Clinical Research Oriented Workshop (CROW) Meeting: May 8, 2014

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

Start Up: How to tell when someone is willing to accept a complement about shaving skills.

1.                  Discussion: GeoMed Online Dashboard overview by Ben

a.       REDCap survey tool disseminated through many on-line sources to collect data on BMI and location

                                                  i.      750 responses to date, from the mid-East to Pacific islands

                                                ii.      STATA “do” file takes in REDCap spreadsheet and automatically produces graphics, when run

                                              iii.      May be able to increase responses through community-based project websites, such as REDDIT

b.      Geo Med Drivers: 5 states (VT, ME, OR, WA, IL) resulting in 21.5m records

                                                  i.      Drivers’ records differ by states; data are cleaned through a “do” file, missing files from ME for date of issue

                                                ii.      Obesity varies by state of residence and age

                                              iii.      Obesity peaks in the fifties and falls through the 70s and 80s

c.       County analysis of behavioral health risk data from adults (~900,000) in every county (8000) in the U.S.

                                                  i.      Added census and geographic data by county

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.       May 8: Status update on geomed and Twitter research – Ben Littenberg

b.      May 15: Vegetables, depression and cardiac outcomes and women – Rodger Kessler’s selection for journal article review

c.       May 22: Emily’s other paper (no Marianne)

d.      May 29:

Recorder: Connie van Eeghen

Here's a new article by Susan Kasser, PhD, Associate Professor of Movement Science and colleagues:

Am J Phys Med Rehabil. 2014 Jun;93(6):461-9. doi: 10.1097/PHM.0000000000000049.

Exploring physical activity in women with multiple sclerosis: associations with fear of falling and underlying impairments.

Kasser SL1, Jacobs JV, Littenberg B, Foley JT, Cardinal BJ, Maddalozzo GF.

Author information

Abstract

OBJECTIVE:

The aim of this study was to conduct an exploratory analysis of fear of falling (FoF), balance, gait, and strength impairments and future physical activity in women with multiple sclerosis.

DESIGN:

This prospective study followed a convenience sample of 99 women with multiple sclerosis for 1 yr. The participants were assessed on FoF and perceived mental health by questionnaire. Objective measures included Limits of Stability, the Sensory Organization Test, and the Functional Ambulation Profile. Strength was quantified by knee extensor power asymmetry. Activity-specific metabolic equivalent values were used to determine minutes per week of moderate and vigorous physical activity.

RESULTS:

Future physical activity most strongly associated with baseline FoF (R = 0.09, P < 0.01), and baseline FoF associated with limits of stability and lower extremity strength asymmetry (R = 0.21, P < 0.001). Follow-up FoF is best predicted by initial levels of FoF independent of intervening falls (β = 3.26, P < 0.001).

CONCLUSIONS:

Future physical activity of women with multiple sclerosis was best predicted by FoF independent of physical and mental functioning. Increased FoF was associated with greater lower extremity strength asymmetry and decreased limits of stability rather than with the experience of falls.

Clinical Research Oriented Workshop (CROW) Meeting: May 1, 2014

Present:  Marianne Burke, Kairn Kelley, Amanda Kennedy, Rodger Kessler, Ben Littenberg, Emily Tarleton, Connie van Eeghen

Start Up: The Importance of Celebrating Life in Paris (or wherever); The Importance of Getting Feedback and Responding to it Honestly

1.                  Discussion: Manuscript titled: “Magnesium Intake and Depression in US Adults” led by Emily and Ben:

a.       Emily and Ben are going to submit to the Journal of Clinical Nutrition (audience is nutritionists, not epidemiologists or psychiatrists)

b.      The discussion about supplementation does not clearly address the use of medications in the population under study.  Should it be included or used as exclusion criteria?

c.       The introduction was a strong literature review; is that needed in this kind of journal article?

d.      The discussion of elderly seems incomplete, given the final results.

e.       The “board of editors” found the article to be very strong, and recommended submission as soon as fine tuning could be completed.  Well done!

