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Research Projects
The National Resource Center for Primary Care Practice Based Research Networks. Funding was received from the Agency for Healthcare Research and Quality (AHRQ) to operate and manage the National Practice Based Research Network (PBRN) Resource Center. 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 May.
Developing a Distributed Research Network and Cooperative to Conduct Population-based Studies and Safety Surveillance. This subcontract was awarded by the Agency for Healthcare Research and Quality (AHRQ). 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.
The Minnesota Academy of Family Physicians Research Network (MAFPRN). The MAFPRN was recently 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. Each contractor will be guaranteed at least one task order over the course of the contract.
In addition to these new studies, there are several ongoing studies.
Atherothrombosis Intervention in Metabolic Syndrome. Funding for this project was awarded by the National Institutes of Health (NHLBI) through subcontract with the Axio Research. As a clinical center for the AIM-HIGH Trial, testing will be done to determine whether the combination of niacin and simvastatin lowers the risk of heart attacks and strokes more than just taking simvastatin alone. The scope of work includes recruitment and informed consent of approximately 55 eligible subjects, collection of the required baseline data, post-randomization clinical events and fasting laboratory values according to the prescribe visit schedule. All required data collection will be entered on the study’s secure website.
Cancer Central Clinical Database (C3D) Trial. The ePCRN 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. We are currently in the process of identifying possible cancer trials to conduct.
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, 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. Sophisticated videoconferencing is also supported by the ePCRN.
AccessGrid. Internet video conferencing has become a crucial resource for supporting the development activities of the electronic Primary Care Research Network. The ePCRN has successfully adopted the AccessGrid Toolkit, an open-source, community developed software package managed by the Argonne National Laboratory. The high quality visual and audio performance produced by the AccessGrid is unlike teleconferencing most people have experienced. By using the AccessGrid, ePCRN directors located across the nation meet monthly as though they are in the same room. Also, weekly ePRCN systems and software development meetings take place among team members located in San Francisco, Minneapolis, and Birmingham, England. Since each site presents visual and audio content to other sites simultaneously all participants can equally interject during discussions and gauge reactions simply by sight. Efforts by the ePCRN are underway to make this technology available to most primary care physicians in the clinical settings. Possibilities exist for clinician training and clinician-patient interaction remotely. Recent breakthroughs hold great promise toward achieving these goals.
ACCORD. Phalen Village Clinic is one of the few Family Medicine Clinics participating in the NIH sponsored 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. This study completed the recruitment phase in October, 2005 enrolling 10,251 patients at 70 sites in the US and Canada. Phalen Village Clinic has 184 participants enrolled. The study will be completed in 2009. The aim is 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. The National Heart, Lung, and Blood Institute (NHLBI), which sponsors the ACCORD trial, recently stopped the intensive blood sugar lowering treatment in the study and is transitioning participants in that treatment group to the same goal as participants in the standard treatment group. 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. Therefore, ACCORD participants will continue to receive blood sugar treatment from their study clinicians until the planned trial conclusion in June 2009.
