Archive for: January 2012

Pioneer Grantees Top RWJF's Most Influential Research Articles of 2011

Jan 31, 2012, 8:57 AM, Posted by Brian C. Quinn

And the winner is …

We were quite proud and excited by the recent news that the work of two Pioneer Portfolio grantees placed first and second in the Most Influential RWJF Research Articles of 2011, as announced by David Colby, vice president of research and evaluation at RWJF, in January’s Evidence Matters.  

Coming in at number one, The Use of Twitter to Track Levels of Disease Activity and Public Concern in the U.S. During the Influenza A H1N1 Pandemic, published in May’s PLoS ONE. Dr. Phil Polgreen and colleagues at the University of Iowa monitored disease activity during the H1N1 outbreak by analyzing public messages or "tweets" on Twitter. The study established a model for monitoring disease outbreaks in real time.

Second place went to Project ECHO’s Outcomes of Treatment for Hepatitis C Virus Infection by Primary Care Providers, published in June’s New England Journal of Medicine. Dr. Sanjeev Arora and colleagues demonstrated that through Project ECHO’s transformative model of health education and delivery, primary care providers can be trained via video communications and real-time, case-based learning to manage complex chronic conditions formerly outside their expertise, thus expanding their ability to bring better care to more people in their own communities. By putting the best available medical knowledge into the hands of everyday clinical practitioners, Project ECHO exponentially expands the capacity of the health care workforce to provide high-quality care in local communities.

Congratulations to these grantees for their influential and innovative work to transform health and health care. We’re proud to call you part of the Pioneer family.

And a big thank you to all who voted or helped spread the word about these and the other great research articles in 2011’s top 25 list. You can still join in the conversation by using #Final_5 on Twitter, Facebook, and LinkedIn to discuss the winners and congratulate all the grantees who participated.

While you’re reviewing the Most Influential Research Articles of 2011, take a look at the top three most viewed Pioneering Ideas blog posts from 2011:

We look forward to exploring more pioneering ideas with you in 2012 and highlighting the important work of our grantees. Keep checking back or better yet, sign up to receive Pioneer’s content and funding alerts and future Pioneering Ideas posts.

'Exergames' Can Improve Cognitive Function in Older Adults

Jan 26, 2012, 2:35 AM, Posted by Pioneer Blog Team

We all hear about the benefits of physical activity beyond weight management. According to the Centers for Disease Control, exercise helps to improve your ability to do daily activities, mental health and mood. This is especially important later in life to improve cognitive function protecting against the onset of dementia. However, as the CDC estimates, only 14 percent of adults aged 65 to 74 years and 7 percent of those over 75 years exercise regularly.

Health Games Research grantee Dr. Cay Anderson-Hanley and her fellow researchers from the Healthy Aging and Neuropsychology Lab at Union College, New York set, out to find new interventions motivating older adults to exercise and promote good brain health.  They tested the impact of virtual reality-enhanced exercise, or exergames, that combine pedaling a stationary bike with an interactive video game compared to traditional exercise. Researchers evaluated participants’ executive cognitive function such as their ability to multi-task, problem-solve, and working memory and attention.

What they found was that adults ages 58 to 99 who participated in ‘cybercycling’ two to three times a week for three months had significantly better executive functioning than those using a traditional stationary bike.  This is the first study to quantitatively evaluate the benefits of exergames. 

You can also check more about the research featured in The Atlantic’s “Study of the Day,” CNN’s The Chart Blog, MedpageToday.com and The Los Angeles Times Booster Shot Blog.

To learn more, see the article in the February issue of the American Journal of Preventive Medicine, or check out Pioneer’s national program Health Games Research to see what they are doing to explore ways to advance the research, design, and effectiveness of digital games and game technologies that promote health.

Shorter Antibiotic Regimens Might Counter Antibiotic Resistance

Jan 12, 2012, 9:05 AM, Posted by Pioneer Blog Team

Antibiotics on the shelf today are increasingly losing their potency against resistant microbes or “superbugs” like the potentially lethal methicillin-resistant Staphylococcus aureus, or MRSA.

Extending the Cure researchers published an analysis this week that questions the conventional wisdom regarding antibiotic dosing practices and suggests rethinking the guidelines to minimize the growing public health crisis posed by antibiotic resistance. Ramanan Laxminarayan, director of Extending the Cure, and his colleagues, used mathematical models to study antibiotic treatment guidelines, the regimens physicians follow for the standard dose and duration of antibiotic treatment for common infections.

While antibiotic dosing regimens have typically been designed to cure bacterial infections, rarely have these guidelines taken antibiotic resistance into account.  All antibiotic use contributes to the development of antibiotic resistance, and the new research suggests dosing guidelines could be optimized to both treat infections and limit the spread of resistant microbes. The analysis, published January 11 in the online scientific journal PLoS ONE, indicates that in many cases, a shorter regimen of antibiotic treatment could work just as well as a longer course yet still reduce the risk of resistance.

