Research Projects

NEW RESEARCH PROJECTS: Improving Performance in Practice This project, funded by the American Board of Medical Specialties (primary: Robert Wood Johnson), is a national initiative supported by the primary care specialty societies and boards to develop, test, and deploy a sustainable, state-based approach that can support efforts by primary care providers, including internists, family physicians, and pediatricians and their care teams, to improve the way chronic illness and preventive care is provided to patients. Minnesota Complexity Assessment Method in Diabetes Patients Funded by UCare Minnesota, this project will examine the validity of the Minnesota Complexity Assessment Method in a sample of clinic patients with poorly controlled diabetes. Physicians in 1 or 2 clinics will be asked to assess their patients with poorly controlled diabetes. The complexity tool is a method to help plan additional assistance for patients. Participation by Primary Care Practices in Health Information Exchange Funding for this project was awarded by the Agency for Healthcare Research and Quality (AHRQ) to assess factors that influence the participation of primary care practices in electronic health information exchange initiatives including benefits and barriers to participation. Study will involve practices that are comprised of 20 or fewer full-time clinicians. Nine primary care clinics around the state will be involved in the research.   CONTINUING RESEARCH PROJECT UPDATES: Resource Center for Primary Care Practice Based Research Networks The MAFPRN is in its second year of operating and managing the National Practice Based Research Network (PBRN) Resource Center. Funded by the Agency for Healthcare Research and Quality (AHRQ), the Resource Center serves as the major Federal source of infrastructure support to primary care PBRNs, especially new and emerging networks. It provides resources and assistance to primary care PBRNs engaged in clinical and health services research. The staff provides support to registered PBRNs through a series of web-based seminars and the provision of technical research expertise. The PBRN resource center also helps plan and manage the annual AHRQ PBRN Research Conference held in June (www.pbrn.ahrq.gov). The Minnesota Academy of Family Physicians Research Network (MAFPRN) In 2007, the MAFPRN was awarded a task order contract by the DHHS Agency for Healthcare Research and Quality (AHRQ) for Primary Care Practice Based Research Networks (PBRNs). All work required under this contract will be performed through the issuance of task orders. Competitive (or justified sole source) requests for task orders (RFTOs) will be sent throughout the fiscal year. To date the MAFPRN has received funding for one task order: Participation by Primary Care Practices in Health Information Exchange. Atherothrombosis Intervention in Metabolic Syndrome  (AIM-HIGH) This study began in 2005 and is being funded by the National Institutes of Health (NHLBI) through a subcontract with the Axio Research. As a clinical center for the AIM-HIGH Trial, testing is being done to determine whether the combination of niacin and simvastatin lowers the risk of heart attacks and strokes more than just taking simvastatin alone. ACCORD Trial The ACCORD trial which began in 2000 is sponsored by the National Heart, Lung, and Blood Institute (NHLBI) and the first phase of the trial is scheduled to be completed this year in June. Observation will continue through December 2010. Phalen Village Clinic is one of the few Family Medicine Clinics that has been participating in the ACCORD Study. The findings of ACCORD are producing national changes in health care quality measures. ACCORD is an acronym for Action to Control Cardiovascular Risk in Diabetes. The aim of the study has been to test whether intensive control of blood glucose (A1c less than 6) is more effective in reducing cardiovascular events than conventional control. The separate effects of two levels of blood pressure and two methods of lipid control are being tested as well. Sub-studies looking at the effect of blood glucose control, lipid management and blood pressure control on bone density, vision and memory are underway also. It should be noted that the intensive blood sugar lowering treatment in the study was stopped last year and participants in that treatment group were transitioned to the same goal as participants in the standard treatment group. The NHLBI decided to change this treatment due to safety concerns after a thorough review of the available data and a recommendation by the study’s Data and Safety Monitoring Board. The other two treatment questions being examined in the study--the blood pressure and lipid trials--will continue until June 2009 as planned. Developing a Distributed Research Network and Cooperative to Conduct Population-based Studies and Safety Surveillance This subcontract, awarded by the Agency for Healthcare Research and Quality (AHRQ), began in 2007. The Distributed Ambulatory Research in Therapeutics Network (DARTNet) is a prototype federated network of electronic health record (EHR) data from eight organizations representing over 200 clinicians and over 350,000 patients. The prototype system will capture, codify and standardize over 200 unique data elements per patient for up to 24 months of time. It will explore how currently available EHR data can be used to supplement data from large administrative datasets in order to answer questions concerning the safety and effectiveness of medications and medical devices. Furthermore, the expertise of the participating PBRNs will be used to explore the ability to fill gaps in clinical data using point of care data collection techniques.   RECENTLY COMPLETED RESEARCH PROJECTS: Cancer Central Clinical Database (C3D) Trial The University of Minnesota Department of Family Medicine and Community Health (DFMCH) was awarded a contract from the caBIG, an initiative of the National Cancer Institute, NIH, DHHS to conduct two clinical trials using the C3D. The C3D is a web-based clinical data management solution originally developed for NCI’s intramural research program but is now available to other research organizations in a hosted Application Service Provider model. C3D supports data standardization, reuse, sharing, and interoperability through electronic Case Report Forms based on Common Data Elements maintained in NCICB’s Cancer Data Standards Repository and controlled by terminology from the NCI Enterprise Vocabulary Services. Through participation as an early adopter, the DFMCH used this clinical trial management system to support two studies that are relevant to cancer detection and prevention. The studies used were: Increasing Colorectal Cancer Screening by Primary Care Physicians in Appalachia PA, William J. Curry, MD, MS, Principal Investigator, Penn State University Physical Activity Intervention for Smoking Cessation in Women Aged 50 and Older; Sharon S. Allen, MD, PhD Principal Investigator, University of Minnesota Results of these studies will be presented at future meetings.   The electronic Primary Care Research Network (ePCRN) This project, funded by an NIH award to a collaboration of the Federation of Practice-based Research Networks (FPBRN), the MAFPRN, and the University of Minnesota, has been successfully completed and makes it possible for PBRNs to participate in large randomized controlled trials. The ePCRN is designed to support primary care providers in conducting clinical research in their practices and to provide secure, cutting-edge technology along with training, support and technical assistance. This technology enables practices to create disease registries and report quality indicators, and to better communicate and coordinate activities among practices. Project results were presented at the NIH Translation Conference in May, 2008 and will also be presented at the American Medical Informatics Association Meeting in May 2009.

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