MedStar Health—Georgetown University Research Symposium and the Colloquium for Educators in the Health Professions – Register Today!

Don’t forget to register for the MedStar Health—Georgetown University Research Symposium and the Colloquium for Educators in the Health Professions, taking place NEXT WEEK: Monday, May 10, 2021 through Wednesday, May 12, 2021.

This three-day event brings together the MedStar Health and Georgetown University communities to celebrate the great work of our colleagues. It offers the unique opportunity to connect with researchers, educators, residents, executive leaders, and collaborative partners from across the region and our system to build meaningful relationships to further advance the health of our community.

You may register and find other details including the agenda at http://bit.ly/MSH-GUMC.

Hosted by the MedStar Health Research Institute, MedStar Health Academic Affairs, CENTILE, and Georgetown University Medical Center.

      
2021 Symposium and Colloquium Agenda
Monday, May 10
1 pm Welcome and Opening Remarks

  • Stephen R. T. Evans, MD 
    Executive Vice President, Medical Affairs, and Chief Medical Officer, MedStar Health 
  • Kenneth A. Samet, FACHE 
    President and CEO, MedStar Health 
  • John J. DeGioia 
    President, Georgetown University 
2 pm       Keynote Speaker
Dr. David J. Skorton, AAMC President
3 pm      Resident & Fellow Oral Presentations
As part of the MedStar Health system-wide resident research day, residents and fellows with the top scoring abstracts are invited to give a short oral presentation on their research to attendees. These presentations allow residents and fellows to gain the experience of presenting their research and allow them to share their work with the larger MedStar Health & Georgetown University communities.
4 pm      Moderated Poster sessions
Research Symposium & CENTILE Colloquium 
4 pm      Networking Sessions
Tuesday, May 11
10 am to 12 pm      Colloquium for Educators in the Health Professions
Hosted by GUMC’s Center for Innovation and Leadership in Education (CENTILE), the Colloquium for Educators in the Health Professions Colloquium is an opportunity for those across the system focused on education to gather, share ideas, and learn together.
1 pm     

Plenary Speakers

  • Leon “Lee” Jones, MD
    Dean for medical education, Georgetown University School of Medicine
  • Stephanie Detterline, MD
    Program Director,  MedStar Health Internal Medicine Baltimore Residency Program
1:30 pm      Educational Workshops
Research Symposium & CENTILE Colloquium

  • Demystifying the IRB
    This session will provide an overview of the joint IRB system, including tips for success when utilizing the new platform to facilitate a smooth submission process.
  • Stats Fundamentals
    Led by an experienced MHRI biostatistician, this session will provide an overview of statistical approaches used most commonly in clinical research. The session serves as an introduction to the topic of biostatistics and resources at MedStar.
  • Tips for Funding Success
    A successful grant application requires an innovative idea from an investigator, strong administrative support, and a willing funder. In this session, we will present these three perspectives and how they work together for funding success. We will also cover different mechanisms and strategies for funding support.
  • Abstracts, Manuscripts, Journals…Oh my!
    Conducting research is only the first step…preparing your scholarship for publication or presentation will follow! This session will provide helpful pearls, as well as identify avoidable pitfalls, in taking your results from “data” to paper, poster, or the presentation screen.
  • Feedback in the Clinical Setting 
  • Privilege and Intersectionality 
Following your registration, you will receive a separate email with the virtual event instructions and platform link. The platform will allow you to attend any portion of the event, including all of the educational workshops.
2:30 pm      Moderated Poster sessions
Research Symposium & CENTILE Colloquium 
3 pm      Networking Sessions
Wednesday, May 12
1 pm      Plenary Speakers

  • Jay Khanna, MD, MBA
    Physician Executive Director, MedStar Orthopaedic Institute, DC; Chair and Professor, Department of Orthopaedic Surgery
  • Aviram M. Giladi, MD, MS
    Hand Surgery and Plastic Surgery
    Research Director, The Curtis National Hand Center, MedStar Union Memorial Hospital
1:30 pm      Educational Workshops
Research Symposium & CENTILE Colloquium

