Department of Epidemiology and Biostatistics – One Big Idea

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A Little Big Idea: Intensive Scientific Retreats

Submitted by Steven Cummings on April 25, 2019 - 8:06pm Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Awarded

 Phase 2 Proposal

 Co-sponsors:  Steve Cummings and Mark Pletcher

Other sponsors and supporters:  Maria Glymour, Jacquelyn Torres, Tom Newman, Lydia Zablotska, Mike Nevitt, June Chan, and Isabel Allen

Background

Our academic time is fragmented, interrupted and often conducted in silos.  We make more progress, and generate good ideas, when we have long blocks of protected time to focus on a shared project, or a new area of collaborative research with other faculty.  Many organizations successfully use targeted retreats to create collaborative new directions.  Epi and Biostat should, too.

Proposal

Establish a fund for Intensive Scientific Retreats. Retreats would be proposed and conducted by groups of Epi and Biostat faculty. They would submit a proposal for support of a retreat that would be evaluated by the Chair and a small faculty committee.

The team proposing the retreat would submit a 1 or 2-page proposal describing 1) background and areas of focus, 2) goals and products (e.g. a strategic plan for a new research direction, new projects leading to grant proposals, detailed plans for a new Division, or learning a new area or skill, such as machine learning, that may be valuable to creating new research proposals), 3) description of the participants, involving at least 4 Epi and Biostat faculty, and potentially including others and UCSF and expert(s) / scientist(s) outside of UCSF, 4) duration (1/2 to 2 days), location, and plans for protecting the time and attention of attendees (e.g. no mobile devices), and 5) requested support for space rental (if needed), food during the retreat, reimbursement of external scientist/expert(s), materials or other anticipated expenses.

Examples (provided by co-sponsors and supporters of the Idea)

These retreats could be integrated into other Big Ideas, such as Diabetes, as a way to start or accelerate development of those projects.

Here are examples from faculty who support and co-sponsor this Big Idea:

  • Planning a Center for Public Health (Kirsten's idea) that would work with local communities to provide accurate information on effects of environmental exposures and, potentially, initiate new studies.  The retreat would develop a comprehensive plan, resources needed, team, and timeline.  A goal would be to strengthen Environmental and Occupational Epidemiology in the Department.
  • Introduce Epi Biostat faculty to “How to Use Actual UC-wide EHR data.”  Participants would bring or develop a project, and execute the beginning of that project - with code, table shells, and manuscript outlines done by the end of the retreat.  They would also establish a timeline for completion of the project.
  • Plan the new Life-course Division, with its faculty mapping out the conditions, methodologies, collaborations and organization. Within this area, there are several potential topics that might benefit from retreats to map out research, teams, and proposals on social determinants of healthy aging; biological mechanisms of social inequalities in aging; life-course epidemiologic methods, and aging; social policies to reduce the population burden of Alzheimer's disease.
  • A disease-oriented project on shortness of breath could start with a retreat to map out several causes -  age-related, environment-related, disease-related, economically-related.  Then develop a plan of research for each potential cause and methodologies to address it.
  • A retreat could address a broad topic that would lead to more specific proposals for research and funding, for example (from Tom Newman): How to use epidemiologic methods to improve healthcare value or (from June Chan): novel uses of mobile technologies for epidemiologic and health research.

Costs

We propose that $20,000 be set aside for initially funding 3 retreats. Potential budgets would be included in proposals for Retreats.

Evaluation

A “Retreats Committee” (or Epi-Biostat leadership) would review the reports of the results of the retreat and subsequent accomplishment and products from the 1st 3 retreats. and make recommendations about whether to continue and how to improve the Scientific Retreats program.  

This Big Idea meets the review criteria

1) It would engage a very broad and diverse group of Epi and Biostat faculty; essentially, any individual could propose or may participate in a retreat pertinent to their area of interest. 2) An essential goal of a retreat would be to plan future grant proposals and/or outreach to potential donors. 3) Successful retreats would lead to new projects and new collaborations that would, by nature, increase the visibility of the Department within UCSF and/or external communities. 4) This is essentially a pilot program of 3 retreats that would be evaluated based on their products.

 

Commenting is closed.

