MedStar Health Investigator Receives 5 Million Dollar Award from the Centers for Disease Control and Prevention to Reduce Inequities in Cancer Outcomes

Hannah Arem, PhD, Scientific Director of Implementation Science at the MedStar Health Research Institute, was selected for funding from the Centers for Disease Control and Prevention for her five-year project entitled, “Reducing Inequities in Cancer Outcomes through Community-Based Interventions on Social Determinants of Health.”

The purpose of this award, in collaboration with George Washington University and Howard University, is to conduct research to further institutionalize screening and follow up for social determinants of health among cancer survivors in DC at three cancer institutes.  Additionally, the researchers will conduct anti-bias training at the three cancer institutes with all providers interacting with patients. The long-term goal of this study is to develop scalable interventions to identify and address social needs for cancer survivors. This project is intended to establish sustainable clinical-community linkages and improve survivor health and well-being. This research aims to advance our understanding of what works in different settings, for whom and why.

Understanding the burden of social needs in our population, the available community resources, and solidifying integrated, closed-loop referral systems to address those needs is critical to improving quality of life for cancer survivors and reducing disparities in outcomes.

Announcing Dr. Hunter Groninger as NEW Scientific Director for MedStar Palliative Care

Since 2014, MedStar Palliative Care has grown to provide expert interdisciplinary care for patients with advanced illness, such as cancer or heart failure, and their families across.  Our interdisciplinary approach spans our system – last year alone, Palliative Care clinicians completed over 9000 consultations across hospitals, clinics, and telehealth settings.

Medical assessment and management, complex communication strategies, and innovative healthcare delivery models are all part of the science of palliative care. For several years, MedStar Palliative Care clinicians have been advancing this science through grant-funded and investigator-initiated clinical research. Examples of ongoing research include telehealth strategies for home-based palliative care delivery, virtual reality for cancer pain management, and massage therapy to improve self-efficacy in left ventricular assist device recipients.

To leverage the ongoing scientific work while growing the palliative care research portfolio to achieve national recognition, the MedStar Health Research Institute is pleased to announce the appointment of Dr. Hunter Groninger as Scientific Director for MedStar Palliative Care. Dr. Groninger currently serves as Director of Palliative Care at MedStar Washington Hospital Center, as Professor of Medicine at Georgetown University Medical Center and as a funded investigator at MHRI. In his new role as Scientific Director, Dr. Groninger will engage investigators and stakeholders across the MedStar-Georgetown system to explore opportunities for scientific collaboration and to elevate the interdisciplinary success of palliative clinical research.

August Peer-Reviewed Publications from MedStar Health

Congratulations to all MedStar researchers who had articles published in August 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. Delayed Digit Replantation: What is the Evidence?
    The Journal of Hand Surgery, 2021. DOI: 10.1016/j.jhsa.2021.07.007
    Harbour PW, Malphrus E, Zimmerman RM, Giladi AM. 

  2. Circulating Syndecan-1 and Tissue Factor Pathway Inhibitor, Biomarkers of Endothelial Dysfunction, Predict Mortality in Burn Patients. 
    Shock, 2021. DOI: 10.1097/SHK.0000000000001709
    Keyloun JW, Le TD, Pusateri AE, Ball RL, Carney BC, Orfeo T, Brummel-Ziedins KE, Bravo MC, McLawhorn MM, Moffatt LT, Shupp JW

  3.  Single-Center Experience With the LOTUS Edge Transcatheter Heart Valve. 
    Cardiovascular Revascularization Medicine, 2021. DOI: 10.1016/j.carrev.2021.04.024
    Medranda GA, Rogers T, Case BC, Shults CC, Cohen JE, Satler LF, Ben-Dor I, Waksman R.
     
  4. Defining a Minimum Hospital Volume Threshold for Minimally Invasive Colon Cancer Resections. 
    Surgery, 2021. DOI: 10.1016/j.surg.2021.06.031
    Bader NA, Sweeney M, Zeymo A, Villano AM, Houlihan B, Bayasi M, Al-Refaie WB, Chan KS.

MedStar Health Proud of SPIRIT Award Recipient Melissa Gonzales

Melissa Gonzales was awarded the SPIRIT of Excellence Award for the first quarter of 2021 during the MHRI Virtual Town Hall.  Melissa is a Clinical Research Coordinator for the MedStar Health Research Institute at MedStar Washington Hospital Center. The award was presented by Ron Migues, Executive Director, MedStar Health Research Institute.