  • GUMC Academic Appointments & Promotions Updates
    Learn about all the different faculty career paths available to you at GUMC and how you can continue to advance and develop your academic career through this informative workshop.
  • Demystifying the IRB 
    This session will provide an overview of the joint IRB system, including tips for success when utilizing the new platform to facilitate a smooth submission process.
  • Stats Fundamentals 
    Led by an experienced MHRI biostatistician, this session will provide an overview of statistical approaches used most commonly in clinical research. The session serves as an introduction to the topic of biostatistics and resources at MedStar.
  • Tips for Funding Success
    A successful grant application requires an innovative idea from an investigator, strong administrative support, and a willing funder. In this session, we will present these three perspectives and how they work together for funding success. We will also cover different mechanisms and strategies for funding support.
  • Abstracts, Manuscripts, Journals…Oh my!
    Conducting research is only the first step…preparing your scholarship for publication or presentation will follow! This session will provide helpful pearls, as well as identify avoidable pitfalls, in taking your results from “data” to paper, poster, or the presentation screen.
  • Clinical Specialty Disrespect
  • Bias in Clinical Grading
Following your registration, you will receive a separate email with the virtual event instructions and platform link. The platform will allow you to attend any portion of the event, including all of the educational workshops.
2:30 pm      Moderated Poster sessions
Research Symposium & CENTILE Colloquium 
3 pm      Networking Sessions

 

Advancing Health through Research, Education, and Clinical Care Delivery

To learn more, visit MedStarHealth.org/Symposium
Questions? Contact [email protected]

 

 

MedStar Health Investigator Develops Risk Assessment Tool for Resuming Research in Low Resource Settings During the COVID-19 Pandemic

This collaborative research project sought to develop a framework to assess the risk of conducting clinical trial activity during the COVID-19 pandemic in rural, low resource settings. This research specifically looked at the continuation of the multi-country Household Air Pollution Intervention (HAPIN) trial, which is a randomized controlled trial in rural areas of Guatemala, India, Peru, and Rwanda that is assessing the health benefits of providing liquefied petroleum gas (LPG) stoves and an 18-month supply of free LPG to 3200 households that otherwise depend on solid biomass fuel (wood, animal dung, or crop residue) for cooking. While the study was conducted overseas, it has application for any rural area.

In 2020, the spread of COVID-19 led to the temporary suspension of many non-COVID-19 related research activities worldwide. Where restarting research activities is permitted, investigators need to evaluate the risks and benefits of resuming data collection and adapt procedures to minimize risk. The goal of this study is to maximize the integrity of research aims while minimizing infection risk based on the latest scientific understanding of the virus.

The HAPIN study collects measurements of cooking behavior, personal and in-home exposure to air pollution, biological samples and clinical measurements from pregnant women and their newborns in every household, along with an older, non-pregnant adult woman, if she resides in the house. The study involves home visits, as well as visits to health centers and hospitals during the woman’s pregnancy and the first year of the child’s life.

In developing the risk assessment tool in the context of COVID-19, the research team used a combination of expert consultations, risk assessment frameworks, institutional guidance and literature and systematically graded clinical, behavioral, laboratory and field environmental health research activities in four countries for both adult and child subjects using this framework.

The framework assessed risk based on staff proximity to the participant, exposure time between staff and participants, and potential viral aerosolization while performing the activity. For each activity, one of four risk levels, from minimal to unacceptable, was assigned and guidance on protective measures was provided.

The researchers assessed research activities that included LPG fuel delivery, administration of tablet-based surveys, data downloads from environmental monitors, personal exposure assessment to household air pollution, biological sample collection (e.g. urine, nasal swabs, venous blood) and lab processing of biological samples in the field laboratories, clinical, observations in homes of pregnant women/new mothers, children, and vascular procedures in adults.

The study results show that almost all of the research activities were deemed to pose potentially manageable risks. The activities with the highest level of risk were those that potentially aerosolize the virus during the procedure.

The study team concluded that by applying a systematic, procedure-specific approach to risk assessment for each research activity, it can minimize the disruption in trials due to the pandemic and continue to protect participants and research team and support the completion of primary outcomes. The study team also believes their framework can be applied be tailored to other research studies conducted in similar settings during the current pandemic to guide investigators in assessing the risk of each research activity and implementing appropriate safety measures, where the level of risk is acceptable.

