Goal 2: Reduce Human Disease

Linking Clinics and schools to improve asthma control and reduce health disparities

How can we improve communication between schools and clinicians in order to develop support systems for children with severe asthma with health disparities?

 

How can we eliminate inefficiency in medical communication to better serve children with severe asthma?

Submitted by (@stanley.szefler)

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

Details on the impact of addressing this CQ or CC :

Children with asthma, especially severe asthma, are compromised by school absence and sleep disturbance. School scan play a significant role in identifying these children, assisting in monitoring their adherence to therapy and supporting the clinician's management plan. However, steps must be taken to improve communication systems that link clinics to schools and allow schools to communicate effectively with clinicians. While systems are in place for some schools that have active asthma management programs, there are many schools that do not have these resources or infrastructure. Model systems can be developed to assist these schools and improve the overall care of asthma in the United States.

Feasibility and challenges of addressing this CQ or CC :

Challenges that must be overcome is standardization of communication forms and harmonization of approach to asthma care, as well resolving barriers that exist due to confidentiality barriers in sharing medical information.

Name of idea submitter and other team members who worked on this idea : Stanley Szefler, MD

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

Institutional Support for K applicants as they transition to independence

What can research institutions do to entice and support potential and actual K award applicants to become independent scientists?

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 :

The period between the end of the K award and the first R01 is a critical one wherein many trainees, with no financial support from their institutions, opt out of a science career and pursue other viable sources of income, such as in the clinics, in teaching, or in the private sector. An investment from their institution, either by way of bridge awards, protected time, or salary commitment will enable retention of these highly- trained individuals and ensure a vibrant research workforce in the years to come.

Feasibility and challenges of addressing this CQ or CC :

This type of activity can be initiated immediately by the private institutions as a way of motivating physician- scientists and other scientists to remain in the academe, and eventually reap the rewards by way of research awards that bring prestige and indirect costs back to the institution.

In an analysis of 132 NHLBI Division of Lung Diseases K08 grantees between FY2005-2011, only 52% applied for subsequent NIH grants, whereas 48% did not even try, suggesting more incentives should be given for them to stay within the biomedical research workforce. However, among the Early Stage Investigators (ESIs) funded in 2013, 58% had previous training grants, suggesting training grants give Research Project Grant (RPG) applicants a definite edge.

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

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74 net votes
102 up votes
28 down votes
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Goal 4: Develop Workforce and Resources

Accounting for indirect costs

Strengthen institutional accountability to the investigator for appropriate use of indirect funds

Submitted by (@flogerfo)

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

Details on the impact of addressing this CQ or CC :

If the PI had some way of affirming institutional accountability for use of indirect funds, it would greatly strengthen PI support and respect. This would result in better space, admin support, support for resubmission,and overall prestige within the institution. The end result would be more effective research and attractiveness of a research career. Clinician scientists would benefit greatly.

Feasibility and challenges of addressing this CQ or CC :

Institutions rarely are interested in accounting to the investigator for use of IDC. Quite possibly due to fear that the investigator would be unreasonable demanding. Some creativity could get around this. A list of Investigators "rights" or "expectations" in terms of institutional support in the effective use of public funds. A committee of PIs to report to NIH on Institutional support. Perhaps with a response for the Institution. The value of this might be judged by the intensity of the pushback from institutions. Nonetheless, hospitals and schools are accountable to JCAH, etc. Having PIs participate in an evaluation by the NIH would in essence be no different.

Name of idea submitter and other team members who worked on this idea : Frank W LoGerfo

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17 net votes
24 up votes
7 down votes
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Goal 3: Advance Translational Research

pre-SBIR grant mechanism

SBIR STTR programs currently offer funds to support phase 1 and phase 2 development of translation with corporate involvement. Several here have pointed out that there is need for additional NIH support of investigator initiated translation, and I concur. There is indeed need for early stage and pre-IND support. Such a program would support relatively small grants for proof-of-principle studies, pre-clinical work needed ...more »

Submitted by (@wjones7)

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

Details on the impact of addressing this CQ or CC :

This program would support investigator initiated translational work by supporting pre-clinical proof of principle data before involvement of a company. This would allow for better development of IP, and better developed projects would be more attractive to industry. The work would have to involve some support for project development, so access to regulatory and pharmacological resources and/or consultants to develop the idea could be supported. These could be reviewed by existing SBIR/STTR study sections and funded by the set aside funds.