Melissa was recognized for being a team player that pays attention to detail. Her colleagues appreciate her dedication to ensure our research participants have a positive research experience while also meeting enrollment and financial targets.

"Thank you for always willing to help out even without being asked. You just jump right in when the situations needs it. You just always offer to help the team with no questions asked. You are truly a team player. I commend you for being great with our patients and PI's. Your professionalism and commitment is outstanding." - Patricia Tanjutco, MD

"Melissa is the “secret weapon” that any professional team would be jealous to have in their arsenal. She is always two steps ahead of what needs to be done in a clinical trial, and before everyone else is aware of the need, Melissa has already taken care of the issue and figured out a way to make the process easier for everyone else! She is an excellent Clinical Research Coordinator, with an incredible eye to detail and a confident and caring manner that makes her a valuable asset to any research team." - Maureen McNulty, RN, MS

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.

Department of Continuing Professional Education Fall Meetings

What’s in store this fall? Below is a list continuing education meetings taking place virtually starting September 2021. Each conference gives you access to earning continuing education credit and expanding your knowledge and skills in these different areas. In addition to learning state-of-the-art advances and treatments, you have the opportunity to network with fellow attendees and enjoy interactive panel discussions.

Register now to add us to your calendar!

Click here for the most up-to-date information.

Conference Highlight

3rd Annual MedStar Georgetown Transplant Institute Symposium
September 18  | A Virtual Conference
Conference Chair: Thomas M. Fishbein, MD
Course Directors: Matthew Cooper, MD; Alexander J. Gilbert, MD;
Stuart S. Kaufman, MD; Rohit S. Satoskar, MD

MedStar Georgetown Transplant Institute is proud to be hosting the 3rd Annual MedStar Georgetown Transplant Institute Symposium (MGTI 2021). The educational program will consist of three parallel tracks navigating the diagnosis and treatment options for kidney, pancreas, liver, and intestinal disorders including those requiring a transplant. These tracks include: Advances in Liver Diseases and Transplantation, Current Issues in the Care of Dialysis and Kidney/Pancreas Transplant Patients, and Update on Liver Diseases, Intestinal Failure, and Transplantation for Children.

Advances in Liver Diseases and Transplantation track will address the gap between best and current practices in order to provide the best care to patients, reduce morbidity and mortality, and reduce the burden of liver disease in the Mid-Atlantic region. Up to date information on liver disease and transplant topics relevant to community practitioners will be highlighted. We will focus special attention on tumors multidisciplinary management of tumors of the hepatobiliary tract as well.

Through the Current Issues in the Care of Dialysis and Kidney/Pancreas Transplant Patients track the content will examine kidney and pancreas transplantation with a special emphasis on the multidisciplinary approach in pre and post-transplant care of patients with renal dysfunction and post-transplantation.

The third track, Update on Liver Diseases, Intestinal Failure, and Transplantation for Children will focus on topics that will be of interest to pediatric gastroenterology, primary care and allied health providers in the course of their interactions with infants and children with small bowel disease, parenteral nutrition, and chronic liver diseases including those likely to lead to transplantation.

The 8th Annual Gastric and Soft Tissue Neoplasms
September 25 | A Virtual Conference
Course Directors: Waddah B. Al-Refaie, MD, FACS; Nadim Haddad, MD;
Dennis A. Priebat, MD, FACP; Mark A. Steves, MD, FACS
MedStar Associates: Use promotion code GSMG for
complimentary registration!

The 4th Annual MedStar Heart Failure Summit
October 23  | A Virtual Conference
Course Directors: Samer S. Najjar, MD; Mark R. Hofmeyer, MD

13th Biennial Thyroid Update: New Concepts in the Diagnosis and
Treatment of Thyroid Disease

December 3  | A Virtual Meeting
Course Directors: Kenneth D. Burman, MD; Jason A. Wexler, MD

Save the Date!