This research was led by one of our newest MedStar Health investigators, Suzanne M. Simkovich MD, MS, Physician Investigator, MedStar Health Research Institute, Assistant Professor of Medicine, Georgetown University.

MedStar Health Researchers Examine Feasibility of a Telemedicine-Enabled Mental Health Intervention for Adults With Type 2 Diabetes

Collaborative research from MedStar Diabetes Institute, MedStar Health Research Institute, and the Georgetown University Department of Psychiatry examined the feasibility of co-delivering a mental health intervention with an evidence-based type 2 diabetes (T2DM) boot camp care management program. The research team also examined the preliminary impact of participation on symptom scores for depression and anxiety and A1C.

In the United States, over half of the adults living with type 2 diabetes mellitus have at least 1 other chronic physical or mental health condition. Depression is one of the most prevalent comorbities of type 2 diabetes. To improve type 2 diabetes outcomes, it is important to diagnose and treat both diabetes and depression/anxiety when patients present with both.

The study was a 12-week pilot intervention with African American adults with uncontrolled type 2 diabetes and moderate depression and/or anxiety, who were participating in an existing Diabetes Boot Camp program. The participants were then enrolled in the diabetes and mental health co-management (DM-MH) pilot study. This program was offered via a combination of 2 initial on-site visits and subsequent remote telehealth visits using telephone, text, or email. The mental health intervention component involved 6 structured sessions with a mental health interventionist, who was also trained to recognize worsening mental health symptoms, identify and evaluate safety concerns, seek consultation, and make appropriate referrals. The structured mental health component targeted depression and/or anxiety symptoms based on the PHQ-9 and GAD-7 baseline scores. Participants were assessed at baseline and 90 days.

The study results showed significant improvements in mental health outcomes, as measured by a reduction in Patient Health Questionnaire − 9 scores of 2.4 ± 2.9 (P = .01) and in Generalized Anxiety Disorder − 7 scores of 2.3 ± 1.9 (P = .001). The pre-post intervention mean A1C improved by 3.4 ± 2.1units from 12% ± 1.4% to 8.5% ± 1.7% (P < .001).

The study team concluded that the data supports the feasibility of delivering a diabetes and mental health co-management intervention using a combination of in-person and telemedicine visits to engage adults with T2DM and coexisting moderate depression and/or anxiety. Further research with a control group and a larger sample size could show potential in improving glycemic and mental health outcomes in patients with T2DM via co-management of their T2DM and moderate anxiety and/or depression.

The research team included Michelle F. Magee, MD, MBBCh, BAO, LRCPSI from MedStar Diabetes Institute, MedStar Health Research Institute, and the Georgetown University School of Medicine; Carine M. Nassar, RD, MS from MedStar Diabetes Institute and MedStar Health Research Institute; Mihriye Mete from MedStar Health Research Institute and Georgetown University Department of Psychiatry; and Stacey I. Kaltman, PhD from Georgetown University Department of Psychiatry.

Funding for the study was provided by an intramural grant from the MedStar Health Research Institute.

April Peer-Reviewed Publications from MedStar Health

Congratulations to all MedStar researchers who had articles published in April 2021. The selected articles and link to PubMed provided below represent the body of work completed by MedStar Health investigators, physicians, and associates and published in peer-reviewed journals last month. The list is compiled from PubMed for any author using “MedStar” in the author affiliation. Congratulations to this month’s authors. We look forward to seeing your future research

View the full list of publications on PubMed.gov here.

Selected research:

  1. The Impact of Smoking on Early Postoperative Complications in Hand Surgery
    Journal of Hand Surgery, 2021.DOI: 10.1016/j.jhsa.2020.07.014
    Cho BH, Aziz KT, Giladi AM. 

  2. Comparison of Characteristics and Outcomes of Patients With Acute Myocardial Infarction With Versus Without Coronarvirus-19
    The American Journal of Cardiology, 2021. DOI: 10.1016/j.amjcard.2020.12.059
    Case BC, Yerasi C, Forrestal BJ, Shea C, Rappaport H, Medranda GA, Zhang C, Satler LF, Ben-Dor I, Hashim H, Rogers T, Waksman R.
  3. Providing Care for Caregivers During COVID-19
    American Journal of Nursing, 2021. DOI: 10.1097/01.NAJ.0000749752.80198.c0
    Morales C, Brown MM.