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.       May 8: Status update on geomed and Twitter research – Ben Littenberg

b.      May 15: Vegetables, depression and cardiac outcomes and women – Rodger Kessler’s selection for journal article review

c.       May 22: Emily’s other paper (no Marianne)

d.      May 29:???

Recorder: Connie van Eeghen

Recognition for Connie van Eeghen

The 2013 North American Primary Care Research Group Meeting featured a presentation by Connie van Eeghen DrPH, Amanda Kennedy PharmD, Mark Pasanen MD, Benjamin Littenberg MD, and Charles MacLean MD on "Using Lean Management to Improve Opioid Prescribing for Pain in Ambulatory Care." It was so well received that it has been named a "best-of NAPCRG" PEARL based on several factors including interest and the potential impact of the results. NAPCRG PEARLs are featured at several different primary care clinical meetings, such as the Family Medicine Forum in Canada. 

Congratulations to Principal Investigator Connie van Eeghen DrPH!

Clinical Research Oriented Workshop (CROW) Meeting: March 27, 2014

Present:  Kairn Kelley, Rodger Kessler, Mark Kelly, Connie van Eeghen

Start Up: Welcome to Diantha Howard for a discussion about REDCap.  Kairn finally received IRB approval – hooray!

1.                  Discussion: Advanced Topics on REDCap to follow previous CROW workshop

a.       Randomization Module:

                                                  i.      Allows user to input a coding order (the randomization plan), which REDCap uses to assign surveys.  Randomization is a choice in Project Set Up (after allowing user permission to access Randomization under User Rights).  Once the randomization plan is updated, it is fixed – it cannot be changed.

                                                ii.      Example: Kairn is planning to give 3 tests to subjects in 6 different possible orders.  She would like to use all six orders, evenly distributed and randomly assigned.  She has to develop the assignment system outside of REDCap, e.g. in Excel.

                                              iii.      Randomization may be stratified, for example, on gender, so that within each gender there will be a similar number of different treatments.  In this case, there is a table for each stratified alternative, each with its own randomized plan.

                                              iv.      There are strategies for balancing randomization when the n is low, but these happen in the randomization plan outside of REDCap (e.g. an algorithm for a Latin Square).

b.      Report building

                                                  i.      Primary purpose: view the data – does NOT do much to summarize the data – in order to check for data collection or to produce a list of records for action

c.       Tips:

                                                  i.      Keep in mind that there are two REDCap applications available to us: FAHC (behind a firewall) and UVM (the only application that can mail out surveys to email addresses)

                                                ii.      Multiple projects can be managed using the Bookmark feature in the future, after the next upgrade.

                                              iii.      The choice of a “longitudinal” study means using the EXACT same form (survey) more than once.  It results in a file that creates multiple rows per subject.

d.      Thank you, Diantha!

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.       April 3: Rodger’s discussion of research design for PCORI study comparing integrated models of care.

b.      April 10:

c.       April 17:

Recorder: Connie van Eeghen

SUB-Clinical Research Oriented Workshop (CROW) Meeting: March 13, 2014

Just a sub-workshop meeting with: Kairn Kelley, Connie van Eeghen

Start Up: Happy half a snow day!

1.                  Discussion: Surveys for Toolkit on Behavioral Health Integration, Connie van Eeghen

a.       Introduction needs tightening.  Clarity needed on who the audience is and what the surveys is for.

b.      Questions related to “organizational readiness” read differently – should this be better described in the instructions?

c.       Some questions in pre-project survey are similar to pre-decision survey.  Clarify; make the questions in pre-project specific to BHI.  This is an opportunity to link back to questions in the pre-decision survey.

d.      The pre-project survey is focused on determinants of effective change; need to know opinions about behavioral health services at the practice?

e.       Back to the drawing board – thanks Kairn!

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.       March 20: Rodger on VIP metrics

b.      March 27:

c.       April 3:

Recorder: Connie van Eeghen