Clinical Research Oriented Workshop (CROW) Meeting: May 20, 2021

Present:   Levi Bonnell, Nancy Gell, Ben Littenberg, Adam Sprouse-Blum, Connie van Eeghen (5)

 1.                   Warm Up: It’s May… life is good in VT… maybe not so much in less vaccinated places

2.                   Adam’s K Award application: Reviewed Research Strategy

a.       Formatting:

                                                   i.      Watch for orphans

b.       Significance:

                                                   i.      Impact on people – how burdensome is migraine?

                                                 ii.      What is the additional burden of left sided headache?

                                               iii.      If bilateral is important, where does it belong in the Significance section, and why? Add to second paragraph. “Is bilateral migraine different from L/R or is bilateral the combination of L/R?”

c.       Language

                                                   i.      “I” or “We” – whatever you use, be consistent.  OK to be 1^st person singular in a K award.

d.       Analyses

                                                   i.      What to do about adjusting for multiple hypotheses? TBD

e.       Potential problems:

                                                   i.      Not generalizable to rare forms of migraine or other headache syndromes

                                                 ii.      Convenience sample: patients close to the Med Center and can come in without notice; may not be generalizable to other groups

                                               iii.      Small sample size

                                               iv.      Inadequate sample size is a threat to the study, however… (bridge to existing language in draft)

                                                 v.      Patients lost in prior study: 1 out of three not able to conduct study; able to retain when presented with their next attack

1.       Unable to tolerate scan – all 10 finished the migraine scan but, for the non-migraine scan, 1 was retriggered during the scan due to flashing lights (reaction to the protocol) – later returned to repeat scan without flashing lights; we will use such tactics going forward

f.        Other:

                                                   i.      Consider a conceptual model that drives migraine responsiveness in different hemispheres: are there structural differences in the brain that are reflected in migraine laterality, such as:

1.       Blood flow

2.       Neuronal activity

3.       Cerebral vascular reactivity

4.       Cognition based on what lights up

                                                 ii.      Or, are there intrinsic brain structures that influence laterality, or there is something else that affects laterality, are the symptoms primary to migraine?

                                               iii.      Include a list of outcomes

1.       Identify predictor: laterality of migraine

2.       Identify outcomes in relationship to predictor

3.                   Next week:  TBA

Clinical Research Oriented Workshop (CROW) Meeting: May 5, 2021

 

Present:   Levi Bonnell, Justine Dee, Nancy Gell, Emily Houston, Ben Littenberg, Charlie MacLean, Liliane Savard, Connie van Eeghen, Mariana Wingood (9)

 1.                   Warm Up: Covid vaccinations internationally are slowly picking up… but not in time for travel plans

2.                   Justine Dee’s poster for IASP: Was scooped on her dissemination plan; decided to proceed with poster as she had additional information related to the type of abuse involved

a.       Format

                                                   i.      Bullet points!

                                                 ii.      Reduce size of Odds Ratio tables

                                               iii.      OK to change the title on the poster, as long as it is not part of the way-finding process for viewers

                                               iv.      QR Code to Justine’s webpage

                                                 v.      Middle section: make decimal points consistent, in text, P values, OR tables, and on RR graph

                                               vi.      Use “adjusted” and “non adjusted” rather than “multi-variate” and “univariate”

b.       Analyses

                                                   i.      Odds ration or Relative Risk – not both

1.       Converting OR based on multi-variate analysis: identify the non-exposed prevalence (baseline prevalence in non-abused population: 8%)

2.       Use the Odds Ration to Risk Ratio Converter on the Internet

3.       https://clincalc.com/Stats/ConvertOR.aspx

c.       Message

                                                   i.      Key point: how pain is related to abuse or overall health impact

1.       Goal: make connections, gain new contacts, and learn new points

2.       The small interest group on torture survivors are looking for clinicians

3.       Focus the conclusion on the clinical relevance

                                                 ii.      How useful is the wide variability of abuse experience in the Background?

                                               iii.      There is a mix of groups in the poster:

1.       Background: refugees

2.       Methods and Results: immigrants

                                               iv.      Identify how pain is assessed?  How is abuse assessed?

1.       Instrument was burdensome (long and complex); may have affected reporting

2.       Does not identify rape as a kind of harm; may be under-reported

                                                 v.      Findings: express the populations more simply: immigrant population, abuse population

                                               vi.      Conclusion: use to identify the opportunity for clinical research, making connections to IASP

1.       There are data that show the need for trusting relationship and time to develop them

d.       This is interesting and relevant – keep going!

                                                   i.      Does not include/acknowledge asylees, those who do not have time to become refugees

3.                   Next week:  TBA