  4. Does Scalp Cooling Have the Same Efficacy in Black Patients Receiving Chemotherapy for Breast Cancer?
    The Oncologist, 2021. DOI: 10.1002/onco.13690
    Dilawari A, Gallagher C, Alintah P, Chitalia A, Tiwari S, Paxman R, Adams-Campbell L, Dash C.

  5. Representation Matters: An Assessment of Diversity in Current Major Textbooks on Burn Care.
    Journal of Burn Care and Research, 2021. DOI: 10.1093/jbcr/irab066 
    Shivega WG, McLawhorn MM, Tejiram S, Travis TE, Shupp JW, Johnson LS.

Celebrating Nurses at MedStar Health and the Research Institute

Join MedStar Health in recognizing the work of our nurses during Nation Nurses Week, from May 6 to 12, 2021. As our nurses continue to care for patients in the new world with COVID-19, we want to celebrate and thank nurses throughout our system for their commitment to patient and associate care and wellness.

Because of the burden that COVID-19 has on the national health system in general and nurses specifically, the  American Nurses Association has extended  the 2020 Year of the Nurse through  May 2021. In honor of the 200th anniversary of Florence Nightingale’s birthday, commonly considered the founder of modern nursing research, the World Health Organization declared 2020 the International Year of the Nurse and Midwife.

Joan K. Bardsley, MBA, RN, assistant vice president at MHRI, serves as MHRI’s representative to MedStar’s Chief Nursing Council, on the MHRI executive team, and the Nursing Research Council. Ms. Bardsley says, “It has been over a year that our health system has faced COVID and its impact on those for whom we care. Nurses from across MedStar Health have risen to the occasion in ways that showed their unbridled dedication and caring.  MHRI nurses are among those who truly went above and beyond what could have reasonably been expected.  They  transitioned to work in occupational  health, provided vaccines throughout  MedStar and the community, followed-up with those with a  COVID diagnosis, and expanded their work to include dozens of COVID studies in all areas of practice that have changed  the way care and treatment is delivered. THANK YOU is not enough for what they accomplished but needs to be said to every nurse. I am honored to practice with these dedicated professional at MHRI and MedStar Health who have made the positive difference in so many lives.”

During National Nurses Week, we would like to extend a special thanks to all our clinical research nurses, and all nurses in the MedStar Health system, as they continue to provide the highest level of quality care to our patients. They are critical in helping provide the best care to our community and are dedicated to advancing health. We appreciate you for what you do.

A HIPAA Refresher for Research

What is HIPAA?

The Health Insurance Portability and Accountability Act (“HIPAA”) governs how healthcare data is shared, both in terms of research and in medical care.  It has several components, which govern specific situations.

  • Security Rule (45 CFR Part 164): Safeguards to ensure confidentiality, integrity, availability of electronic PHI
  • HITECH: Debuted “Breach Notification Rule,” increased penalties for non-compliance
  • HHS Omnibus Rule: Extended regulations directly to business associates, required subcontractor compliance
  • Breach Notification Rule: Sets rules for notification to HHS and to individuals in the event of breach

Who does HIPAA apply to?

Health Plans (i.e., insurers), Clearinghouses (“billing services”), and Health Care Providers, including hospitals are considered covered entities for HIPAA. This means that they are required to follow the rules and regulations of HIPAA.

In addition, HIPAA can apply to business associates. Business associates are considered persons that create, receive, maintain, or transmit protected health information on behalf of a covered entity or another business associate. The role of business associates is to support the ability of a covered entity to execute on its ability to provided healthcare, and their access to health information is limited to what is necessary to support that work. This work can include payments/healthcare operations activities, claims processing, utilization review, quality assurance, and data analysis/aggregation. HIPAA does not consider research to be a business associate function.

HIPAA Privacy Rule

Protected Health Information is defined as “individually identifiable health information held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral communication”. This data can be in the context of an individual’s past, present, or future physical or mental health condition; or provision of health care to the individual; or past, present or future payment for providing health care to the individual. It contains enough detail that there is a reasonable basis to believe that the information can be used to identify the individual.