Funding the future

Submitted by Nadia Diamond-Smith on May 1, 2019 - 4:30pm Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

Submitted by: Nadia Diamond-Smith, Jackie Torres, Patience Afulani

 Many faculty in our department, especially junior faculty, have differing streams of research but overlapping interests or complimentary skill sets and areas of expertise and would like to start working on projects together. However, setting time aside to write a new proposal or do a preliminary analysis on a topic not directly stemming from a current project can be impossible, since we are all funded on specific other grants. Supporting new proposals or projects that bring together faculty who have not previously received funding to work together will not only expand the innovation and breadth of topics that our department is contributing to scientifically and known for, but it will help bring in more funding, which has long lasting impacts on the careers of faculty, staff and students in the department, the latter of which would be involved in the resulting projects in various roles. These types of collaborations will also build community among members of the department, helping to ensure that the department can retain its faculty, especially junior faculty laying the foundation of a career in the department.

 We propose a fund that groups of faculty (at least 2) who have not previously been funded to work together can apply to. Groups can include non-faculty members, such as post-docs, students, and research assistants at various levels, however, some of the funds must be used to cover faculty time (in other words, trainees cannot do all the work). Funds will be prioritized for groups that have at least 1 junior faculty member (assistant level) participant. Funds will also be prioritized for proposals that involve members from other departments in order to create more collaboration between UCSF departments. Funds can be used to support a small portion of faculty salary for a limited time to write grant proposals for funding research projects they are interested in pursuing together. The funds can also be used for such groups to do a secondary data analysis project together that is envisioned to directly lay the foundation for a grant proposal (and ideally publications as well).

 

Proposals to the fund would be short (1-2 pages) and describe the research idea that the faculty would like to write a grant/do the analysis for, the innovation of the partnership, and why the request salary time and amount are necessary. This would include how their funds would be distributed and among whom. For grants, the funding mechanism to be pursued should be stated clearly, as well as a timeline towards reaching that goal. For data analysis projects, the longer-term vision (eventual funding or publication) and target funding source or journal should be stated, as well as timeline. Proposals would also discuss why this groups cannot do this without the support of this extra salary coverage and how this will expand their current work, build collaborations, and develop new areas of focus for the department as a whole.  

 Total budget requested: $100,000

 Structure: Groups can apply for support of up to $20,000 (total) to support their time/effort to write proposals/do analysis together. We anticipate that this will fund at least 5 groups (or more if some groups request smaller amounts). Groups can be of any size and money/time can be allocated in the way that the group see fit, and within any time frame the group sees fit. For example, the funds could be spread evenly (or not) among at least 2, but up to a larger group, of members, and it could be used within 1 month or spread over the course of a few months.

 We envision that there could be 2 funding cycles. Cycle dates are proposed to align roughly with NIH cycles (although not all proposals need to be grant proposals), so funding would be available about 4 months before the next submission cycle. Proposals will be reviewed by a committee of department members and 2-3 groups will be selected at each cycle. Midway through the process, the selection committee will review the success of the proposal submissions. Success would be measured by 1) submission of grants, 2) time to grant submission, 3) completion and dissemination of any secondary analyses that served as preliminary data for grant proposals. This will help us quantify the amount of new interactions that the funded faculty members had that they would not have had otherwise AND/OR any interactions beyond the DEB that were generated from the funds.  If modifications to the process are needed, it will be adjusted before Round 2.

 Milestones:

 Round 1: Call for proposals (August 15), proposals submissions (Sept 15), selections announced (Oct 1)

 Review Round 1: March 2020: review progress of Round 1 grants

 Round 2: Call for proposals (April 15), proposals submissions (May 15), selections announced (June 1)

Commenting is closed.

The UCSF Epi/Center Lectureship

Submitted by Robert A. Hiatt on May 3, 2019 - 9:42am Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

 

Submitted by Bob Hiatt, John Witte, and Maria Glymour

Background

The Department of Epidemiology and Biostatistics is virtually unique on campus in not being well defined as either a basic science or a clinical department, but rather in the center of campus academic research and teaching. In many ways are (and could be more) supportive of progress across all UCSF departments and centers. Being the EpiCenter is a way of expressing our mission in research and training that is at the center of biomedical research because the disciplines of epidemiology and biostatistics are key to understanding and solving challenges in health and disease at all levels of biologic organization from “cells to society”.

