In the final year of her undergraduate studies, Claire Houchen was looking to expand her research experience. Read more >>>
The UMKC School of Medicine has received a nearly $400,000 grant from the National Institutes of Health to continue and build upon a successful two-year training program in clinically oriented cardiovascular disease outcomes research through the Department of Biomedical and Health Informatics and UMKC’s new Healthcare Institute for Innovations in Quality (HI-IQ). The funding covers the first of five years of support through the National Heart, Lung and Blood Institute, bringing the total grant funding to just less than $2 million.
Immense research investments have improved the care of patients afflicted with cardiovascular disease, the leading cause of death and disability in the United States. But continued evaluation of patient-centered outcomes, including patient symptoms, function and quality of life and how to apply that knowledge in clinical settings is needed, said John Spertus, M.D., professor, clinical director and endowed chair in metabolic and vascular disease research.
“Collectively, our committed team will provide formal training, mentorship and research experiences for trainees to make significant contributions to the scientific literature, embark on successful academic careers, and improve the value and patient-centeredness of medical care,” Spertus said.
Hands-on research is one of the key components of the program that provides a basic foundation in clinical research, including a master’s degree in bioinformatics with a clinical research emphasis, and specialized skills for outcomes research, coupled with academic survival skills.
Hallmarks of the research experiences include multi-disciplinary group and individualized mentorship to meet each trainee’s needs, as well as access to numerous existing data. Clinical populations for primary data collection and implementation, training in entrepreneurship and highly experienced statistical support are provided to support trainees’ success.
Program enhancements are also planned that include a more robust collaboration with the University of Missouri system, increased engagement in clinical trial design and a growing focus on implementation science with access to HI-IQ’s multistakeholder collaboration of 19 regional hospitals.
“We want people to feel welcomed, we want them to feel like they’re in an environment that they know, they trust, they frequent often,” said Jannette Berkley-Patton, a professor at UMKC’s School of Medicine, and a team member. Read more….
COVID vaccination rates are tremendously low in communities of color in Kansas City. On average, only 43% of individuals get vaccinated, which is about 7% lower than the national average. Read more….
Jannette Berkley-Patton, Ph.D., professor of biomedical and health informatics and director of the University of Missouri-Kansas City Health Equity Institute, took up the challenge to bring the message as well as the needed vaccines to Kansas City communities with some of the lowest vaccination rates in the city. Read more…..
UMKC School of Medicine researcher John Spertus, M.D., M.P.H., is part of two large NIH-funded clinical studies published in the New England Journal of Medicine, Monday, March 30. The studies indicate eliminating unnecessary revascularization treatments for cardiac patients could save the United States hundreds of millions of dollars annually.
Spertus serves as professor of medicine and Daniel J. Lauer, M.D., Endowed Chair in Metabolism and Vascular Disease Research at the School of Medicine, and Clinical Director of Outcomes Research at Saint Luke’s Hospital.
The studies looked specifically at coronary artery disease patients who had high-risk blockages with least 10 percent or more of the heart muscle being at risk. One focused on patients with preserved kidney function and the other targeted patients with end-stage kidney failure. That latter group has largely been excluded from almost all cardiovascular trials, despite having a high prevalence of coronary artery disease and death, Spertus said.
Both studies, conducted in unison, examined the most important outcomes for patients, clinical events (e.g. heart attacks, death) and patients’ symptoms, function and quality of life. Participants were randomized to undergo invasive angiography and revascularization with aggressive medical therapy or aggressive medical therapy alone. The goals of the medical treatment were cholesterol reduction, blood pressure control, aspirin and medications to treat chest pain.
The studies in patients with preserved kidney function showed that invasive medical procedures provided no reduction in clinical events, but did improve patients’ symptoms and quality of life, if they had chest pain within a month of entering the trial. These health status benefits were evident within three months and sustained out to four years.
“Importantly, this benefit was only observed in patients who had angina, chest pain, and not in asymptomatic patients,” Spertus said. “There is no indication for these procedures in patients whose symptoms are well-controlled with medications alone. If we avoided revascularization in asymptomatic patients, we could potentially save about $500 million to $750 million a year in the United States alone.”
Among patients with very severe kidney disease, there was no significant difference in clinical events or in patients’ symptoms and quality of life.
“While disappointing, this is a very ill patient population for whom an aggressive, invasive treatment strategy does not seem to offer much benefit,” Spertus said.
The NEJM is publishing four papers from these studies on March 30, one for each trial focusing on the clinical events and another for each trial focusing on the quality of life outcomes. Spertus was involved in writing all four and is the lead author on the two quality of life papers. He and his team designed, analyzed and led the health status, quality of life components of both trials.
Spertus is the author of the Seattle Angina Questionnaire (SAQ) that used in the studies. It is widely recognized throughout the world as the gold standard for quality of life measurement in cardiac medicine.
“Our group has led its use and analyses in multiple studies and quality improvement efforts,” Spertus said. “In light of these findings, the SAQ may start becoming a routine part of clinical care in cardiology.”