Scary Cases in Endocrine Surgery
October 28 | A Virtual Conference
Course Director: Jennifer E. Rosen, MD, FACS

Breast Cancer Coordinated Care (BC3): An Interdisciplinary Conference
February 24 to 26, 2022 | JW Marriott | Washington, D.C.
Course Directors: David H. Song, MD, MBA, FACS; Kenneth Fan, MD;
Ian T. Greenwalt, MD

Diabetic Limb Salvage (DLS) 2022
April 7 to 9, 2022 | JW Marriott | Washington, D.C.
Course Chairmen: Christopher E. Attinger, MD; John S. Steinberg, DPM
Course Directors: Cameron M. Akbari, MD, MBA; Karen Kim Evans, MD;
J.P. Hong, MD, PhD, MBA

Mastering Clinical Challenges in IBD
May 7, 2022 | The Ritz-Carlton, Tysons Corner | McLean, VA
Course Directors: Mark C. Mattar, MD; David T. Rubin, MD

Abdominal Wall Reconstruction (AWR) 2022
June 2022 | A Dynamic Virtual Conference with Expert Faculty
Conference Chairman: Parag Bhanot, MD
Course Directors: Karen Kim Evans, MD; William W. Hope, MD; Jeffrey E. Janis, MD

Please visit medstar.cloud-cme.com for more information and to register.

Artificial Intelligence Predictors of Death from COVID-19

Researchers at MedStar Health led an international team that used artificial intelligence to evaluate cardiac images from patients across the globe who had COVID-19. Artificial intelligence derived heart measurements on echocardiograms were able to predict COVID-19 (SARS-CoV-2) mortality in an international cardiac ultrasound study of COVID-19 patients. The Echocardiographic Correlates of in-hospital Death in Patients with Acute COVID-19 Infection: The World Alliance Societies of Echocardiography (WASE-COVID) Study was presented at the American College of Cardiology (ACC) 2021 virtual Scientific Session.

This is an international, multi-center study conducted by the World Societies of Echocardiography to determine the clinical and echocardiographic phenotype of acute cardiac disease in COVID-19 patients, to explore phenotypic differences in different geographic regions across the world, and to identify parameters associated with in-hospital mortality. New research has revealed key insights into the varying international use of cardiac ultrasound on COVID-19 patients, and how artificial intelligence derived heart measurements were able to predict COVID-19 mortality. Federico Asch, M.D., director of the cardiovascular and echo core labs at MedStar Health Research Institute is the lead principal investigator.

This study looked at the crossover between COVID-19 and cardiac measurements among 870 patients from 13 medical centers in nine countries throughout Asia, Europe, United States, Latin America. Clinical and laboratory data were collected along with patient outcomes. The echocardiograms were analyzed with automated, machine learning-derived algorithms to calculate various data points.

The results showed significant regional differences in terms of patient co-morbidities, severity of illness, clinical biomarkers, and left ventricular and right ventricular echocardiographic metrics. In-hospital mortality rates varied by region, 11% in Asia, 19% in Europe, 27% in Latin America, and 26% in U.S.. Parameters associated with mortality were age, previous lung disease, left ventricular longitudinal strain, lactic dehydrogenase, and right ventricular free wall strain. The regional differences in cardiac phenotype highlight the significant differences in patient acuity as well as echocardiographic utilization in different parts of the world.

"Our original WASE Study first set out to see the state of healthy normal hearts across the world. It took us a few years to manually review all of that data," said Dr. Federico Asch, Director of the Cardiovascular and Echo Core Labs at MedStar Health Research Institute. "When the pandemic began, we knew that the clinical urgency to learn as much as possible about the cardiovascular connection to COVID-19 was incredibly high, and that we had to find a better way of securely and consistently reviewing all of this information in a timely manner."






MedStar Health Investigates New Algorithm for Electrical Injury Treatment

Researchers from the Firefighters’ Burn and Surgical Research Laboratory at MedStar Washington Hospital Center examined the utility of an electrical injury treatment algorithm.  This examination compared the incidence of testing done on a cohort of burn patients before and after implementation. Published in the Journal of Burn Care & Research, “Institutional Experience Using a Treatment Algorithm for Electrical Injury” sought to assess the utility of this electrical injury treatment algorithm in identifying patients at risk for complications while reducing unnecessary testing, monitoring, and admissions.

Electrical injury can be associated with high morbidity and mortality but due to its low incidence, evidence-based guidelines to triage and treat electrical injuries are lacking.  Diagnostic tests such as electrocardiogram, serum troponin, and creatine kinase are used in the emergency room to determine the patient’s risk of negative cardiac outcomes. However, the predictive efficacy of these tests is not understood and there is high variability in diagnosis and management among clinicians.

In July 2015, The Burn Center implemented a new algorithm for triage and management of electrical injury. This retrospective cohort study involves patients admitted to The Burn Center over a course of 5 years. The study team hypothesized that protocolized treatment for electrically injured patients will improve quality of care by reducing unnecessary tests, hospital admissions, and ultimately healthcare costs.

