Goal 3: Advance Translational Research

Translation Research Dissemination & Implementation Frameworks

We need to identify and test the proven effective dissemination and implementation frameworks that are relevant to heart, lung, and blood disorders in order to scale up evidence-based interventions in real world settings, ultimately improving health equity among minority populations, including low income minority residents living in public housing.

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

• Ability to determine how much of an evidence based intervention can be sustained in real world settings.

• Add utilization of D&I frameworks to researcher’s core competency training skills.

• Promote long term sustainability of evidence based interventions.

Feasibility and challenges of addressing this CQ or CC :

• Researchers from the 2014 NIH’s Annual Conference on the Science of Dissemination and Implementation: Transforming Health Systems to Optimize Individual and Population Health presented compelling evidence that dissemination and implementation frameworks are an effective means to scaling up evidence based interventions.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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4 net votes
13 up votes
9 down votes
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Goal 4: Develop Workforce and Resources

Reproducibility Initiatives in Heart, Lung and Blood Research

Scientists feel tremendous pressure to publish numerous scientific papers in order to receive NIH funding and tenure at academic institutions. Cognitive biases of scientists and publication biases of journals that publish this barrage of papers will likely result in the publication of findings that are probably not reproducible (see "Why Most Published Research Findings Are False" by John P. A. Ioannidis in PLOS Medicine ...more »

Submitted by (@jalees)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

By distinguishing research findings which are reproducible from those which aren't, researchers will be able to build future research programs on solid scientific foundations.

 

There are many reasons for why research may not be reproducible, ranging from simple biological variations (cells from one supplier may behave differently than cells from a different supplier) to conscious/unconscious biases or misconduct. No matter what the underlying cause is, irreproducible research findings that are not recognized as such will result in a tremendous waste of time and resources. Graduate students or postdoctoral trainees may waste entire years of their precious training period conducting experiments that are based on published papers which may turn out to be irreproducible.

 

NHLBI could significantly improve the quality of research by building an infrastructure that supports the assessment of reproducibility and widely shares these findings.

Feasibility and challenges of addressing this CQ or CC :

One of the challenges for assessing reproducibility of published work is that it is considered not very innovative and there is no funding available. NIH grants are awarded to highly innovative proposals which venture into new territories and not proposals which want to confirm the validity of published work. However, the returns of investing into reproducibility testing might be enormous because irreproducible results would be identified and weeded out, thus preventing loss of resources and time.

 

The NHLBI could develop funding mechanisms specifically designed to support research proposals that will test the reproducibility of high impact findings that have not yet been independently verified. The study sections would review these proposals using novel criteria designed for such studies. The emphasis of the study section review would lie on questions such as "Is this an important enough question that it merits reproducibility testing?" instead of the traditional "Is this a cutting-edge technology that nobody has previously used?"

 

Challenges would include identifying journals that would published results of these studies and agreeing on what constitutes reproducibility (i.e. is it enough if the major conclusion or effect is reproduced even though the effect size may be very different?).

Name of idea submitter and other team members who worked on this idea : Jalees Rehman

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5 up votes
3 down votes
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Goal 3: Advance Translational Research

T4 Translation Research Informing Early Stage Translational Research

There is a need to utilize insights gained from T4 translation research and implementation science to inform the design and execution of early-stage translational research and clinical trials.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

• Assure that early stage translation research will be suitable for implementation in real world setting

• Aligns the research interventions from T1-T3 research to those appropriate to T4 research

• Potential to focus early stage research in key high burden areas

• Provides research community an understanding of the connections from early stage to late stage translation research which will potentially refine research strategies and directions at all levels

Feasibility and challenges of addressing this CQ or CC :

• Promote the importance of translation to population of heart, lung, blood, and sleep researcher to broader research community

• Potential for more T4 research contributions for guiding investment into translation research from T1-T3

• Provide avenues for T1-T3 investigators to translate their ideas into positive outcomes for population health

• Successful T4 research will stimulate feedback loop and identify opportunities for early translation research

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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3 net votes
13 up votes
10 down votes
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Goal 3: Advance Translational Research

Expand the H3Africa Partnership Model to Decrease HLB diseases

Is there a way to decrease the risks for HLB disease leveraging the H3Africa genomics platform? • Leverage partnerships providing resources to the H3African populations • Identify the best collaborative partners to reach out to the low resource population • Find the best mechanism for collaborations to facilitate the interventions in low resource settings • Merge NHLBI research objectives and goals with those of potential ...more »

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Leverage the existing infrastructure (NHLBI & UnitedHealth investment in the Centers of Excellence in Kenya and South Africa; NIH and Wellcome Trust investment in H3Africa) to decrease the burden of HLB using genomics in low resource settings

• Proof of concept: H3African countries & affiliated sites can be used to create a T4 model

