Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

2009 — Multi-Center HSR&D Intervention Studies: Lessons from the Field

Safford MM (Deep South Center on Effectiveness at Birmingham VAMC) , Levine D (Deep South Center on Effectiveness at Birmingham VAMC), Litaker D (Cleveland VAMC), Halanych J (Deep South Center on Effectiveness at Birmingham VAMC), Hawn M (Deep South Center on Effectiveness at Birmingham VAMC), Houston T (Deep South Center on Effectiveness at Birmingham VAMC), Tipton E (Deep South Center on Effectiveness at Birmingham VAMC), Kiefe CI (Deep South Center on Effectiveness at Birmingham VAMC)

Workshop Objectives:
The Deep South Center on Effectiveness at the Birmingham VAMC is successfully conducting several multi-VAMC intervention trials. We will share effective strategies for engaging administrators and investigators, coordinating multiple IRB applications, and collecting data. Audience members will be invited to share their experiences, and will receive a CD to help them apply our methods.

Activities:
1. Engaging the non-research side of the VA house. We share our successful strategies on how to negotiate barriers in partnering with the medical care delivery side of the VA, including the Office of Quality and Performance (OQP), the Medical Service, and facility managers. Drawing from our experience with MI-Plus, a multi-center study that has enrolled over 300 providers at 160 VA CBOCs (plus over 200 Medicare providers in the private sector), we discuss strategies for recruitment and report on provider participation. 2. Managing multiple IRBs in multicenter studies. For many VA HSR&D studies, IRB approval is needed from multiple VAMCs. From our experience gained in several multicenter trials, (e.g., VA MI-Plus includes 48 separate VA IRBs), we share our do’s and don’ts of long-distance IRB relationships, including specific details on finding and engaging long-distance site PI’s, manpower issues for budgeting purposes, tips on how to expedite the process, and pitfalls to avoid. 3. Data Collection. Going beyond centralized Austin databases and performing medical record review across multiple centers can be expensive and time consuming. We have successfully used two methods to address this challenge. First, we will discuss the advantages and challenges of using VISTA Web for remote chart review. Second, we have developed text search algorithms (custom-built computer programs that search VISTA text fields for specified strings of text) to find missing race/ethnicity, smoking status, smoking cessation counseling, and other data elements commonly examined using medical record review. CD’s including our validated algorithms and approaches to semi-automated text searching will be provided.

Target Audience:
VA HSR&D researchers

Assumed Audience Familiarity with Topic:
No special preparation or skills are required to benefit from this workshop.