Fifty-six patients with electrical injury were admitted to The Burn Center pre-algorithm implementation and 38 patients were admitted post-algorithm implementation. There were no significant differences between groups in terms of age, sex, race/ethnicity, proportion of work-related injuries, or voltage exposure. Furthermore, there were no significant differences between groups in presence or extent of cutaneous burn area, Glasgow coma scale on arrival to the hospital, or proportion of patients with loss of consciousness immediately after sustaining electric shock.

The result show there was no difference in the proportion of patients who received electrocardiogram testing after implementing the algorithm. However, the proportion of patients who received testing in the pre-algorithm cohort was significantly higher for troponin (79% vs 34%), urinary myoglobin (80% vs 45%), and creatine kinase (82% vs 47%). Of 44 patients who had troponin levels tested in the pre-algorithm cohort, only 14% had abnormal results. The results also show there were more days of telemetry monitoring and greater intensive care unit length of stays, prior to algorithm implementation. There were no significant differences in total hospital lengths of stay, incidence of intensive care unit admissions, in-hospital mortality, or 30-day readmissions.

The study team concluded that use of this algorithm allowed for reduction in testing and health care costs without increasing mortality or readmission rates. Further data collection, targeted quality improvement and the use of actual cost-differences vs cost-savings estimates would be considered for future research.

The study team included Saira Nisar, MBBS, MS; John W. Keyloun, MD; Sindhura Kolachana, BS; Melissa M. McLawhorn, RN, BSN; Lauren T. Moffatt, PhD; Taryn E. Travis, MD; Jeffrey W. Shupp, MD; and Laura S. Johnson, MD.

Journal of Burn Care & Research, DOI: 10.1093/jbcr/irab020

MedStar Health Teaching and Research Scholars Capstone

The first virtual MedStar Health Teaching and Research Scholars Capstone program was held on Thursday, May 20th to celebrate education, innovation, and scholarship from our Teaching & Research Scholars. This event culminates the two years of research done by the scholars while in either program. It was also chance to view the works in progress of the scholars who have completed their 1st year. 

The evening started with an open poster session to view the research of our graduating Teaching and Research Scholars as well as those in their first year. Following this, the formal presentations began with opening remarks from our very own Dr. Stephen Evans, Executive Vice President and Chief Medical Officer.   

Next, we had our Teaching Scholars and Research Scholars presentations.

Research Scholar, Heather Hartman-Hall, PhD, is a clinical psychologist on the MedStar Health Internal Medicine (MHIM) faculty as well as a behavioral health consultant in the Primary Care Center at MedStar Franklin Square Medical Center. As an assistant professor of Clinical Medicine in the Georgetown University School of Medicine, she teaches didactics and mentors research projects on well-being and behavioral health topics. Heather presented "We don’t really talk about it: Role Modeling and Coping with Patient Deaths in the ICU" (see poster).  The purpose of this study is to better understand what attendings are intending to teach and what residents perceive they are learning about how to cope with death. The primary findings identified gaps in role modeling about coping with patient deaths in the intensive care unit, creating an informal curriculum that may leave residents unprepared to cope. Also, team briefings after a difficult patient death could bridge these gaps.  Next steps include piloting team debriefings after patient deaths in the intensive care unit to clarify the best methods and address potential barriers.

Teaching Scholar, Pashna N. Munshi, MD, is an Assistant Professor of Oncology at Georgetown University and is the associate director of the MedStar Georgetown Stem Cell Transplant and Cellular Immunotherapy Program at MedStar Georgetown University Hospital (MGUH). Her clinical and research interests focus on management of cellular immunotherapy toxicities focused in improvements in patient and caregiver health-related quality of life.  Pashna presented, "We’re in This Together: Self-Preparedness, Caregiver Burden, and Patient-Reported Outcomes in Patient/Caregiver Dyads in the Hematopoietic Stem Cell Transplantation Setting" (see poster). The purpose of this study is to examine health-related quality of life trajectory in patient/primary caregiver to explore associations between patient and primary caregiver perceptions of preparedness and health-related quality of life domains (anxiety, depression, fatigue, sleep, physical functioning and pain) using validated tools. The primary findings indicate that poor caregiver preparedness post-transplant negatively affects patient and caregiver health related quality of life 3 months post-transplant. Also, high caregiver burden 3 months post-transplant negatively affects patient sleep and physical functioning at 3 months post-transplant. Next steps for further research are to identify interventions targeted towards improving health-related quality of life for patients/primary caregivers and decreasing primary caregiver burden.