• Extension: expand the H3Africa model to other LMICs

Feasibility and challenges of addressing this CQ or CC :

• Existing NHLBI investment in capacity building in some of the H3African countries can be leveraged to address heart, lung, blood, sleep diseases

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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-6 net votes
6 up votes
12 down votes
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Goal 4: Develop Workforce and Resources

Develop Vascular Anomalies Medical Training and Research Programs

Patients with vascular anomalies frequently see many physicians and undergo extraneous tests with incorrect diagnoses. A major reason for this is due to the fact that medical training does not include Vascular Anomalies in the syllabus. Thus, many specialties erroneously use the term "hemangioma" for any vascular diagnosis. Over the past 2 decades, there have been major breakthroughs in basic and genetic research, as ...more »

Submitted by (@fblei0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Developing a training program for vascular anomalies will facilitate improved, more efficient and meaningful patient care. It will also engender collaborative research and data collection for these patients.

Feasibility and challenges of addressing this CQ or CC :

This is very feasible. There are key individuals, advocacy groups, and programs in each of the disease entities - Hemangiomas of infancy, Syndromic Vascular Anomalies (CLOVES, Sturge Weber, Proteus, Maffucci, Klippel Trenaunay, Cutis Marmorata, PTEN Associated Hamartoma Syndrome, Lymphedema Syndromes, etc) which would benefit from a coordinated strategic plan to pool resources, develop a data bank and tissue bank and foster collaborations to move this field forward. This could also serve to develop a network of tiered Vascular Anomalies Programs with certification.

Name of idea submitter and other team members who worked on this idea : Francine Blei, MD

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7 up votes
8 down votes
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Goal 3: Advance Translational Research

Community Trials for Cardiovascular Health Enhancement

There is a need to initiate innovative community trials that are: theory-based; are integrated multi-component, multi-setting, and multi-level (i.e., they target individual, family, community, and built environment); engage community stakeholders; and use community-participatory research principles to enhance cardiovascular health (CVH) in vulnerable and diverse populations.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Global impact on cardiovascular health.

Feasibility and challenges of addressing this CQ or CC :

There are smaller scale community interventions but none in the literature that focuses on larger-scale multi-level trials as proposed here. This CQ would target vulnerable and diverse populations to reduce health disparities.

NHLBI supported the stroke belt initiative, and the exemplars in community CV health research: (e.g., the Stanford 5 City Project, The Minnesota Heart Health Program, The Pawtucket Heart Health). The next generation of community CVH research should harness the lessons from these studies, findings for the 8 Americas (Chris Murray), and numerous results from NHLBI cohort studies to implement large-scale community trials for cardiovascular health enhancement.

Resources for a large scale study could be a challenge. Ability to motivate a whole community, to prevent contamination, and to sustain interventions would be a challenge.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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-1 net votes
9 up votes
10 down votes
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Goal 4: Develop Workforce and Resources

Promoting Translational Research training using the R03 mechanism

We in Wisconsin have developed a robust training program for mixed MD and PhD postdocs in a clinical dept and yet their future in research is blocked by few faculty positions, poor funding and over complicated NIH applications. One of the simplest grants is the R03 and we have already had graduates with only a few years postdoc experience succeed in gaining R03 funding. The R03 is a very simple very flexible mechanism. ...more »

Submitted by (@ianbird)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

More MD and PhD Postdoc trainees will spend more time focused on work and less writing grants - and the efficiency of expenditures by NIH would go up in terms of paper generated per dollar. MDs who may have a desire to dip in and out of funded research as their clinical path demands would be able to do that. R03 funding does not at any time change your status as a new or early career investigator. Its perfectly reasonable to hold more than one even without a faculty title but as a PhD scientist or practicing clinciian.

Feasibility and challenges of addressing this CQ or CC :

Its easy to do - just decide to do it. Also writing an R03 is the best possible training for writing an R01. I run a T32 for predocs and I mentor K12 postdocs. I know what NIH INTENDS in its training grants. But also recognize just to take on the longer and longer and more demanding K application after already being well trained is a real disincentive to everyone, even if those pages in training plan are well intentioned. IF omeone has not had the chance to train or is cross training to a new area then a K99 is perfect. But someone who is well trained, may stay in their area and has already proven themselves needs a fast submission fast review process to get funding NOW that may be the difference between continued employment though this funding crisis or not. This could provide that for them. Especially with expedited review!