Proposal

This proposal (Big Idea) is to sponsor an annual named lecture (The EpiCenter Lectureship) on topics that illustrate how epidemiologic and biostatistical methods and perspectives are central in solving important problems (e.g., dementia and cognitive decline, the control of HIV/AIDs and emerging infections, health inequities, climate change and health). This would draw attention to the department in a really intellectually stimulated way. The proposal is ‘outward facing’ and intended to educate and inform a broad audience across UCSF and related stakeholders. Other noteworthy Big Ideas are ‘inward facing’ and designed to strengthen the work we do in the department. These approaches might be considered together as complementary in advancing the interests of the DEB.

The idea of establishing a formally named EpiCenter Lectureship within the DEB is that it would specifically call out the disciplines of epidemiology & biostatistics as the core to successfully addressing complex contemporary problems that would benefit patients and populations. It does not duplicate the annual Population Health Colloquium because it will be focused on epidemiologic methods and solutions.

Examples of high-profile outside speaker who would meet this challenge might be:

            Miguel Hernan – Causal Inference and Population Health Problem Solving

            Michael Marmot - Social Justice and the Determinants of Health

            Sherman James – John Henryism, stress and illness

            David Hunter – Genomics and the Future of Epidemiology

            Lisa Berkman or Ichiro Kawachi – Social support, social capital

            John Ioannidis – “Evidence”-based medicine and Epidemiology

            Valarie Beral – Largescale meta-analyses and women’s cancers.

            Muin Khoury – Precision population health and population genomics

Approach

A small committee would be formed to nominate and select speakers to invite based on the criteria that they represent forward thinking in the field and applications to the improvement of the health of populations and communities. We would also want them to be engaging speakers and to represent the gender and race/ethnic diversity of our discipline. The committee could distribute suggestions for nominees to the whole department to build broad support and involvement.

In coordinating with  speaker confirmation, full-scale planning for the event of the EpiCenter Lectureship would be operationalized. Anticipated attendance might be 150-250 people. It could be open to the broader academic community in the Bay Area and the public with proper planning.

The visit of the named Lecturer would be planned for at least two days and include smaller seminars open to all faculty and students as well as one-on-one meetings to pursue ideas and projects of joint interest.

We would heavily advertise the event through departmental means and School of Medicine and Campus public relation offices.

Financial Support

On an annual basis $20,000 would go towards the support of the annual lecture from and an outside institution and associated activities. This would cover airfare, hotel (2 nights), ground transportation,  and honorarium (~$1500-2000) and incidentals. Sustained support for such an undertaking could be a naming opportunity for a donor that could endow the EpiCenter Lectureship.

Evaluation

Success of the EpiCenter Lectureship would be based on attendance and feedback solicited at the time from attendees. Other means of evaluation could include social media recognition (e.g. Tweets) and recognition by campus leaders outside the DEB. The EpiCenter Lectureship should be considered a pilot to be assessed after one and two years to determine whether they should be continued.

Commenting is closed.

Hunters Point Shipyard epidemiological study

Submitted by Lydia Zablotska on May 7, 2019 - 1:56pm Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Hunters Point Shipyard has a legacy of ground contamination by particulate radiation. While the politicians are arguing who is responsible for the cleanup, wether the previous cleanup was done correctly or not, and what should be done about it, epidemiologists have a role to play to provide the local community and the larger Bay Area community with solid data to develop evidence-based solutions. UCSF and UC Berkeley are already working together to analyze the quality of procedures which were used to test for radiation contamination. The next step would be for epidemiologists and biostatisticisns to put their heads together to quickly analyze the data on population health in Hunters Point which coul be easily accessed. For example, among those who have lived at Hunters Point for at least five years, is there any evidence of increased risks of lung cancer or bone cancer (cancers we would expect to increase with this particular type of radiation)? Or, has there been any increase in respiratory problems in children?

The 1990 NCI report of populations living near nuclear facilities concluded that cancer mortality rates were the same whether a reactor was nearby or not. While this was a negative finding, it proved to be extremely effective in discussions with local communities. As the institution literally next-door to this community, we should provide residents of Hunters Point with the evidence on potential risks to their health.

Commenting is closed.

