Goal 3: Advance Translational Research

What are the most effective strategies for reducing alarm fatigue and optimizing cardiorespiratory monitor alarm management?

Hospital cardiorespiratory monitors have great potential to save lives, but are hampered by high false alarm rates that contribute to alarm fatigue. While the long term solution is developing new medical devices that will do this better, few hospitals will benefit from new device innovations in the next decade. In order to better identify early signs of cardiorespiratory deterioration in the hospital at an early stage ...more »

Submitted by (@chrisbonafide)

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

Details on the impact of addressing this CQ or CC :

Improved strategies for optimally detecting deterioration using existing bedside cardiorespiratory monitoring technologies has the potential to impact the care of hundreds of thousands of hospitalized adults and children each year.

Feasibility and challenges of addressing this CQ or CC :

This is highly feasible with a fairly modest allocation of resources. This work falls under heart and lung disease, hospital medicine, nursing research, and implementation science.

Name of idea submitter and other team members who worked on this idea : Chris Bonafide, MD, MSCE

Voting

-6 net votes
4 up votes
10 down votes
Active

Goal 4: Develop Workforce and Resources

Improving Biomedical Careers

There is a critical challenge to retain highly trained basic and clinical scientists in the biomedical research enterprise and expediently promote their independence and capacity to produce innovative discoveries. There is a need to provide more funding opportunities for collaborative, team-science approaches to scientific investigation by interdisciplinary teams comprised of clinician scientists, basic researchers, and ...more »

Submitted by (@nhlbiforumadministrator)

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

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

Voting

32 net votes
50 up votes
18 down votes
Active

Goal 3: Advance Translational Research

Leveraging Networks of Federally Qualified Healthcare Centers

How best do we leverage the existing Federally Qualified Healthcare Center’s (FQHC) infrastructure to study T4 Implementation Research for heart, lung, blood, sleep diseases and conditions among high risk and vulnerable populations?

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 :

• Develop strategies to reduced Health Inequities

• Potentially be scaled up across an entire health system with huge population impact

• Studies would be done in the environment and context where the findings with be implemented leading to better uptake and sustainability.

Feasibility and challenges of addressing this CQ or CC :

• Formative FQHC groups are already being organized but do not have strong leadership and support

• FQHCs have ready access to the high risk and vulnerable populations that would benefit most from the research

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

Voting

-14 net votes
7 up votes
21 down votes
Active

Goal 1: Promote Human Health

Paracrine Signaling in the Heart

We need to improve the understanding of the molecular and physiological bases of paracrine signaling of heart, and use the knowledge gained to develop improved, effective approaches to diagnose, treat, and prevent cardiac disorders.

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 :

Although myocytes comprise approximately three-fourths of the entire volume of mammalian ventricles, they account for only about one-third of all myocardial cells. Ninety percent of the remaining myocardial cells are cardiac fibroblasts which are located primarily in the interstitium. Understanding how complex paracrine signals interact at the molecular, cellular, and organ levels continues to be a challenge to investigators. Clearly, the cardiac fibroblast plays an important role in signaling by its ability to respond to a wide variety of chemical signals that are involved in the paracrine regulation of cardiac function. These and other cardiac paracrine signaling pathways need to be better elucidated before specific clinical interventions targeting them are developed.

Feasibility and challenges of addressing this CQ or CC :

This is presently an understudied area of research. Studies however suggest that paracrine factors released from fibroblasts are likely to play an important role in modulation of heart growth and function. This may be especially so in regulation of STEM cell differentiation and following insults to the adult heart.

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

Voting

13 net votes
27 up votes
14 down votes
Active

Goal 4: Develop Workforce and Resources

Promotion of interdisciplinary and team science by T-32 Institutional Training Grants.

Are T32s doing a sufficient job of promoting interdisciplinary and team science? Should we change the way these programs are structured?

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 :

T-32 programs train few thousands junior biomedical scientists every year. Training grants that succeed in integrating multiple discipline will produce a workforce that is more attuned to the needs of modern medicine and will be more competitive in the job market of the 21st century.

Feasibility and challenges of addressing this CQ or CC :

Activities along this line can be implemented immediately by strongly encouraging the institutions to revise or re-design their training programs.

Interdisciplinary training has become a necessity in the present time; there is a strong interest in today’s medicine at looking at the patient in its entirety and at disease processes from all angles. This requires data integration and scientists that are familiar with the language of different disciplines and can ask scientific and medical questions that span these disciplines.