 

 

 

 

 

A pipeline for investigato-initiated translational science

http://nhlbistrategicvisioning.ideascale.com/a/dtd/74967-32287

Feasibility and challenges of addressing this CQ or CC :

This might be considered a "phase 0" SBIR/STTR and as such would not need to be a large grant (say $150K). These could be used to supplement institutional grants for entrepreneur activity (which are not usually sufficient) for synergy. We have the perfect study sections that already review SBIR/STTRs and funding some of these might impact the SBIR/STTR funding levels, which are fairly generous, but not by much. Would be filling one missing link in the process of funding translation form NIH funded research.

Name of idea submitter and other team members who worked on this idea : Keith Jones

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-12 net votes
10 up votes
22 down votes
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Goal 2: Reduce Human Disease

Optimal Use of mechanical circulatory support devices to Minimize Pump Thrombosis & AEs

There is a need for the development of a collaborative observational study that leverages off of existing registries, such as INTERMACS and STS, that will follow mechanical circulatory support devices (mechanical circulatory support device) patients prospectively and collect process-of-care data to identify 1) optimal approaches for the management of patients and 2) pumps to minimize the occurrence of adverse hemodynamic ...more »

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 :

Completion of the proposed observational study would optimize mechanical circulatory support device/left ventricular assist device use and minimize serious adverse events such as pump thrombosis.

Feasibility and challenges of addressing this CQ or CC :

Use of mechanical circulatory support is expanding to less sick populations, so optimal and safe use of these devices is critical.

Mechanical circulatory support devices (mechanical circulatory support device) have become important therapeutic options for patients with advanced heart failure. Considerable efforts are underway to develop newer generations of devices that are smaller, more durable and reliable, with fewer adverse events. However, mechanical circulatory support devices that are currently being used continue to have considerable risks and hemodynamic complications associated with them including bleeding, stroke, and intra-pump thrombus formation. Many factors influence the occurrence of these adverse events in patients receiving mechanical circulatory support devices, including patient selection, patient management such as the anticoagulation regimen used, pump selection, surgical placement and implantation of the pump, and mechanical aspects of the pump including pump speed and pulsatility, among other factors. The existence of multiple factors and complexities influencing and contributing to these adverse event outcomes preclude a standard clinical trial approach.

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

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4 net votes
15 up votes
11 down votes
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Goal 2: Reduce Human Disease

Understanding Right Ventricular Function and Failure

There is a need for understanding of right heart failure (RHF) and its consequences following left ventricular assist device (LVAD) support, as well as to develop devices to optimally support the right ventricle.

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 :

Understanding the pathophysiology and risk factors of right heart failure in the context of LVAD use might lead to preventative and therapeutic options for these patients.

Feasibility and challenges of addressing this CQ or CC :

Current resources in terms of a National Registry for VADS (INTERMACS) exists and can be leveraged.

While we have a substantial understanding of the risk factors associated with poor outcomes of patients with heart failure and left ventricular dysfunction, much less is known about the syndrome of heart failure and right ventricular (RV) dysfunction. Right-sided heart failure occurs in approximately 20% of patients receiving LVAD support. Investigation into the pathophysiology of right ventricular failure and its consequences following LVAD support, including identification of risk factors and treatment strategies, remains a high priority according to the Joint NHLBI-American Association for Thoracic Surgery (AATS) Working Group convened in 2011 (http://aats.org/CME/2011-AATS-NHLBI-Symposium.cgi). Development of new devices designed to optimally support the RV are warranted.

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

Voting

19 net votes
31 up votes
12 down votes
Active