Establish a Population and Maternal-Child Health Accelerator (PUMA) program

Submitted by Laura Jelliffe on May 8, 2019 - 6:39am Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

Advisors/ Partners: Jacquelyn Torres, Patience Afulani, Brittany Chambers, Nadia Diamond-Smith, Deb Karasek, Dilys Walker, Maria Glymour   

While a great deal of research related to maternal and child health is being conducted within the Department of Epidemiology & Biostatistics (DEB), no DEB mechanism exists for connecting the work of these groups. In addition, while many of these groups work closely with clinical and other UCSF programs to leverage data related to maternal and child health currently held by DEB faculty for subanalyses and targeted products (manuscripts, grants), no formal mechanism exists for connecting clinical researchers and trainees with DEB faculty and data or for supporting associated analytic and investigative efforts. If such a program existed it would serve not only to connect faculty, staff and trainees within and outside of the department but it would also aid in accelerating discovery and translation focused on maternal and child health.

We propose to establish a PopUlation and Maternal-Child Health Accelerator program within the department that would work in concert with other clinical and academic programs to investigate critical maternal and child health problems with translation of innovative findings into clinical and public health settings. Our hope is that eventually, PUMA will become a nested center within DEB that serves as a hub for interdisciplinary maternal and child-health focused research wherein intense intellectual engagement, debate and progress is fostered.

PUMA would serve a critical need within the department in that it would link the multiple teams currently doing research in maternal and child health and it would allow for the creation of a virtual core of experts and data sources that could be applied to a broader scope of outcomes and health inequities than are currently being addressed by individual projects. PUMA would also provide a critical bridge to other clinical and academic programs, faculty, and trainees who often want to gain access to data but have neither the time, resources, or expertise to secure and utilize them. Examples of data that could be leveraged for this effort includes State and National birth certificate, environmental and census data, state hospital discharge data, and data related to health care, pregnancy, birth and other outcomes collected in Africa, India and in other developing settings. Through PUMA, programs and trainees could gain access to data and to department experts. As such, we believe that PUMA would lead to new and productive partnerships and ultimately to accelerated translation from data and discovery to clinical and public health interventions.

PUMA would be a multi-year effort. The first year of the program would focus on establishing the program and on creating a resource and sustainability plan. Specifically, in year one we would: 1) Convene a cross-department summit to a) learn about data that is currently in use across the department that could be leveraged towards this focus; And, b) learn about within department programs and project teams working in maternal and child health; 2) Meet with chairs and faculty from other departments to assess their data and collaboration needs for faculty and trainees and to explore co-funding opportunities (starting with Obstetrics, Gynecology and Reproductive Sciences, Pediatrics, and Psychiatry); 3) Develop a department page for PUMA that provides information on department resources and projects and personnel doing work in maternal and child health that includes an engagement tool for facilitating connections between our department and other clinical and academic programs; 4) Create a sustainability plan for funding in year two and beyond that includes outreach and potential trainings across the university depending on other clinical and academic program needs; 5) Initiate at least three demonstration projects (at least one of which will be focused on data from a developing setting; And, 6) Draft an NICHD R21/R33 phased infrastructure development grant (submission Fall 2020) to support PUMA (with an eventual eye on an R24 for obtaining further support, a T32 training grant, and nested topic-specific R21, R01, and philanthropic grants). Evaluation of PUMA in FY1 will be focused specifically on completion of activities 1-6.

Total request for the first year of the program is $100,000 which includes: $15,000 for a Program Coordinator at 15% time; $40,000 for faculty support at 5% maximum time for demonstration project leads (with a focus on junior faculty); $7,000 for a faculty retreat; $8,000 for website development and launch and for nested RedCap/ Qualtrics survey; $30,000 for analytic support for demonstration projects.

Of note is the strength of this project with respect to the DEB BIG IDEA review criteria. The proposed project meets and excels with respect to all criteria in that it: 1) Engages a broad group of faculty within the department (via outreach to individuals and via the proposed retreat); 2) It has the potential to attract future funding through university and clinical funding and through grants, contracts and philanthropy that would support specific nested projects and PUMA infrastructure; 3) It has the potential to dramatically increase the visibility of DEB within UCSF and elsewhere in that it will increase awareness around existing resources, will provide access to data and experts, and will lead to the acceleration of research on maternal and child health; 4) It will be able to show significant project within one year across multiple fronts based on targeted and time-specific deliverables; 5) It includes a focused sustainability plan that will require no or minimal departmental funds after the first year.