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

Voting

25 net votes
37 up votes
12 down votes
Active

Goal 1: Promote Human Health

Understanding NANCs and Neuropeptide Function in the Heart

Understanding the complexity of NANC transmitter release and neuropeptide function could be helpful in establishing new, effective therapeutic strategies for treating heart disease.

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 :

Could lead to the development of fundamental knowledge required to develop effective new therapeutic interventions to treat heart disease.

Feasibility and challenges of addressing this CQ or CC :

Several studies have already demonstrated associations been NANC transmitter release and neuropeptide co-localization with pathogenic changes in cardiac function.

Identification within cardiac nerves of neural peptides that are co-released with traditional transmitters is an interesting and still emerging story. Studies with nonadrenergic, noncholinergic (NANC) transmitters in both the atria and ventricle have shown that a variety of neuropeptides also are localized within the heart, and several, including vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), substance P, and calcitonin gene-related peptide, have been shown to markedly affect heart rate and modulate cardiac function. NPY is also elevated in heart failure patients, and other neuropeptides, including VIP, calcitonin gene related peptide (CGRP), substance P (SP) and their receptors are associated with various types of cardiomyopathies.

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

Voting

3 net votes
14 up votes
11 down votes
Active

Goal 3: Advance Translational Research

What is the optimal way to improve cardiac arrest resuscitation?

Sudden Death from cardiac arrest and gaps in knowledge of emergency cardiovascular care are the #1 killer of more than 400,000 Americans each year. This epidemic of death and disability is largely ignored and underfunded by NIH and all funding agencies and kills more than HIV, Cancer, Diabetes, and infectious diseases. There is no national registry of cardiac arrest, no mandatory reporting, and poor funding for both fundamental, ...more »

Submitted by (@nadkarni)

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

Details on the impact of addressing this CQ or CC :

Answering this question will save more lives and quality of life-years than all other infectious diseases in North America. The potential interventions are well developed and we need more fundamental, translational and implementation science to impact this most significant problem. An upcoming IOM report on needless deaths resulting from cardiac arrest is anticipated to be published in 2015.

Feasibility and challenges of addressing this CQ or CC :

Very feasible, just needs support and funding. A call to arms is being issued by the American Heart Association and Institute of Medicine. The roadmap is outlined, and all we need to do is follow the roadmap.

Name of idea submitter and other team members who worked on this idea : Vinay Nadkarni MD

Voting

19 net votes
37 up votes
18 down votes
Active

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

Voting

3 net votes
13 up votes
10 down votes
Active

Goal 3: Advance Translational Research

Implementation science research to reduce adverse effects of SCD

From various publications and reports, we have characterized the risks associated with sickle cell disease (SCD) and understand many of the barriers for treatment of SCD in LMICs. How can implementation science research be used to reduce the negative outcomes of SCD in low/middle income countries?

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 :

• Reduction of deaths and negative outcomes associated with SCD and in LMICs

• Provide the evidence base that supports culturally relevant implementation strategies that reduce deaths associated with SCD in LIMCs

Feasibility and challenges of addressing this CQ or CC :

• Yes

, this is feasible

• Common goals and deliverables between NHLBI and partners will need to be identified

• Partnerships can be with international organizations, Ministries of Health and other partners

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

Voting

18 net votes
31 up votes
13 down votes
Active

Goal 1: Promote Human Health

Achieving Excellence in Health and Science Communication

At least two thirds of US adults use the internet to access health information. The accuracy and quality of health and science information found on news media websites, corporate websites of the healthcare industry, blogs of healthcare providers and social media networks varies widely. Nevertheless, this information can have a profound influence on the healthcare-related decision-making of patients. The anti-vaccination ...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 :

The NHLBI could lead the way by providing resources and funding to study the most effective ways to improve health and science communication. Examples of such approaches could be grants that fund how information pertaining to heart, lung and blood disease is disseminated to the public and how the quality of the content is regulated.

 

How do information hubs (media organizations, blogs, Twitter and Facebook accounts) assess the accuracy and quality of the medical and scientific content disseminated to their audiences?

 

Can collaborations between communicators (journalists, TED talkers, writers, etc.) and scientists/physicians help provide a more realistic and evidence-based portrayal of ongoing research efforts and the efficacy of treatments?

 

If the NHLBI is able to build such collaborations then the benefit to society could be quite significant. The public will be provided with resources to understand ongoing research efforts as well as obtain high-quality, up-to-date analyses of how research studies are relevant for them and their personal decisions regarding their health.

 

Even citizens who are not seeking medical advice would benefit from this because it would allow them to develop a realistic perspective and appropriate enthusiasm for the ongoing efforts in the basic sciences.

