UMKC researcher helped lead studies published in New England Journal of Medicine

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.”

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Thesis and Capstone Options

Students in the Master of Science Bioinformatics degree program who complete the degree without an emphasis, or with a Clinical Research or Computational emphasis may choose to develop either a Master’s Thesis or a Capstone Project. Both options require students to conduct original research under the guidance of a coordinating committee, produce a final report of their project, and give an oral, public presentation defending their methodology and findings.

Students completing the degree with a Genomics emphasis are required to develop a Master’s thesis.

Developing the Master’s Thesis

The UMKC School of Graduate Studies governs the format of the Master’s Thesis. In order to complete the thesis requirement for graduation, students must meet the SGS specific requirements. Click here to read about format and submission guidelines.

After completing required and elective coursework for the Master of Science in Bioinformatics degree program, students who plan to complete a Master’s Thesis will enroll in 6 credit hours of MEDB 5599, Research and Thesis. These hours may be taken in one semester or split between two (or more), and will be guided by decisions made in the Agreement Between Research Advisor and DBHI Graduate Student form. Click here to read through the agreement template.

The Thesis research project should apply informatics concepts in a practical (real-world) scenario. In consultation with their research advisor, and after a comprehensive review of the available literature, students will formulate a research question or hypothesis that will guide their project.

Developing a Master’s Capstone Project

The Master’s Capstone Project allows students to demonstrate their mastery of core competencies without completing a traditional, long-form thesis. Students will enroll in three credit hours of MEDB 5595, Capstone Experience, and work with a supervisory committee to determine a unique research project with various final products based on emphasis area and interest. For clinical research questions, the student will prepare a literature review addressing the content area, assist in the collection or analysis of data which may answer the question and provide a report with recommendations. The report should have a writing component, but may be the form of a poster presentation. For informatics questions, the student may be asked to follow a similar strategy or may be asked to develop and/or apply computer solutions to the problem. Students completing the Capstone Project will need to enroll in an three additional credit hours of coursework.

Evaluation

Evaluation of the final Thesis or Capstone Project will be based on how well students demonstrate their ability to:

  1. perform statistical analysis
  2. generate a research hypothesis
  3. propose, conduct, and report research.
  4. apply knowledge and skills in biomedical informatics.
  5. communicate scientific information in writing and through oral presentation.
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Students completing a Master’s Thesis or Master’s Capstone Project will receive guidance and evaluation from a Master’s Thesis or Capstone Committee. Students are responsible for the creation of their own committees, which must include a chair (that will serve as the student’s research advisor) and two other faculty members. The committee chair must be a member of the UMKC Graduate Faculty. Full-time students should pick a thesis chair and propose a topic by the end of their first year. Often the student’s faculty advisor is a natural choice for their committee chair, but that is not required. Students should communicate with their faculty advisor about their options for committee chair as soon as possible.

Committee members will use the following forms for final evaluations:

Secondary Faculty Appointments

Faculty members with a primary appointment in another department or at an external institution who contribute expertise through guest lectures, the Research and Statistical Consult Service, and/or in course development.

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Peter Almenoff, M.D., F.C.C.P.

Clinical Professor, Vijay Babu Rayudu Endowed Chair of Patient Safety, Special Advisor, OSVA (Healthcare Value), Senior Fellow, VA Center for Innovation, Director, Operational Analytics and Reporting, Office of Informatics and Analytics, Veterans Health Administration
Department(s) of Internal Medicine, Biomedical and Health Informatics
Kansas City Veterans Medical Center
Almenoff, Peter
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David Bamberger, M.D.

Professor, Years 3-6 Docent, Vice-chairman, Educational Affairs - UMKC School of Medicine, Section Chief, Infectious Diseases - UMKC School of Medicine, Medical Director - Kansas City Health Department STD Clinic, Medical Director, Occupational Health - University Health
Department(s) of Internal Medicine
Section: Infectious Disease
UMKC School of Medicine, University Health - UMKC Health Sciences District

Specialties and Research/Medical Interests

Infectious Diseases

Bamberger, David
235-1942
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Karen Bame, Ph.D.

Associate Professor
Department(s) of Biomedical and Health Informatics
UMKC School of Biological Sciences
Bame, Karen
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Donna M. Buchanan, Ph.D.

Associate Professor
Department(s) of Biomedical and Health Informatics
Saint Luke's Hospital
Buchanan, Donna M.
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Ian Z. Chuang, M.D., M.S.

Adjunct Assistant Professor, Senior VP - Healthcare Informatics and Chief Medical Officer - Netsmart Technologies
Department(s) of Biomedical and Health Informatics
UMKC School of Medicine
Chuang, Ian Z.
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Betty M. Drees, M.D., F.A.C.P., F.A.C.E.

Professor, Dean Emerita, Program Director - Endocrinology, Diabetes and Metabolism Fellowship, President - Stowers Institute for Medical Research Graduate Program, James B. and Annabel Nutter/Harry S. Jonas Endowed Professor
Department(s) of Internal Medicine, Biomedical and Health Informatics
Section: Endocrinology
UMKC School of Medicine, University Health - UMKC Health Sciences District Drees, Betty
Drees, Betty M.
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Lawrence A. Dreyfus, Ph.D.