Name of idea submitter and other team members who worked on this idea : Ian Bird

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-1 net votes
10 up votes
11 down votes
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Goal 3: Advance Translational Research

Addressing Health Inequities through Nontraditional Partnerships

What non-traditional partnerships can be leveraged to address health inequities?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

- Broaden reach to underserved populations

- Increase ability to generate evidence based solutions to address health inequities

- Bring expertise and resources to core partner (NIH)

- Enhance ability to identify unanticipated problems and strengthen efforts across all phases of the implementation research agenda

Feasibility and challenges of addressing this CQ or CC :

Feasibility:

- Increased emphasis on health and health inequities by non-profit and particularly, for-profit organizations

- Affordable Care Act (ACA) includes both general and explicit provisions that could narrow the health disparities gaps through implementation research.

- Can leverage and build upon current research partnerships that exist between government agencies and health care delivery systems to address questions of major public health importance

- Opportune time to employ implementation research addressing health inequities through non-traditional research partnership with sectors such as education, state and local government, transportation (built environment), penal and re-entry systems (health risks and disparities), ministries of health, and for-profits, foundations, and non-profits with health care focus.

 

 

Challenges:

 

 

- Risk of disagreements and friction among partners and management with different priorities

 

- Synchronization of timing for decision making

 

- Achieving partners’ concurrence on decisions that provide the most cost effective solutions

 

- Time needed to establish trust among partners that do not routinely partner to address health inequities

 

- There are limited resources dedicated to fostering Public Private Partnerships

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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6 net votes
19 up votes
13 down votes
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Goal 2: Reduce Human Disease

Congential heart defects in diabetic pregnancies: a devastating reality

There is an urgent need to understand the mechanisms underlying diabetes-induced congenital heart defects (CHDs) through basic science research and biomarker identification in human maternal circulation. Majority of the current research in CHDs is related to genetic analyses; however, environmental factors contribute to the majority of human CHDs, but the underlying mechanism is unknown. There is 60 million worldwide ...more »

Submitted by (@pyang0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

More than 32,000 infants are born with heart defects each year in the United States, and about 1 in 150 adults are expected to have some form of congenital heart defect. Approximately, 25% of infants born with heart defects (2.4 per 1,000 live births) require invasive treatment in the first year of life, and in 2009 heart defects were the most common cause of infant death. Therefore, understanding the underlying causes of abnormal heart formation is an essential step towards developing effective new therapeutic treatments or preventions for heart defects. Using diabetes-induced CHDs as research models will reveal critical molecular pathways that contributes to heart cell proliferation and apoptosis.

Feasibility and challenges of addressing this CQ or CC :

The same types of heart defects seen in human diabetic pregnancies can be recapitulated in diabetic animal models, making rodents ideal models to investigate how maternal hyperglycemia may induce congenital heart defects. Dietary supplements of natural compounds may be effective against CHDs in diabetic pregnancies. Clinically, new imaging techniques needs be developed for the early diagnosis of CHDs in diabetic pregnancies. Biomarkers in human blood samples needs be detailed analyzed so that we can use small molecules such as microRNA for reliable and early diagnosis.

Name of idea submitter and other team members who worked on this idea : Peixin Yang

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22 net votes
22 up votes
0 down votes
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Goal 4: Develop Workforce and Resources

Safeguarding Mentorship for the Next Generation

There is a need to ensure that mentors have adequate skills, time, and incentives to mentor successfully.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Continuity of research discoveries requires that outstanding mentors impart their passion and research skills to the next generation. Opportunities and incentives must be provided to ensure that highly qualified scientists can devote adequate time and effort to mentor promising junior colleagues, as well as enhance their own research output.

Feasibility and challenges of addressing this CQ or CC :

Mentor-directed opportunities can be immediately made available to provide protected time and salary for scientists with a passion for mentoring.

The current K24 mechanisms have been shown to be quite beneficial, not only for the mentor who can advance his career in the academe, but more so for the trainees who are exposed to the science that the mentor brings. However, K24 awards are primarily for patient-oriented research which enhance clinical skills. Non-clinical biomedical research will also benefit from similar programs.

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168 up votes
30 down votes
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Goal 2: Reduce Human Disease

Basic Research & Precision Medicine

How can NHLBI best encourage basic research areas that are critical to the development of precision medicine approaches for lung disease?

Submitted by (@skrenrich)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : Cystic Fibrosis Foundation

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-2 net votes
3 up votes
5 down votes
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Goal 1: Promote Human Health

leveraging EHR through improved partnerships

Large medical delivery systems have an abundance of information stored in their EHR systems. What steps are necessary to develop partnerships between NHLBI and medical delivery systems or other agencies such as AHRQ to access these EHR systems, develop a common terminology (if icd 9 and other common codes are ineffective for merging data) and add that data to dbGap for NIH/community use?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Accessing the EHR systems of the large care systems would provide a wealth of knowledge/data for the research community.

Feasibility and challenges of addressing this CQ or CC :

The stored data will only expand in the EHR systems and it would certainly be of value and interest to any number of research projects.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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1 net vote
13 up votes
12 down votes
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