Dosing strategies for antibiotics are not set in stone.  For example, many physicians have switched from the traditional 10-day course of antibiotics and now effectively prescribe a three-day regimen to treat otitis media, or middle ear infections. In some cases, the authors argue, shorter dosing regimens like this one could limit the selection pressure for resistant bacteria and thus reduce the threat of resistance.

Extending the Cure, a project of the Center for Disease Dynamics, Economics & Policy sponsored by the Robert Wood Johnson Foundation’s Pioneer Portfolio, is working to change how we think about antibiotics, a resource that can be depleted with overuse. This study suggests that shorter treatment regimens, in some cases, may help us preserve the power of the antibiotics we still have left.

Let us know what you think:  Are there any risks to shortening current treatment regimens? Are there any other benefits? Leave a comment here or tweet at @ExtendgTheCure and @PioneerRWJF #SaveAbx to tell us what you think.

Project HealthDesign Provides Input on Health IT Policies

Jan 10, 2012, 8:37 AM, Posted by Patricia Flatley Brennan

Since health reform passed almost two years ago, we’ve seen the health care system begin to change quite a bit. The push for better uses of health IT has brought about many proposed rules and programs, and federal agencies have requested public input on many of these proposals.

Because Project HealthDesign has always included multi-disciplinary teams of researchers, clinicians, and patients who are helping to lay the foundation for a patient-centered health IT system, we’ve seized these opportunities to share our unique insights by commenting on several proposed policies. In the process, we’ve been able to share our thoughts about promising practices for collecting patient-generated data and incorporating it into the clinical care process.

In 2011, Project HealthDesign provided feedback on seven proposed policies. These ranged from applauding the HHS Proposed Rule on Patient Access to Lab Reports, which would allow patients to become more engaged with their health data, to calling for better distinctions between mobile apps and mobile medical apps under the FDA Mobile Medical Application Guidance. Working together to help refine these types of policy proposals is even more critical now as we enter a new era of widespread adoption and use of health IT.

Read Project HealthDesign’s policy comments, watch “How Clinicians Can Help Guide Federal Conversations About Health IT,” or visit the Project HealthDesign website to learn more.

You can also check out Dr. Roger Luckmann's post on KevinMD.com about how Project HealthDesign is helping people with chronic diseases manage pain.

Inviting Patients to Read Their Doctors' Notes

Jan 10, 2012, 4:00 AM, Posted by Pioneer Blog Team

Will patients be more likely to seek a second or third opinion? New York Times

Will reading your doctor's notes lead to better health? USA Today

Can Patients Handle the Truth? TIME

These questions and others were posed following the release of OpenNotes’ findings about patient and doctor attitudes toward opening doctors’ medical notes to patients. The survey of nearly 38,000 patients and 173 primary care physicians revealed patients were enthusiastic about the prospect of reading their doctors’ notes while doctors were cautious.

Patients who signed up for the project, such as Linda Johnson, 63, a Harborview patient,  told The Seattle Times she found the notes helpful in recalling what she and her doctors had talked about and how she was supposed to follow up. "I have found, as I get older, I need more visits to the doctor, and there are more things we need to talk about…I find having them written down helps a lot." Patient Candice Wolk, a 39-year-old mother of twins, told the New York Times that reading her notes after a pregnancy check-up reminded her to follow-up with a dermatologist to have a dark spot on her back checked. 

Doctors enrolled in the project also shared their thoughts. David Ives, MD, an internist at Beth Israel Deaconess, told American Medical News he thinks OpenNotes is a rousing success, saying “The patients loved it, and it had absolutely no impact on me really at all. It was amazing how little impact it had.”

Bloggers chimed in too, including patient advocate Trisha Torrey who called on her readers to “continue to encourage your doctor to share your records –  to provide easy access to you” and Ted Eytan, who wrote that “here’s something in health care that most patients want to receive, but not all doctors want to provide.”

The media stories and blog posts such as those on The Health Care Blog, TIME’s Healthland Blog, NPR’s Shots Blog, and Vitals on MSNBC.com sparked conversations and debate and were shared widely through social networks.  You can join the conversation by commenting on these stories or tweeting @myopennotes or @pioneerrwjf.

Looking ahead, one thing is clear: the final results of OpenNotes, due later this year, are eagerly awaited and have the potential to spur real change in the way doctors share information with patients about their health and health care.

OpenNotes is funded by the Robert Wood Johnson Foundation’s Pioneer Portfolio. The survey results were published December 19, 2011, in the Annals of Internal Medicine.