Professor, Vice Chancellor for Research
Department(s) of Biomedical and Health Informatics
UMKC School of Biological Sciences
Dreyfus, Lawrence A.
235-1520
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Sarah Fouquet, Ph.D.

Research Assistant Professor
Department(s) of Biomedical and Health Informatics
Children's Mercy Hospital
Fouquet, Sarah
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John Foxworth, Pharm.D.

Professor, Associate Dean for Academic Enrichment, Director of Research, Internal Medicine Residency, Fellow, American College of Clinical Pharmacology and American Society for Clinical Pharmacology and Therapeutics, Member and UMKC SOM Councilor - AOA (Alpha Omega Alpha)
Department(s) of Internal Medicine
Section: Pharmacology
UMKC School of Medicine, University Health - UMKC Health Sciences District Foxworth, John

Specialties and Research/Medical Interests

Teaching research methodology, Biostatistic and evidence-based medicine

Foxworth, John
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Kimberly L. Gandy, M.D., Ph.D.

Adjunct Associate Professor, Surgical Director - Cardiac Transplantation
Department(s) of Biomedical and Health Informatics
Section: Cardiovascular Surgery
Children's Mercy Hospital, UMKC School of Medicine
Gandy, Kimberly L.
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Mary M. Gerkovich, Ph.D.

Adjunct Emeritus Associate Professor, Tenured
Department(s) of Biomedical and Health Informatics
UMKC School of Medicine
Gerkovich, Mary M.
235-1322
M5-121
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Mark Hoffman, Ph.D.

Adjunct Associate Professor, Research Associate Professor, Director - Translational Bioinformatics - Children’s Mercy Kansas City
Department(s) of Biomedical and Health Informatics, Pediatrics
Children's Mercy Hospital
Hoffman, Mark
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Hongying (Daisy) Dai, Ph.D.

Associate Professor, Senior Biostatistician, Research Development and Clinical Investigation
Department(s) of Pediatrics, Biomedical and Health Informatics
Children's Mercy Hospital
Dai, Hongying (Daisy)
701-5233
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Dev Maulik, M.D., Ph.D.

Professor, Chair, Senior Associate Dean - Women's Health
Department(s) of Obstetrics and Gynecology
Section: Maternal Fetal Medicine
University Health - UMKC Health Sciences District, Children's Mercy Hospital
Maulik, Dev
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Matthew J. McLaughlin, M.D.

Assistant Professor
Department(s) of Pediatrics
Section: Rehabilitation Medicine
Children's Mercy Hospital
McLaughlin, Matthew J.
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Jill Moormeier, M.D., M.P.H.

Professor, Chair - Department of Internal Medicine
Department(s) of Internal Medicine
Section: Hematology/Oncology
UMKC School of Medicine, University Health - UMKC Health Sciences District

Specialties and Research/Medical Interests

Assessment and evaluation, Program development

Moormeier, Jill
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Reem Mustafa, M.D., M.P.H., Ph.D.

Clinical Associate Professor, Years 3-6 Docent, Director - Outcomes and Implementation Research
Department(s) of Internal Medicine, Biomedical and Health Informatics
Section: Nephrology and Hypertension
University Health - UMKC Health Sciences District, UMKC School of Medicine
Mustafa, Reem
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Mark Patterson, Ph.D., M.P.H.

Associate Professor
UMKC School of Pharmacy

Specialties and Research/Medical Interests

Health Informatics, Psychiatry

Patterson, Mark
235-6320
HSB 4245
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Gary A. Salzman, M.D.

Professor, Senior Docent
Department(s) of Internal Medicine
Section: Respiratory and Critical Care
UMKC School of Medicine, University Health - UMKC Health Sciences District Salzman, Gary

Specialties and Research/Medical Interests

Pulmonary / Critical Care, Internal Medicine

Salzman, Gary A.
235-1974
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Julie L. Strickland, M.D., M.P.H.

Professor, Program Director - Pediatric Adolescent Gynecology Fellowship Program
Department(s) of Obstetrics and Gynecology
Children's Mercy Hospital
Strickland, Julie L.
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Gary Sutkin, M.D., M.B.A.

Professor, Associate Dean of Women's Health, Victor and Caroline Schutte Chair in Women’s Health
Department(s) of Biomedical and Health Informatics, Obstetrics and Gynecology
University Health - UMKC Health Sciences District Sutkin, Gary
Sutkin, Gary
235-6785
M3-204
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Karen B. Williams, Ph.D.

Professor, Chair Emerita
Department(s) of Biomedical and Health Informatics
UMKC School of Medicine
Williams, Karen B.
M5-132
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Gerald J. Wyckoff, Ph.D.

Associate Professor
Department(s) of Biomedical and Health Informatics
Section: Molecular Biology and Biochemistry
UMKC School of Biological Sciences
Wyckoff, Gerald J.
235-2065
525 SCB
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