Under HIPAA, a covered entity may not use of disclose protected heath information, except as the privacy rule permits or requires, or the individual whose protected health information it is provides written authorization.

There are specific instances where disclosure is permitted without authorization, but those are limited to:

  • To the individual
  • Treatment, Payment, Healthcare Operation
  • Public Interest and Benefit Activities (which includes research with waiver)
  • Limited Data Set (with a Data Use Agreement)

Use and Disclosure of Protected Health Information for Research

With authorization (i.e., HIPAA Authorization embedded into or separate from the Informed Consent Form), protected heath information can be used for research purposes.

If the research team does not seek authorization from individuals, protected heath information can be accessed through the following processes:

  • Documented IRB/Privacy Board Approval of an alteration or waiver of the requirement to obtain an individual’s authorization.
  • Representations from researcher that use or disclosure of PHI is solely for a purpose preparatory to research (i.e., preparing a protocol)
  • PHI of Decedents
  • Limited Data Set

De-identified data is not considered protected heath information and not regulated by the Privacy Rule.

Questions?

If you have questions specific to your research, please contact our Office of Research Integrity at [email protected]. If you have questions regarding data use agreements, business associates, or other contract vehicles for research, contact our Office of Contracts and Grants Management at [email protected].

MedStar Health Publishes Collaborative Research to Explore the Prevalence of Inflammatory Heart Disease Among Professional Athletes With Prior COVID-19 Infection

Recently published collaborative research evaluated the prevalence of detectable inflammatory heart disease in professional athletes with prior COVID-19 infection, using current return-to-play screening recommendations. The major North American professional sports leagues were among the first to return to full-scale sport activity during the COVID-19 pandemic. Each of these professional sports leagues (MLS, MLB, NHL, NFL, and the men’s and women’s NBA) implemented a program for all players who had tested positive for COVID-19 prior to resumption of team-organized sports activities. “Prevalence of Inflammatory Heart Disease Among Professional Athletes With Prior COVID-19 Infection Who Received Systemic Return-To-Play Cardiac Screening” was published in JAMA Cardiology.

The goal of the study is to assess the prevalence of clinically detectable and relevant cardiac injury in athletes testing positive for COVID-19 and the efficacy of consensus screening recommendations in achieving a safe return to competitive sports. This cross-sectional study reviewed return-to-play cardiac testing performed between May and October 2020 on professional athletes who had tested positive for COVID-19. Troponin testing, electrocardiography (ECG), and resting echocardiography were performed after a positive COVID-19 test result. Those with abnormal screening test results were referred for additional testing, including cardiac magnetic resonance imaging and/or stress echocardiography.

The study included 789 professional athletes. The results show a total of 460 athletes had prior symptomatic COVID-19 illness and 329 were asymptomatic or minimally symptomatic but had tested positive for the virus. Using the return-to-play cardiac screening algorithm, 6 athletes had an abnormal troponin level, 10 athletes had ECG abnormalities warranting further cardiac evaluation, and 20 athletes had an echocardiographic finding necessitating additional testing to exclude acute cardiac injury. No adverse cardiac events occurred in athletes who underwent cardiac screening and resumed professional sport participation.

The study team concluded “while long-term follow-up is ongoing, few cases of inflammatory heart disease have been detected, and a safe return to professional sports activity has thus far been achieved.” Further research is needed to understand whether there may be long-term cardiac effects among athletes infected with COVID-19, whether or not they were symptomatic.

This study was co-authored by Dr. Andrew Tucker, Medical Director of MedStar Union Memorial Hospital Sports Medicine and. Dr. Tucker also serves on the US National Football League General Medical Committee.

Jama Cardiology, 2021. DOI: 10.1001/jamacardio.2021.0565

MedStar Health Researchers Investigate the Effects of Headgear in High School Girls’ Lacrosse

A collaborative investigation was undertaken to evaluate potential differences in rates, extent, and game-play characteristics of impacts among players with and without headgear during high-school girl’s lacrosse competition. “The Effects of Headgear in High School Girls’ Lacrosse” was published in The Orthopaedic Journal of Sports Medicine. The research was completed in collaboration with the Sports Medicine Assessment, Research & Testing (SMART) Laboratory at George Mason University in Manassas, VA.

