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

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Goal 2: Reduce Human Disease

Heart Failure Therapies

We need much more support for critical basic research to understand and develop transformative therapies for this enormous health care burden. This is not simply a question of epidemiology and large multicenter population data bases. We really need hard core science. It is impossible to know where the next breakthrough will come, and setting aside funds for hot button things - stem cells, or iPS, or gene editing per ...more »

Submitted by (@dkass0)

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

Feasibility and challenges of addressing this CQ or CC :

NIH needs to stop trying to guess what the next big thing is and putting funds aside to support something that is popular at the moment. This has been done frankly with GWAS, with Stem cells, and perhaps ongoing now with "personalized medicine". All hot areas, but so are a ton of other things. IN my 30 years as a physician scientist, I cannot count on one hand the number of discoveries that were really transformative that came out of this type of ear-marked planning. Need more resources to support innovative individual scientists, particularly those with a track record of discovery, translation, and iinnovation We do not do that well enough at all.

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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

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Goal 4: Develop Workforce and Resources

Basic and Clinical Multi-disciplinary Partnerships to Understand Lung Disease

Basic scientists and clinicians have different training and bring different perspectives to lung disease research. Additionally, mechanisms that facilitate interactions of scientists from different fields may improve communication and facilitate novel ideas for lung disease research. I would like to see a funding mechanism that encouraged such partnerships in addressing fundamental disease questions and/or treatments. ...more »

Submitted by (@bmoore)

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 mechanisms could bring more perspectives to bear on questions in lung disease and would facilitate multi-disciplinary interactions and ideas.

Feasibility and challenges of addressing this CQ or CC :

If single awards, budgets would need to be large enough to allow for funding basic science as well as providing dollars to collect clinical samples. It should be possible to support some core facility infrastructure if needed and allow a budget that could account for basic scientists, animal work, study coordinators, clinicians, etc. Perhaps the RFA could require at least 3 different fields to be represented to try to facilitate multi-disciplinary approaches. Such a mechanism could help replace the loss of grants like SCOR grants and PPGs.

Name of idea submitter and other team members who worked on this idea : Beth Moore

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Goal 3: Advance Translational Research

Increasing the adoption of low tidal volume ventilation in ARDS patients

How can we use implementation science to increase the adoption of low-tidal volume ventilation in patients with acute respiratory distress syndrome (ARDS)?

Submitted by (@lar000)

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

Details on the impact of addressing this CQ or CC :

Low tidal volume ventilation has been shown to significantly reduce mortality in ARDS patients (from 40% to 31% in the ARMA trial published in NEJM in 2000), but it is inconsistently adopted (frequently with rates <50% in both community and academic settings). Improving adherence has the potential to significantly improve mortality in patients with ARDS.

Feasibility and challenges of addressing this CQ or CC :

Given the rapid growth and interest in the field of implementation science over the past several years, addressing this question is now feasible.

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Goal 4: Develop Workforce and Resources

Making R01 funding work for the Medical Sciences

We need to spread R01 funding around more to ensure that the best science has funding adequate to move forward. To do this I believe changing how we think about R01 funding and expenditures can be used to put the NIH funds to better use. Too often successful researchers have the majority of their salaries on R01s and the institutions have little skin in the game. PI salaries can be a large part of the escalating budget ...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 :

The impact of spreading the funding would be to improve funding rates, improve funding of new investigators, and supporting more diverse science. Negative impacts would include reduced funding some large labs. In my experience, in some cases, this would be a good thing. There could be special programs and exceptions for large labs that make significant important contributions and serve as resources to reduce negative impact. Review of grants should include information on manuscript retractions and large labs with many retractions should be carefully scrutinized for defunding.

Feasibility and challenges of addressing this CQ or CC :

Such changes would have to be made incrementally over time since this will require states and institutions to pick up some of the cost of science and therefore must be phased in to allow for time to adjust the workforce in specific places to align with budgetary constraints. Institutions might be encouraged to do more fundraising to actually support science to fill gaps.

Name of idea submitter and other team members who worked on this idea : Keith Jones with major input from Pieter de Tombe

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44 up votes
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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

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37 up votes
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Goal 4: Develop Workforce and Resources

Career Development in "Group Based" Science

As the current chair of the Research and Training Division, I would like to convey that the AAAAI membership would like the NHLBI to consider the following in the development of its strategic plan:

 

NHLBI should be challenged on how best to provide career development grants to junior faculty involved in “group based” clinical and bench science.

Submitted by (@wheeze)

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 : Mitchell Grayson on behalf of the American Academy of Allergy, Asthma, and Immunology

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Goal 2: Reduce Human Disease

What types of questions are most likely to improve the health of the public? The importance of discovery science.

Congressional eagerness to see research funding translate into improvements in health care may make studies that address “how-to-deliver-care-questions” seem attractive. But the answers to “how–questions” are often so context dependent that the findings are neither generalizable nor durable. The answers to “how–questions” too often become obsolete when the health-care system, the electronic medical record, or the insurance ...more »

Submitted by (@psaty0)

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

Details on the impact of addressing this CQ or CC :

Improvement in the health of the public.

Feasibility and challenges of addressing this CQ or CC :

It is easily a matter of focus.

Name of idea submitter and other team members who worked on this idea : Psaty & Tracy

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29 up votes
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Goal 3: Advance Translational Research

T4 Implementation Research Platform in Low Income Countries

What are the best strategies to stimulate development of a T4 Implementation Research network within low income countries (LICs)?

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 :

• Currently there are huge implementation challenges within LIC contexts and only limited progress is being made to address the gaps

• Conducting research in the context where its finding will be scaled up will vastly increase its appropriateness, adoption and uptake, fidelity, and sustainability

• Small improvements in the challenging context of LICs should provide opportunities to make a large burden reduction

Feasibility and challenges of addressing this CQ or CC :

• Currently there are formative efforts to engage biomedical research in LICs with H3Africa, Global Alliance for Chronic Diseases, and others

• NHLBI Think Tanks and Workshops have found much interest and demand to T4 Implementation research engagement

• Key non-traditional partners (World Bank, USAID) are working on implementation strategies in LICs currently and will be strong partners

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

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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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19 up votes
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Goal 3: Advance Translational Research

NHLBI Cohort Populations for T4 Implementation Research

How best can NHLBI observational cohorts be utilized to study observational T4 Implementation Research among both general and vulnerable US 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 :

• Would help identify key factor associated with successful implementation that could be studied in interventional T4 implementation research

• Result would refine implementation strategies and health and social policy aimed to reduce heart, lung, blood, sleep diseases and conditions

• Builds on excellent established platform of research with high quality outcomes in well characterized study populations over long term follow-up.

Feasibility and challenges of addressing this CQ or CC :

• Big data is developing methods to link large data sets from national, state, and community level surveys – surveys that can define exposures to various policies and interventions in place, time, and population.

• A family of high quality cohorts are available for ancillary observation studies

• Collection of community level and more broad policy level exposures is feasible through data already collected and through potentially new data collection.

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

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11 up votes
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