Feasibility and challenges of addressing this CQ or CC :

One challenge will be that this approach will require collaborations between diverse disciplines in order to be successful. Clinicians/Researchers in the cardiovascular, pulmonary and hematologic sciences will need to work closely with experts in communication sciences, behavioral experts and journalists to develop new approaches to health and science communication.

 

On the one hand, we want the science and medicine to be portrayed accurately, on the other hand, it is also important to ensure that this information is conveyed in a manner that is accessible for a non-specialist audience.

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

Voting

5 net votes
5 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Culturally competent T4 research interventions to reduce heart, lung, blood, sleep

Using previous federal and partner infrastructure, what are the best methods to promote culturally competent T4 interventions that will reduce cardiopulmonary risk factors in global populations with a disproportionate burden of heart, lung, blood, sleep diseases?

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 :

Reduction of cardiopulmonary risk factors

Reduction of health inequities

Feasibility and challenges of addressing this CQ or CC :

Proven, evidence-based interventions exist for common diseases that can be adapted to reduce burden in low resource settings.

However,determining the best way to adapt existing interventions that are culturally competent and effective is a sensitive issue.

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

Voting

-7 net votes
9 up votes
16 down votes
Active

Goal 2: Reduce Human Disease

Behavior change labs: an interdisciplinary team approach

Will integration of behavior science in clinical research improve effectiveness of interventions for HLBS diseases associated with behavioral risk factors?

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 :

Currently, there is no industry support for T1 (basic to clinical) behavioral research and therefore little incentive for basic and clinical behavioral scientists to work together to develop and test new, innovative strategies for changing HLBS-related behaviors based on basic behavioral science findings on motivation, perception, cognition and social relationships. Bringing together collaborative, interdisciplinary teams of basic behavioral scientists and clinically-oriented behavioral researchers could spur development and testing of innovative new approaches to difficult HLBS-related behavioral problems such as obesity, unhealthy diets, sedentary lifestyles, smoking and non-adherence to preventive and therapeutic HLBS regimens.

Feasibility and challenges of addressing this CQ or CC :

New research in the behavioral sciences is elucidating the basic psychological, cognitive, social and behavioral processes underlying behavior and behavior change. Findings in this area could be developed into new strategies targeting problematic HLBS-related behaviors, but a mechanism for developing and testing novel ideas is needed. Networks designed to bring together basic and clinically-oriented behavioral researchers can enable better understanding of the bases of HLBS-related behaviors and accelerate the translation of findings into new approaches.

Adopting and maintaining healthy habits and lifestyles – such as eating healthy diets, engaging in regular physical activity, stopping smoking, and regularly taking prescribed medications – are crucial to heart, lung, blood and sleep (HLBS) health (Akesson et al, 2014; Mozaffarian, 2014). However, for most people, engaging in and maintaining a healthy lifestyle is challenging. Interventions designed to promote behavior change have had limited success, often influencing individuals over the short-term but failing to alter behaviors over longer periods of time, which is necessary to realizing the full benefits of a healthy lifestyle. Underlying the problematic behaviors associated with HLBS-related behavioral risk factors are fundamental psychological, motivational, cognitive and social processes that represent promising targets for the development of new, more effective behavioral interventions. For example, basic behavioral scientists are investigating the role of poor executive function in unhealthy eating behavior and exploring new ways to address the "self-control" failures that lead to impulsive eating.

 

However, unlike the biomedical arena where the translational pathway from basic science to clinical application is supported by both NIH and industry, there is no industry support and relatively little NIH funding devoted to T1 behavioral research -- i.e., research translating basic behavioral science findings into clinically significant behavioral interventions. As a result, basic behavioral science researchers have little incentive to collaborate with clinical researchers to develop and test novel behavioral treatments. Bringing together collaborative, interdisciplinary teams of basic behavioral scientists and clinically-oriented behavioral researchers could spur development and testing of innovative new approaches to difficult HLBS-related behavioral problems.

 

A compelling question is how to bring together these disparate researchers over a long enough time frame to enable them to identify, develop and testing new strategies for tackling resistant behavioral problems. One way to address this question is to fund a network of "behavior change labs," each of which brings together teams of basic behavioral scientists who are investigating the bases of behavior and behavior change with clinical researchers interested in designing, optimizing and testing novel ideas for tackling the difficult behavioral problems represented by obesity, unhealthy diets, sedentary lifestyles, smoking and non-adherence to medications used to prevent or treat HLBS diseases and disorders.

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

Voting

83 net votes
129 up votes
46 down votes
Active