Clinical Research Oriented Workshop (CROW) Meeting: Jan 27, 2022

 

Present:   Levi Bonnell, Justine Dee, Nancy Gell, Emily Houston, Ben Littenberg, Jen Oshita, Liliane Savard, Adam Sprouse-Blum, Connie van Eeghen (9)

1.                   Warm Up: Covid is a thing, with a new incoming variant and recoverers from Omicron everywhere

2.                   Check in – round table

a.       Ben

                                                   i.      Final report for PCORI IBH-PC

1.       Discovered the need for a missing values report

2.       Conducting several sensitivity analysis based on imputed values for those missing

3.       Review of the data collection methods for patient responses

                                                 ii.      Submitted main analysis to Annals of Internal Medicine

1.       Had to include research protocol, with all amendments: 600 pages long

2.       Blog: open source culture, or what is discovered in the public domain

a.       CIA just declassified a manual on sabotage behind enemy lines for civilians (e.g. for the French resistance in WW2)

                                                                                                                           i.      “Follow every rule”

                                                                                                                         ii.      “Allow no exceptions”

                                                                                                                       iii.      “Make all the workers take every steps every time”

                                                                                                                       iv.      “Assign the least competent person the most important task”

                                                                                                                         v.      “Put the last important task as the first thing to do”

3.       This is a policy (practice wide) intervention

a.       Did not affect the community of patients

b.       Subgroups?  Not the ones we prespecified

b.       Nancy

                                                   i.      Pulling hair out: trying to do too much

                                                 ii.      Pilot project: remote exercise with rural, older cancer survivors; all by zoom or mail

1.       Collecting physical evidence via zoom (e.g. sit to stand with timing)

2.       Deluded that bigger labs would validate the zoom measures – there was a Gerontological task force – but there is nothing

3.       Decided to validate – this is a big task. 

a.       Inter rater reliability with recorded sessions

b.       In person and zoom comparisons

                                               iii.      Levi: check for preprints! 

1.       Nancy: others are working on this

2.       May focus on one population: e.g. cancer survivors

                                               iv.      Liliane: validity of measure for sub populations may be at risk

1.       Zoom measures may be different based on setting, lack of travel, and other variables

c.       Liliane

                                                   i.      Video measurement of subject physical performance using “KINOVEA” software

1.       Uses any movie file, any camera

2.       Software drops a “pin” to give a measurement, regardless of angle

3.       The farther the camera, the less distortion, but less feasible; calibration

4.       No comparison between video and in person measures

                                                 ii.      Requires precision

1.       Intra rater measurement

a.       There is a difference between in person and video measures: 3 cm at start

b.       Precision goes down the closer the measure is to the edge of the frame

2.       Inter rater measurement?

                                               iii.      Decision: what is the minimum difference in measures that is acceptable for valid analysis

1.       Ask previous investigators

2.       KINOVEA is not being helpful in previous outreach; open source changes constantly

                                               iv.      Levi: if the effect size is .5, will that work for the study?

1.       Liliane: depends on the precision related to the area in the frame.  Getting better at this.

d.       Jen: progress on dissertation

                                                   i.      Aim 1: Trinetix and patient outcomes, release of data is hung up in UVM MC Risk Management; was supposed to be available last fall but still not approved

                                                 ii.      Aim 2: conducting case studies on 5-7 HC organizations re: communications accommodations services, aids, and implementation

1.       Initial contacts and interviews done with 3 organizations

a.       Chain sampling off of initial interviews is very slow

2.       Need a Plan B, as getting depth in interview is not easy to do

a.       May ask for  more institutions at superficial level

b.       Get patient perspective (redesign the study) to get experience on accessing accommodations using a “secret shopper” strategy

c.       Will require IRB approval

                                               iii.      Secondary data analysis paper is still getting rejected

e.       Justine:

                                                   i.      Revised manuscript but need to change from raw scores to T scores

                                                 ii.      Waiting for VHCURES data

1.       Missing a variable that would join tables

                                               iii.      Thinking about a lit review topic

f.        Emily:

                                                   i.      Waiting throughout fall to get award letter through SPA from funder

1.       Some language required minor changes in protocol

                                                 ii.      MH clinicians to identify patients with drug induced movement disorder to offer treatment options

1.       Clinicians (10-15) and patients (30) respond to surveys

                                               iii.      Goals: compare two methods (in person and remote) and RE-AIM evaluation

                                               iv.      Recruitment: slow response to emails

1.       Make a flyer for patients and clinicians?

2.       Reach out to medical directors; present at staff meetings

3.       Discussion of other recruitment strategies

a.       Make friends with the chief resident in psychiatry

b.       Look for patients by diagnosis on problem list for tardive dyskinesia

g.       Levi: 3 articles plus review article coming along

                                                   i.      Good sub analyses for IBH-PC underway

                                                 ii.      Skiing and FAT biking

h.       Adam

                                                   i.      R21 submission planned in 2.5 weeks

                                                 ii.      Hawai’i in two weeks

                                               iii.      Quality review for an IRB approved study with no funder – worked out OK, thanks to Adam’s underlying OCD

                                               iv.      Learned that the EHRs provides a flag for patients involved in a study; needs to do it

1.       Emily: a big deal for billing, to ensure the funder pays

2.       Nancy: requirement is not possible if the researcher doesn’t have access to Epic

3.                   Next week:  TBD