Thursday, August 7, 2014

Clinical Research Oriented Workshop (CROW) Meeting: July 31, 2014



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

Start Up: FRED’s AV cables are kept in the drawer on the screen – useful fact to know and remember! According to Rodger, the only good gnocchi’s come from northern Italy.  Ben, Rodger and Connie are waiting for feedback from PCORI on an LOI – no news, in this case, is no news.

1.                  Discussion: Kairn’s research update
a.       Kairn previously sent out two documents describing her literature review:
                                                  i.      Spreadsheet with over 340 sources, with 7 studies that identify trials with subjects
                                                ii.      Whether there should be a formal, systematic level of literature review (such as meeting inclusion criteria) is the subject of today’s discussion
b.      The research question: what do we know about auditory tests to assess auditory systems of children from 7-14?
                                                  i.      There is very little in the literature that met what Kairn is looking for
                                                ii.      Strategies for discussing what is known:
1.      Chronological story of the development of literature, little that there is.  There are no norms or standardized assessment methods.  In fact, clinicians are told to “collect your own norms,” but there is no structure for doing so.
2.      Practice guidelines – little offered
3.      Bottom line: little studied, unknown efficacy.  These tests have never been evaluated in a broad population (beyond children referred for audiology testing) for routine clinical use.
c.       This literature review effort is intended to meet the requirements of the degree program but could be used to write an article with a major finding, which also meets the requirements.  The Graduate College wants to ensure that graduates know the basics of article generation; this can be demonstrated in several ways. For example:
                                                  i.      Key milestones in the development of evidence
                                                ii.      A biologically based assessment of plausibility for those milestone-studies (NOT all of them)
                                              iii.      Review of test development process, with pros/cons
1.      Address different tests, including experimental tests that have been discarded
2.      Currently available tests limited to a selected set
3.      Known intermediate outcomes on only those tests that are available.  These may be limited (there is an average of 38 subjects per study of the 7 that Kairn has found), but can be evaluated using a set of criteria that Kairn can develop
                                              iv.      Conclusion: criticality of the need for Kairn’s study.  The level of detail should be appropriate for a clinician audience of the journal; it will satisfy the requirements of the committee.
d.      Next steps
                                                  i.      Document the methodology, with the criteria that were the conditions of including and excluding the sources found (from the 340+), for example:
1.      Reference source
2.      Focused on children
3.      The type of tests used, including their availability
                                                ii.      This methodology may be different for different milestones in the literature review, which is A-OK.  Keep track of those that were useful; let go of the others – this is a tightening exercise. 
                                              iii.      Develop a standard “lit review” data collection tool, with the filters specified for each criteria.  The literature will not make it easy, so creating a tool to mine the data from the data is critical.
1.      Were the conclusions supported by the data and analysis?
2.      Is it germane to the topic?
                                              iv.      Identify the weak studies, and cite them.
                                                v.      Acknowledge what evidence does exist, regardless of how much/little there is.
                                              vi.      ETA for literature review draft: August 28

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.       August 7: Marianne’s literature review with editor comments (no Ben)
b.      August 14: Rodger’s SIM proposal
c.       August 21: Kairn: draft of literature review
d.      August 28:

Recorder: Connie van Eeghen

Thursday, July 31, 2014

Clinical Research Oriented Workshop (CROW) Meeting: July 24, 2014



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

Start Up:

1.                  Discussion: Marianne’s research update
a.       Marianne provided a draft of her study protocol outline.  Some of the questions that were discussed were:
b.      Study design: the choice of a clustered randomized control trial, rather than a pre-post crossover design. 
c.       Identification of the primary outcome, and whether there is any literature based sources for patient self-assessment of the resolution of dermatological problems. 
d.      Secondary measures, including provider use of the knowledge-based resource.
e.       Sample size (an outcome of the primary outcome discussion) and strategies for dealing with the feasibility of patient consent and data collection.  Marianne is going to do more checking on the use of a “Codman Card.”

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.       July 31: Kairn – research update
b.      August 7: Marianne’s literature review with editor comments (no Ben)

Recorder: Connie van Eeghen

Thursday, July 24, 2014

Clinical Research Oriented Workshop (CROW) Meeting: July 17, 2014



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

Start Up: Ben and Rodger have been invited to a faculty development, 2 day conference at UVM in August.  The focus is big data and there is an opportunity to provide a “flash talk” (5 minutes, 1 slide, and a hook).  Ben may do license data or DARTNet – or both, as an overview, to invite other collaborators to join him.  Rodger has a CCRN data set (similar to DARTNet but not yet merged into it) and/or the SAFETINet data over multiple states.  This is an opportunity to get ideas and meet people.