The evening concluded with closing remarks by Aviad Haramati, PhD, Professor of Integrative Physiology in the Departments of Biochemistry, Molecular & Cellular Biology and Medicine (Nephrology), Founding Director of the Center for Innovation and Leadership in Education (CENTILE), and co-director of the Integrative Medicine and Health Sciences Graduate Program at Georgetown University Medical Center. 

If you were unable to attend, you can view the capstone booklet here and the recording here.

The scholars’ posters and alumni accomplishments can still be viewed our webpage.

Congratulations to all of our Teaching and Research Scholars for their achievement!

MedStar Health-Georgetown University Research Symposium and CENTILE’S Colloquium for Educators in the Health Professions

In May, investigators, educators, innovators, and associates came together virtually for three days at the 2021 MedStar Health-Georgetown University Research Symposium and CENTILE’S Colloquium for Educators in the Health Professions.

Nearly 300 research posters and abstracts were submitted by MedStar investigators and residents in eleven research areas. The first day started with a viewing session for all posters and abstracts followed by opening remarks by both Kenneth Samet (President and Chief Executive Officer, MedStar Health) and Jack DeGioia (President, Georgetown University).  Our keynote address was presented by Dr. David J. Skorton, President of the Association of American Medical Colleges and past president of the Smithsonian Institutes. The first day also included the highest-scoring resident and oral presentations followed by a moderated research poster session and networking. 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.

Day 2 began with the Colloquium for Educators in the Health Professions, with opening remarks from Pamela A. Saunders, PhD, Programs Chair, CENTILE, Center for Innovation and Leadership in Education (CENTILE), Dr. Aviad Haramati, PhD, Director, Center for Innovation and Leadership in Education (CENTILE), and Dr. Edward B. Healton, Executive Vice President for Health Sciences, GUMC, Executive Dean, Georgetown University School of Medicine. After welcoming remarks, there was a presentation on racial and health justice discussing “Diversity, Inclusion and Anti-Racism: A Journey through Undergraduate Medical Education” including speakers Michelle Roett, MD; Sarah Kureshi, MD; Susan Cheng, Ed.L.D., MPP; Keisha Bell, MD; and Megha Fitzpatrick, MD. This was followed by educational plenary speakers including our new Dean of the Medical School, Dr. Lee Jones and Dr. Stephanie Detterline, along with workshops and networking.  

The Symposium wrapped up on day 3, with research plenary speakers Jay Khanna, MD, MBA, and Aviram M. Giladi, MD, MS, followed by additional research posters and educational sessions. 

You can still view the posters on the Attendee Hub for a limited time!  We will be able to offer all sessions as recordings in the future. For now, we are pleased to share the main stage remarks with you here, to watch, share or re-watch.

In order to make future events better, we’d love to get your feedback in a short, anonymous survey: Complete the survey here.

Thank you for your attendance, patience, and engagement in advancing health through research!

May Peer-Reviewed Publications from MedStar Health

Congratulations to all MedStar researchers who had articles published in May 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.  Sex and Racial Disparities in the Treatment and Outcomes of Muscle-invasive Bladder Cancer. 
    Urology, 2021. DOI: 10.1016/j.urology.2020.06.08
    Marinaro J, Zeymo A, Egan J, Carvalho F, Krasnow R, Stamatakis L, Lynch J, Hwang J, Williams S, Kowalczyk K.

  2.  Orthobiologics in Hand Surgery.
    Journal of Hand Surgery, 2021. DOI: 10.1016/j.jhsa.2021.01.006
    Karim KE, Wu CM, Giladi AM, Murphy MS.

  3.  HER2-positive breast cancer and tyrosine kinase inhibitors: the time is now.
    NPJ Breast Cancer, 2021. DOI: 10.1038/s41523-021-00265-1
    Schlam I, Swain SM.

  4.  The impact of COVID-19 patients with troponin elevation on renal impairment and clinical outcome.
    Cardiovascular Revascularization Medicine, 2021. DOI: 10.1016/j.carrev.2021.05.004
    Case BC, Yerasi C, Forrestal BJ, Chezar-Azerrad C, Shea C, Rappaport H, Medranda GA, Zhang C, Satler LF, Ben-Dor I, Hashim H, Rogers T, Weintraub WS, Waksman R.