Goal 4: Develop Workforce and Resources

Training the new generation: not all about “big data” & "omics"

How do we attract more students/trainees into fields that are not popularized by “catchy” names?

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 :

Training the next generation of scientists

Feasibility and challenges of addressing this CQ or CC :

While the need to train the next generation of scientists in emerging fields (e.g. “omics” and “big data”), we should not overlook the need for nurturing “old fashioned” scientists (e.g. physiologists, integrative biologists) which are on the decline.

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

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23 net votes
35 up votes
12 down votes
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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

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-7 net votes
9 up votes
16 down votes
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Goal 3: Advance Translational Research

Improving Drug Safety through Precompetitive Research

The lack of transparency in Pharma clinical studies and the incomplete knowledge of the effect of genetic profiles and pharmacological factors on drug toxicities are challenges in decreasing drug development costs and increasing drug safety.

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 :

Precompetitive research and collaborations directed at improving our understanding of the factors underlying adverse patient responses to investigational heart, lung, blood, sleep drugs will help to expedite the drug development process, increase probabilities of success and reduce product development costs.

Feasibility and challenges of addressing this CQ or CC :

Several public-private initiatives such as The Predictive Safety Testing Consortium and the Cardiac Safety Research Consortium are underway that address components of this problem. NHLBI can join existing initiatives or formulate its own. In either case, NHLBI’s participation as either an honest broker or a funding source will enable substantive progress on several fronts over a 5-10 year period.

Clinical safety complications and chronic exposure toxicities are a major cause of drug trial failures and recalls and thereby contribute to the high cost of pharmaceutical product development and the rising prices of commercial medicines. Safety problems can usually be attributed to the off-target biological effects of drug compounds or their metabolites. Reducing the safety risks associated with drug development will therefore require us to expand our knowledge around the pharmacological and pharmacogenomic factors underlying adverse safety events. Furthermore, adverse events that occur during clinical studies that are conducted by pharmaceutical companies are not usually shared publicly. This lack of transparency contributes to unnecessary inefficiencies and costs in the drug development process.

Mechanisms for minimizing safety hurdles in drug development include funding precompetitive applied research and promoting collaborations among companies to encourage sharing of clinical failure data.

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
17 down votes
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Goal 2: Reduce Human Disease

A Program of Research in the Prevention of Chronic Heart Failure

There is a need to improve identification and surveillance of persons at risk for heart failure and pathological ventricular remodeling prior to development of clinically overt heart failure.

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 :

Substantially reduce the age-adjusted incidence and population burden of chronic heart failure.

Feasibility and challenges of addressing this CQ or CC :

The big data and omics revolutions have made it feasible to collect and analyze a variety of data in large numbers of persons within a relatively short time. A very large sample size provides excellent statistical power. Also, the public health and economic magnitude of the problem create the urgency needed to address the critical challenge expeditiously.

Chronic heart failure (HF) is easily the most common and growing cardiovascular cause of hospitalization and impaired functional status and quality of life in the U.S. and much of the world. This is the case despite improved pharmacologic and lifestyle treatment of HF, as well as improved control of blood pressure in the general population. While some HF in the very elderly may reflect the aging process, the epidemiology suggests that most incident cases could be prevented or postponed for years. Also, there are major ethnic and socioeconomic disparities in the incidence of HF.

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

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14 net votes
28 up votes
14 down votes
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Goal 3: Advance Translational Research

Research Opportunities in HLB to Facilitate Aging in Place

There is a need for greater evidence-based research over the next 5-10 years to reduce healthcare costs, reduce hospitalizations, and support older persons with significant heart, lung, blood, sleep conditions to remain in their private homes if feasible, if technology is utilized that fosters clinical and epidemiologic research.

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 :

No other force will have as big of an impact on our health system as the unalterable rate of our aging population and subsequent increased rate of heart, lung and blood diseases. The impact of doing nothing is unforeseeable.

Feasibility and challenges of addressing this CQ or CC :

Evidence-based research over the next 5-10 years to reduce healthcare costs, reduce hospitalizations, and support older persons with significant heart, lung and blood conditions remain in their private homes is feasible if technology is utilized that fosters clinical and epidemiologic research.

Many cardiovascular risk factors increase as the population ages including uncontrolled systolic hypertension and atherosclerosis both contributing to the well-being of our society and increasingly high health care costs (Izzo, Levy, & Black, 2012). No other force will have as big of an impact on our health system as the unalterable rate of our aging population and subsequent increased rate of heart, lung and blood diseases. The impact of doing nothing is unforeseeable.

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

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17 net votes
35 up votes
18 down votes
Active

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 3: Advance Translational Research

Leveraging PEPFAR infrastructure for CVDs

How do we go about leveraging existing infrastructure, such as PEPFAR, to reduce the risk of HLBS diseases among HIV patients and other vulnerable populations? • Common goals and deliverables between NHLBI and partners will need to be identified • The best return on investment of NHLBI funds will need to be determined • Feasible T4 translation interventions in PEPFAR funded studies utilizing HIV populations with HLBS ...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 :

• Decrease the burden of heart, lung, blood, and sleep diseases in studies funded by PEPFAR in HIV populations

• Lessons learned could be expanded to HIV populations outside of Africa

• T4 translation interventions in these populations could help reduce risk factors for heart, lung, blood, and sleep diseases leading to better health outcomes

Feasibility and challenges of addressing this CQ or CC :

• PEPFAR has identified and recruited existing HIV populations in Africa which can be leveraged by NHLBI for heart, lung, blood, and sleep chronic disease research

• Infrastructure that has received PEPFAR investments can also be leveraged to undertake T4 translation interventions

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

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-1 net votes
7 up votes
8 down votes
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Goal 3: Advance Translational Research

