Goal 3: Advance Translational Research

Asthma Treatment Recommendations for Blacks

Considering the fact that Blacks bear a disproportionate degree of asthma morbidity and mortality, should treatment recommendations be different for Blacks vs. Caucasians?

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 : American Thoracic Society

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Goal 2: Reduce Human Disease

Open up NCATS

The NCATS program for drug repurposing is currently only open to drugs submitted by industry (read, big Pharma). We have had the experience of working to repurpose a generic drug not on their list, and despite great Preliminary data, we could not. This program is a great idea, but needs to be opened to any company and any drug for which solid data backing efficacy and market can be applied. Why do we only want to enhance ...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 :

Opening the program to all FDA approved drugs would benefit development of the most useful repurposed therapeutics. The goal should not be focused upon drugs that large corporations still hold license to, but opened to therapeutic development that helps people, regardless of the size of the corp. Another advantage is that the program could then help small companies, startups, and generic companies develop new uses for drugs proven safe.

Feasibility and challenges of addressing this CQ or CC :

Of course, large corporations can claim that they have the best chances of marketing a repurposed drug, therefore investment should be in areas and drugs they control. The reality is, no matter which entity does the work for repurposing, a successful project will likely be bought and marketed by big Pharma anyway. So the focus should be on repurposing drugs for disease that have few therapeutic options, with exemplary benefit efficacy and low rosk, ect., The focus should not be on a list of drugs submitted by

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

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Goal 4: Develop Workforce and Resources

Similar changes to those in modern manufacdturing are required through our new technical society inlcuding medicine.

Attitudes to Mistakes. Changing prescription and protocol philosophy. As an older patient, I am 89, I have one thing many others do not have, experience. As an engineer with much experience in manufacturing industry I have seen great recent changes in manufacturing sociology. Now, even top management comes to listen to “the Gemba” (the shop floor) and what could be regarded as mistakes are seen as opportunities to improve ...more »

Submitted by (@khop00)

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

Details on the impact of addressing this CQ or CC :

As an engineer with considerable experience in manufacturing industry I have seen great changes in manufacturing sociology. We have come to listen to the Gemba (the shop floor) and inappropriate procedures are now regarded as opportunities to improve not something to be punished. Perhaps I can mention that my writing has been praised on this subject, for example for the book, "The Puritan Gift” by Kenneth and Will Hopper. “This is one of the best books I have ever read in my long life, and I don’t just mean books on business” Foreword: by Russ Ackoff, Wharton Business School. “late in their lives (the Hoppers) have given us an extraordinary gift” (translated from Chinese) Promise Hsu, Vista Magazine

Feasibility and challenges of addressing this CQ or CC :

I suggest as a subject for discussion, that a change to a more aggressive use of antibiotics could save antibiotics. There is an old saying that the best time to hit a man is when he is down. The same surely applies to harmful bacteria.

Name of idea submitter and other team members who worked on this idea : Kenneth Hopper

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Goal 3: Advance Translational Research

Access to healthcare for treatment/management of asthma and allergies, and funding of research on asthma and allergies

It is essential that people with asthma and allergies have access to affordable, quality healthcare for the treatment and management of asthma and allergies, and that research is funded to address prevention, screening, and lifestyle interventions to reduce the incidence and adverse effects of asthma and allergies. These conditions impose significant costs on the overall health care system and on patients and their families. ...more »

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 :

Currently, more people than ever are struggling to live normal and healthy lives in the face of the daily limits that asthma and allergic diseases create. More than 25 million Americans have asthma, 15 million have food allergies, and 50 million have other allergic conditions. AAFA urges the National Institutes of Health (NIH) to continue to focus and accelerate research on asthma and allergies, which are life threatening chronic conditions for which there are no cures.

 

While asthma affects all populations, the burden of asthma falls disproportionately on the black and Hispanic/Latino—largely Puerto Rican—populations, and especially on minority children. Asthma is the third leading cause of hospitalization among children under the age of 15 and is a leading cause of school absences from chronic disease – accounting for over 10.5 million lost school days in 2008. Asthma costs our healthcare system over $50.1 billion annually and indirect costs from lost productivity add another $5.9 billion. Asthma claimed the lives of more than 3,400 Americans in 2010. According to the American College of Allergy, Asthma & Immunology, allergic diseases, which include asthma, are the fifth most prevalent chronic diseases in all ages, and the third most common in children.

Name of idea submitter and other team members who worked on this idea : Asthma and Allergy Foundation of America (AAFA)

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Goal 4: Develop Workforce and Resources

Benefits to the US in funding global health research in LMICs

What are the benefits to the US in funding global health research in low-to-middle-income countries?

Submitted by (@tracywolbach)

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

Details on the impact of addressing this CQ or CC :

Non-communicable diseases (NCDs) are the leading cause of death and disability worldwide. The four leading NCDs are cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes. The most common risk factors are tobacco use, physical inactivity, unhealthy diet, and alcohol use. NCDs and risk factors are shared globally and offer many opportunities and benefits to US funders and academia, such as implementing treatments in under resourced populations that could benefit US under resourced populations; identifying effective treatment for diseases with low incidence and prevalence in the US; and expanding physician training by caring for patients with diseases in early stages that are not commonly seen in the US until they are quite advanced The United Nations recognized the NCD global burden and held a high-level meeting on NCDs September 19-20, 2011. NHLBI should consider increase funding of global collaborations between the US and LMICs to address this increasing global health burden. Funding for these collaborations would help merge the fields of communicable and non-communicable diseases and provide opportunities for HICs to adopt some of the successful health care interventions implemented in LMICs. NHLBI should also consider a strategy to better inform politicians and taxpayers about the importance and benefits of global NCD research and increase their funding for NCD programs at academic institutions to train young chronic disease professionals.