1.                  Discussion: Rodger’s VIP project
a.       Interest is high in this area.  The Profile could become the assessment tool for the Toolkit that support operationalizing these concepts.
b.      The Profile has 8 domains, each of which is evaluated as an average of the questions that were responded to.  In total, there are 35 questions (elements).
c.       Validation strategies:
                                                  i.      Econometric model: detailed vignettes are developed for standardized scores; the elements are calculated to determine their standards
                                                ii.      A priori declaration that each domain is equally important.  Or, split the four domains that were two domains from the original model.
                                              iii.      Arbitrary ratings for each domain, rating (or ranking) them against each other.
                                              iv.      Gold standard outcome measure, e.g. patient outcome, correlated with VIP scores (this is the  least feasible alternative).
                                                v.      SF36 model: two scores, created from all elements (not domains).  Consider doing a factor analysis. 
1.      Two factors proposed: clinical services and practice characteristics.  Need a couple hundred survey results to conduct the analysis.
d.      Next step: VIP version 1 will not create a single score, but will provide a weighted score at the domain level.  Future versions can move to a weighted domains.
e.       Plan:
                                                  i.      Initial validity testing:
1.      Currently in the field for responses around discriminate validity
2.      Two raters in each site
                                                ii.      Update to version 3 (newly updated 7/17/14)
                                              iii.      New scenarios that are rank ordered and associated with VIP ratings, created around the elements in the eight domains, to be assembled in correspondence with specific VIP outcomes

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.       July 24: Marianne – research update
b.      July 31: Open

Recorder: Connie van Eeghen

Monday, July 14, 2014

New Book by Rodger Kessler

Congratulations to Rodger Kessler, PhD, Assistant Professor of Family Medicine, who just had a new book published by Springer:

Handbook of Clinical Psychology in Medical Settings

Evidence-Based Assessment and Intervention
Hunter, Christine M., Hunter, Christopher L., Kessler, Rodger (Eds.)








http://www.springer.com/medicine/book/978-0-387-09815-9

Friday, July 11, 2014

Clinical Research Oriented Workshop (CROW) Meeting: July 10, 2014



Present:  Sylvie Frisbie, Juvena Hitt, Kairn Kelley, Rodger Kessler, Ben Littenberg, Connie van Eeghen, Jon van Luling

Start Up: Jill Jemison and Pamela James (support staff for this application) from COM Technology Services.

1.                  Discussion: Research Collaboration Network: “The Commons” http://commons.med.uvm.edu/
a.       This is a document sharing platform, based on SharePoint, with supportive features:
                                                  i.      Calendars (may be more than one) – can be viewed through Outlook but not vice-versa
                                                ii.      Announcements (straight text)
                                              iii.      Subfolders of documents
                                              iv.      Knowledge Bases: wikis for self-publishing that supports links
1.      Includes version control, for back version capture
2.      Links to OneNote, including highlighting, printing (with stylus), and drawing
                                                v.      List tools
                                              vi.      Discussion Boards
                                            vii.      MS Office Suite
b.      Also includes simple surveys, inside the domain (e.g. faculty)
c.       Limited to 100G of storage to start with; may be expanded
d.      REDCap is run through CCTS in the CoM; not sure of future linkage.  This Intranet can hold the data from REDCap but does not replace REDCap.  (Not directly imported at this point.)
e.       Stata’s high speed server is more protected (less ability to provide access); VCHURES is also on the Stata server.  There may be a “window” provided from the Intranet to this server.
f.       The Intranet is NOT the place for PHI; keep it on a more secured server.  More coming in the future.
g.      Security of the files meets the standards set by FAHC (firewalls with “incursion boxes;” development of policies and memoranda of understanding with every investigator)
h.      “Group” Application: patient centered research collaborative with UVM and community members, as well as researchers from other organizations
                                                  i.      Can use non-UVM email addresses
                                                ii.      Set up as a separate account through “Account Request” form
i.        Request: a 3rd party email application that notifies the users of updates and displays the new discussion/item

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.       July 17: Rodger – Vermont Integrate Profile validation
b.      July 24: Kairn – Lit Review

Recorder: Connie van Eeghen and Sylvie Frisbie

Tim Tourville wins dissertation prize

Timothy Tourville, Ph.D., ATC, research assistant professor of orthopaedics and rehabilitation at the University of Vermont College of Medicine, received the 2014 Doctoral Dissertation Award from the National Athletic Trainers’ Association (NATA) Research and Education Foundation. Tim was our first PhD graduate!

http://www.uvm.edu/medicine/?Page=news&storyID=18796&category=comfacul