Culturally Specific Preventative research

There are ample research evidence related factors contributing to obesity,type 2 diabetes, cardiovascular disease.The research grant money is diverted heavily on "novel" topic such as genes.The preventative efforts are the key to tackle the issues.Often times,researchers on cardiovascular prevention find it difficult to add novel ideas to convince the grant reviewers in their application.There are many communities here ...more »

Submitted by (@athomas4)

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

Voting

-5 net votes
7 up votes
12 down votes
Active

Goal 1: Promote Human Health

Functional and high throughput screening assays

There is a need to develop functional assays and high throughput screening to develop probes and potential drug therapies. A. Functional Assays. Researchers face a challenging gap between identifying many sequence variations of potential interest and recognizing which of these variations have a direct functional effect on the physiological system of interest, as opposed to merely being associated with the actual causal ...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 :

Better tools and assays will help develop therapeutics faster and understand basic mechanisms. Improved genes-to-function screens are critical to accelerating the translation of genomic findings, by making screens of genes and variants for altered physiological function faster, cheaper, and more accurate.

Feasibility and challenges of addressing this CQ or CC :

Current technologies and recent NIH pushes for this type of research has investigators and technological advances primed to influence NHLBI disease areas.

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

Leveraging big data for T1 translational research

How best to train T1 investigators in using big health care data to test their basic science hypotheses related to heart, lung, blood, and sleep disorders and thus generate sufficient confirmation to justify clinical interventions.

Submitted by (@collerb)

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

Details on the impact of addressing this CQ or CC :

• Hypotheses that emerge from small studies of patients focused on mechanistic questions often are not able to be tested at the population level and thus remain unconfirmed. The increasing availability of big data from EHRs permits corroboration at the population level, but requires skills in framing queries and minimizing bias and confounders.

• The emergence of large clinical data sets such as PCORNet and the NIH Collaboratory make this particularly timely.

• By sampling existing data sets rather than having to conduct new randomized studies, this type of research can be performed at relatively low cost and in a much more timely way.

 

T1 investigators are not usually trained in the techniques of using large clinical data sets and so require targeted training.

Feasibility and challenges of addressing this CQ or CC :

Developing educational programs for T1 investigators should be straightforward. Resources will be required to support the queries by T1 investigators required as part of the training, but this should be modest compared to other forms of research.

Name of idea submitter and other team members who worked on this idea : Barry Coller

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2 net votes
3 up votes
1 down votes
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Goal 3: Advance Translational Research

Translation of an intervention to reduce sudden cardiac death

There is a need to identify and to develop pharmaceutical interventions for patients at risk for sudden cardiac death (SCD).

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 :

Markedly reduce sudden cardiac death in high populations. Lead to a new pharmacologic paradigm for preventing lethal cardiac arrhythmias.

Feasibility and challenges of addressing this CQ or CC :

Investigators have already demonstrated in animal models of SCD that inhibition of mitochondrial Na/Ca-exchange is associated with a reduction in ventricular arrhythmias and SCD without a change in corrected-QTC.

Using a novel guinea pig model of heart failure and sudden cardiac death (SCD), researchers (Circ Res. 2014 Jun 20;115(1):44-54) have demonstrated that inhibition of the mitochondrial sodium-calcium exchanger prevents SCD. In people, SCD accounts for 170,000 to 450,000 deaths per year in the US. Basic research focused on identifying cardiac ion channel inhibitors have failed to results in antiarrhythmic drugs that prevent SCD. And although clinical research has thus far failed to identify individuals at risk of suffering a SCD in the general population, subpopulations (for example, those with a low ejection fraction months after suffering a myocardial infarction) have been identified that are at high risk. If an effective pharmaceutical intervention was developed that reduces SCD, deaths in these populations would be markedly reduced. Strategies need to be developed to translate this promising basic science finding into saving lives.

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

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5 net votes
19 up votes
14 down votes
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Goal 4: Develop Workforce and Resources

Implementation Research Workforce Addressing Health Inequities

What are the best strategies to develop a highly competent diverse Implementation Science research workforce 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 :

• Enhance fundamental knowledge about new and trans-disciplinary D&I field.

• Improve understanding on ways to scale-up and deliver proven interventions to address health inequities.

• New knowledge generation regarding important adaptations of interventions implemented in the local context.

• Improve health outcomes, particularly in underserved populations in both the U.S. and abroad.

• Successful D&I research training programs will help ensure a competent diverse D&I research workforce.

• Identification of the most effective career timing and combination (balance) of discipline-specific and trans-disciplinary courses essential to develop a cadre of trans-disciplinary implementation science researchers.

Feasibility and challenges of addressing this CQ or CC :

Feasibility:

• Dedicated NHLBI Center to promote, develop, implement, and disseminate research findings to address heart, lung, blood, sleep-related conditions and diseases.

• Identified new approaches to creating partnerships with trans-disciplinary research teams that expand beyond academia and increased understanding of the unique nature of mentorship needed for this discipline.

• Experience from several other ICs can be leveraged to improve or ability to be successful and decrease our launch time.

• Field is gaining momentum because of the realization of the unsustainable economic burden of health inequities (expected to increase in the future) in the U.S.

 

Challenges:

 

 

• Dedicated training mechanisms are needed to develop and meet our current/future T4 research workforce needs to address health inequities.

 

• Resources needed that provide unique training approaches (e.g., a trans-disciplinary scientific training environment, knowledge and experience with health disparity populations, unique training faculty (mentor) composition and opportunities to train mentees as future D&I mentors, innovative research tools and research experiences, and broad and diverse partnerships.

 

• Unique linkages with practice settings across disciplines needed.

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

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11 net votes
20 up votes
9 down votes
Active