Name of idea submitter and other team members who worked on this idea : Nancy Dianis

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Goal 4: Develop Workforce and Resources

A fully qualiftied EHR (electronic health record) as defined in ACA/HITECH in the hands of patients reduces medical errors

No physician or hospital has an active data management system at point of care. coding is done by third parties and not the diagnosing physician. The Test with MED-O-CARD shows that an integrated Diagnostic/Medication Algorithm allows a patient and his physicians to run and view instant data analytic. This system can be expanded scientifically without pushing the patient again aside. Patient inclusion will increase quality ...more »

Submitted by (@g.pollanz)

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

Details on the impact of addressing this CQ or CC :

Reduces medical errors / forces CPOE / shows instant drug inconsistencies even during surgery and intensive care / forces patient compliance

Feasibility and challenges of addressing this CQ or CC :

Tests with MED-O-CARD at Frankfurt University Hospital show the need of patient education. US providers ignore the legal mandate of the ACA and of HIPAA to transfer all electronic data to the patient. Violation of the law seems a cavalier deli ct with providers and has hardly any consequences.

Personal medical data collected from all providers plus monitoring and mobile apps data collected by the patient plus DNA data on one secured DB in the hands of a patient enables MICRO Analytic (of one patient) and allows entirely new challenges of MACRO Analytic (Population Management) without being dependent on the commercial considerations or providers who (mostly illegal) sell data for predefined pharmacological studies. MED-O-CARD's patient data will not be sold but shall become property of the participating patients and thus allows the free-of-charge creation of scientific BIG DATA for R&D

Name of idea submitter and other team members who worked on this idea : Prof. Thomas Vogl, Frankfurt University Hospital; others, Israel, German and US computer teams

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Goal 3: Advance Translational Research

Recognizing that HLB are components of a whole person

RASopathies is one of a group of syndromes that include heart, lung and blood issues, but these are not all the concerns. Recognizing that these organs are part of a functional network (called the human body), partnering with other Institutes could help expedite knowledge of these systems. Leveraging small pockets of funds through mechanisms such as R13 grants where the primary institution is not NHLBI is an inexpensive ...more »

Submitted by (@lschoyer)

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

Feasibility and challenges of addressing this CQ or CC :

Not hard, no cost.

Name of idea submitter and other team members who worked on this idea : Lisa Schoyer, President, RASopathies Network USA

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Goal 1: Promote Human Health

Interaction of blood cells with their environment

It is beginning to be known that malignant cells interact with neighboring cells and the course of their malignancy is directed by those cells. It is also known that transplanted stem cells interact with nearby cells and acquire direction of maturation and cell type from those cells. In my experience in unpublished work, the nature of the materials that leukocytes and monocytes have encountered during their apheresis ...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 :

Research project: To identify a sensitive method of determining functionality of lymphocytes or/and monocytes. And to use such a method to characterize cells reaction to exposure to foreign surfaces.

Name of idea submitter and other team members who worked on this idea : Herb Cullis

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Goal 2: Reduce Human Disease

Cardiovascular dysfunction in geriatric trauma patients

There is too little research funding addressing cardiovascular dysfunction in geriatric trauma patients. There have been little interest in funding this work. Yet, the geriatric population is growing. Geriatric trauma patients are predominantly women. Historically, the trauma societies provide guidance for diagnosis and treatment of severe trauma. However, "trauma guidance" historically was the same for children, ...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 :

Document and understand the role of cardiac dysfunction in contributing to morbidity and mortality of geriatric trauma patients.

 

Reduce mortality rates in geriatric trauma patients.

Feasibility and challenges of addressing this CQ or CC :

Little research has been conducted to understand the role of cardiac dysfunction in elderly trauma patients. These patients may be intubated and treated with pain meds, so the normal symptoms of cardiac ischemia are silenced. Because 12 lead ECGs or cardiac enzymes are not routinely collected in these patients after admission, the question is what types of cardiac dysfunction occur and can they be prevented?

 

While evidence is scant, we conducted a structured chart review of WMD Shock Trauma patients' medical records in fiscal year 1999 data. Mean age was 76 and mean ISS of 24. In reviewing charts we found 71% of patients had one or more risk factors for ischemic heart disease (beyond age) and 30% had a history of ischemic heart disease. On admission 29% had ECG changes consistent with acute cardiac ischemia, but ischemic changes were noted equally between patients with and without a history of IHD. Cardiac enzymes were ordered for 45% of patients and 19% were positive. We found that patients with acute cardiac ischemia on admission (ECG or enzymes) had more adverse in-hospital cardiac events than those without ischemia on admission. Patients experiencing adverse events were significantly more likely to die.

 

We believe these findings suggest a substantial role of cardiac dysfunction in this population, but we were unable to generate interest in the topic.

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

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Goal 3: Advance Translational Research

Facilitating the translation of discovery science into proof of concepts in preclinical models

What steps can the research community take to facilitate the translation of discovery science into proof of concepts in preclinical models and in humans for diagnosis, prevention, and treatment? • Current regulatory environment • Lack of communication between discovery and clinical research worlds • Lack of training • Getting industry, academia, and NHLBI to partner; and the business model to make it happen. • Limited ...more »

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 :

• Increased number of novel therapeutics, diagnostics and devices in early phase clinical trials

• Increased impact in rare diseases and unmet needs

• Increased number of licensed IPs from academic centers

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

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8 down votes
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