multiple testing. If no CT was obtained during the index visit, 10% received one later in the episode. Total imaging costs and radiation exposure over 90 days were significantly higher when CT was utilized during the index visit. If the initial image obtained during an episode was an US, 20% obtained a CT within 90 days.

Conclusions

Patients who received an initial US avoided CT imaging in 80% of the cases. Avoiding the use of CT at the index visit was associated with substantial reductions in radiation exposure and imaging cost.

Sunday, January 29, 2017

CCTS faculty and staff publish two new papers on the PIP

Here are a pair of papers from Rodger Kessler, Juvena Hitt, Connie van Eeghen and Ben Littenberg on the development and validation of the Practice Integration Profile, an instrument used to assess the degree to which primary care practices have integrated Behavioral Health Services.

The Practice Integration Profile: Rationale, development, method, and research.
Macchi, C. R.; Kessler, Rodger; Auxier, Andrea; Hitt, Juvena R.; Mullin, Daniel; van Eeghen, Constance; Littenberg, Benjamin
Families, Systems, & Health, Vol 34(4), Dec 2016, 334-341. 
Abstract
Insufficient knowledge exists regarding how to measure the presence and degree of integrated care. Prior estimates of integration levels are neither grounded in theory nor psychometrically validated. They provide scant guidance to inform improvement activities, compare integration efforts, discriminate among practices by degree of integration, measure the effect of integration on quadruple aim outcomes, or address the needs of clinicians, regulators, and policymakers seeking new models of health care delivery and funding. We describe the development of the Practice Integration Profile (PIP), a novel instrument designed to measure levels of integrated behavioral health care within a primary care clinic. The PIP draws upon the Agency for Health care Research & Quality’s (AHRQ) Lexicon of Collaborative Care which provides theoretic justification for a paradigm case of collaborative care. We used the key clauses of the Lexicon to derive domains of integration and generate measures corresponding to those key clauses. After reviewing currently used methods for identifying collaborative care, or integration, and identifying the need to improve on them, we describe a national collaboration to describe and evaluate the PIP. We also describe its potential use in practice improvement, research, responsiveness to multiple stakeholder needs, and other future directions.

Development and validation of a measure of primary care behavioral health integration.
Kessler, Rodger S.; Auxier, Andrea; Hitt, Juvena R.; Macchi, C. R.; Mullin, Daniel; van Eeghen, Constance; Littenberg, Benjamin
Families, Systems, & Health, Vol 34(4), Dec 2016, 342-356.
Abstract
Introduction: We developed the Practice Integration Profile (PIP) to measure the degree of behavioral health integration in clinical practices with a focus on primary care (PC). Its 30 items, completed by providers, managers, and staff, provide an overall score and 6 domain scores derived from the Lexicon of Collaborative Care. We describe its history and psychometric properties. Method: The PIP was tested in a convenience sample of practices. Linear regression compared scores across integration exemplars, PC with behavioral services, PC without behavioral services, and community mental health centers without PC. An additional sample rated 4 scenarios describing practices with varying degrees of integration. Results: One hundred sixty-nine surveys were returned. Mean domain scores ran from 49 to 65. The mean total score was 55 (median 58; range 0–100) with high internal consistency (Cronbach’s alpha = .95). The lowest total scores were for PC without behavioral health (27), followed by community mental health centers (44), PC with behavioral health (60), and the exemplars (86; p < .001). Eleven respondents rerated their practices 37 to 194 days later. The mean change was + 1.5 (standard deviation = 11.1). Scenario scores were highly correlated with the degree of integration each scenario was designed to represent (Spearman’s ρ = −0.71; P = 0.0005). Discussion: These data suggest that the PIP is useful, has face, content, and internal validity, and distinguishes among types of practices with known variations in integration. We discuss how the PIP may support practices and policymakers in their integration efforts and researchers assessing the degree to which integration affects patient health outcomes.

- Ben Littenberg

Thursday, January 26, 2017

Ross Colgate passes her PhD comprehensive examination

I'm delighted to report that, as expected, Ross Colgate, did an outstanding job on her PhD comps and has now progressed to the research phase of her studies.

Congratulations to Ross!


- Ben Littenberg

Wednesday, January 25, 2017

Katharine Cheung, MD (PhD candidate in CTS) gets published


Congratulations to Katharine Cheung on the publication of your first PhD manuscript in the American journal of kidney diseases.


Measures of Kidney Disease and the Risk of Venous Thromboembolism in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study    Original Research Article
Available online 23 January 2017
Katharine L. Cheung, Neil A. Zakai, Aaron R. Folsom, Manjula Kurella Tamura, Carmen A. Peralta, Suzanne E. Judd, Peter W. Callas, Mary Cushman

Friday, January 20, 2017

Clinical Research Oriented Workshop (CROW) Meeting: Jan 20, 2017



Present:   Justine Dee, Nancy Gell, Juvena Hitt, Charlie McLean, Gail Rose, Liliane Savard (by phone), Adam Sprouse-Blum, Connie van Eeghen

Start Up: RMS accrediation is in response phase; more to come.

1.                   Justine – poster review  
a.       Annual combined sections of PT; this is a research group; mostly clinicians, all PT related
b.       Comments
                                                   i.      Distinguish the instruments from the variables 
                                                 ii.      Focus on the key message: the ability to predict treatment success
                                               iii.      Move all methods info to left bar; keep together
                                               iv.      Shorten analysis to: univariate comparisons and multi-variable modeling of initial disability and treatment success
                                                 v.      Trim the presentation of Perason’s Correlation to focus on initial ODI, as the analsyis of predictors of treatment success includes this information
                                               vi.      Make “Clinical Relevance” statement short and pithy
                                              vii.      Add narrative interpretation to the Conclusions section
                                            viii.      Limit colors and any extra busy-ness; use color to highlight a few key points/findings
c.       Next: February 14 in San Antonio TX!

2.                   Next Workshop Meeting(s): Fridays, 2:00 p.m. – 3:15 p.m., at Given Courtyard South Level 4 until end of Dec.   
a.       Jan 27: Kairn Kelley’s dissertation defense
b.       Feb 3: Marianne – update
c.       Feb 10: Nancy – grant proposal
d.       Future topics:
a.       Juvena: protocol development
b.       LaMantia: predictors of successful R01 applications: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0155060

Recorder: Connie van Eeghen