The goals of this study were to determine whether differences in the rates and magnitudes of impacts to the head and other areas of the body occurred in players with and without headgear during competition, along with determine if the distribution of impact mechanisms and penalties called for impacts were different with the introduction of headgear. With the growing popularity of girls’ lacrosse among high schools in the US, the reporting of head injuries has also increased. Recent studies have incorporated sensor technology and video surveillance to characterize head impacts and head injuries.

The study included a cohort of 49 girls from a single high school lacrosse team during the 2016 season (no headgear; 18 games) and 2017 (headgear; 15 games). In 2017, a performance standard (ASTM F3137) for girls’ lacrosse headgear became commercially available. Each participant was assigned a wearable sensor affixed behind their ear. All game-related impacts recorded by the sensors were verified on video. Data was collected to describe game-play characteristics among players with and without headgear.

The study recorded 649 sensor-instrumented player-games and 204 impacts ≥20g were verified as game-related impacts using video analysis. The results show that most impacts were imparted to the player’s body (74.5%), rather than to the player’s head (25.5%). Impact rates per player-game did not vary between the no headgear and headgear conditions. No game-related concussions were reported during this study.

The research team concluded that lacrosse headgear use was associated with a reduction in the magnitude of overall impacts but not a significant change in the rate of impacts, how they occur, or how penalties were administered for impacts sustained during competition. Further research is needed with a larger sample and different levels of play to evaluate the consequences of headgear use in girls’ lacrosse.

The Orthopaedic Journal of Sports Medicine., 2020. DOI: 10.1177/2325967120969685

March Peer-Reviewed Publications from MedStar Health

Congratulations to all MedStar researchers who had articles published in March 2021. The selected articles and link to PubMed provided below represent the body of work completed by MedStar Health investigators, physicians, and associates and published in peer-reviewed journals last month. The list is compiled from PubMed for any author using “MedStar” in the author affiliation. Congratulations to this month’s authors. We look forward to seeing your future research.

View the full list of publications on PubMed.gov here.

Selected research:

  1. Pharmacologic Treatments for PCOS Patients.
    Clinical Obstetrics and Gynecology, 2021. DOI: 10.1097/GRF.0000000000000597
    Kodama S, Torrealday S.

  2. Lessons Learned from Caring for Patients with COVID-19 at the End of Life.
    Journal of Palliative Medicine, 2021. DOI: 10.1089/jpm.2020.0251
    Rao A, Kelemen A.

  3. Evaluation of Maternal-Fetal Triage Index in a Tertiary Care Labor and Delivery Unit.
    American Journal of Obstetrics & Gynecology MFM, 2021. DOI: 10.1016/j.ajogmf.2021.100351
    Kodama S, Mokhtari NB, Iqbal SN, Kawakita T.

  4.  Assessing the Relationship Between Bone Density and Loss of Reduction in Nonsurgical Distal Radius Fracture Treatment.
    Journal of Hand Surgery, 2021. DOI: 10.1016/j.jhsa.2021.02.002
    Ghodasra JH, Yousaf IS, Sanghavi KK, Rozental TD, Means KR Jr, Giladi AM.

MedStar Health Proud of SPIRIT Award Recipient Allie Moses

Allie Moses was awarded the SPIRIT of Excellence Award during the MHRI Virtual Town Hall.  Allie is the Manager of the Clinical Research Systems and Recruitment Center, Chair of the MHRI Wellness Committee, and Co-Chair of MedStar Research AIDE. The award was presented by Tina Stanger, Assistant Vice President of Research Administration.

Allie was recognized not only for the work she does as a superb manager day to day but also for leading the work of the Wellness Committee for MHRI along with the work she does with AIDE to change MHRI for the better. Allie is an awesome team player and we are thankful for her “willingness to step up, speak up, and lead.”

“I wanted to make sure you knew from my perspective how incredibly valuable and valued you are to MHRI—as a colleague, manager and leader,” said Deliya Wesley.

The SPIRIT Award is given to recognize and reward one associate (management or non-management) each quarter, who excels in Service, Patient First, Integrity, Respect, Innovation, and Teamwork.

Nominations are based on submission to the MHRI Kudos program. Each quarter, the MHRI Executive Team will review the KUDOS submissions and select an associate or manager who best exemplifies all our SPIRIT values.