 

Commenting is closed.

Investing in human capital to enhance collaboration, expertise and establish DEB as knowledge hub for modern sampling methods for health disparities research.

Submitted by Meghan Morris on May 10, 2019 - 10:27am Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Awarded

 

Phase 2 Propsal

 Leadership: Paul Wesson, Meghan Morris, Thomas Hoffmann, Maria Glymour and YOU!

 1. Rationale. Sampling is a cross-cutting challenge in multiple research domains (including health disparities, genomics, disease-specific research, health care, and precision medicine), and a foundational epidemiologic topic. This initiative will have a broad appeal to departmental and university research and training efforts.

 2. The Idea. This year-long - four-quarter block - initiative will establish DEB as a knowledge hub for sampling methods to improve population science and health disparities research. Each block will cover a pressing challenge as it relates to sampling and population science, and methodological approaches to address those challenges. Month 1 of each block will include a 2-4 hour themed workshop led by a topic expert (e.g., external academic or industry, DEB member) paired with a DEB faculty expert; with the goal of establishing foundational knowledge and encourage intra/extra-departmental collaboration. Two ninety-minute monthly sessions complete the block; held in a journal club format with a DEB facilitator (paid) with the goal of applied methods/theory connecting public health implications of the topic introduced during the workshop. We envision this culminating in a workgroup forming with a core group of DEB members engaged in collaborative implication (e.g., theoretical papers, applied research projects, commentary/op-ed articles, department courses, grants). The year-long series will increase all attendee’s overall knowledge of sampling methods and strengthen expertise necessary to establish our department as a hub for modern sampling methods for population research. The tentative curriculum is as follows: (Block 1) complex sampling designs for representative samples, (Block 2) sampling for hard-to-reach populations, (Block 3) techniques to estimate the “dark figure”, i.e., assessing the magnitude of unreported data points (selection bias) for hard to reach populations, including estimating population size, and (Block 4) internal and external validity concerns as they relate to pooled data sources, including tools to address inconsistent sampling strategies fielded for different population subgroups such as racial/ethnic minorities.

 3. Importance. Sampling is a core study design component and the origins of the analytic sample shape analytic decisions, interpretation, and public health relevance of our research. Many of the technical concepts that arise in sampling relate directly to broader analytic ideas (e.g., the Horvitz Thompson estimator as the basis for inverse probability weighting and marginal structural models). Notwithstanding debates about the importance of representative sampling1, substantial evidence documents the difference between individuals who participate in health studies and the general population about whom we often hope to draw inferences.2,4,5,6,7  At the same time, systematic approaches to transporting effect estimates from one sample to another are being popularized8,9. Many of the statistical tools we use are built from the foundational assumption that our data set comes from a simple random sample. An important contribution from this series will be to highlight and explore this foundational assumption so that we are all better informed on when it is appropriate (and inappropriate) to use certain statistical tools. As far as we know there is not another “hub” focused on sampling let alone cutting edge sampling methods with a methodological and conceptual focus.

 4. General Approach. 4 domains/blocks, each 3-months, will include multiple activities allowing for varying participation levels/types, to enhance the value of the initiative for people across DEB. Proposed activities include journal clubs, case studies from diverse areas of research, workgroup participation for new methods/conceptual application, and workshop attendance and problem sets.

   Each block will launch with a kickoff in-depth training led by a visiting speaker (either academic or non-academic), paired with a DEB faculty member (if desired) with expertise in that domain. These kickoff workshops will be accessible to DEB trainees, faculty, and staff, and the greater UCSF community, regardless of population research area. The next two months will be 90-min journal-club sessions led by a DEB member. Sessions will have food and the session leader will be paid for facilitating. The journal club sessions will focus on applying the sampling challenge (or workshop topic) for public health research and health disparities research, along with applications of the sampling methodology. In addition to a journal article, participants will be encouraged to submit an issue from their own research. The facilitator can group these issues to inform a set of discussion questions/prompts for the journal club session. We hope this will allow attendees to deepen content area knowledge and apply learnings quickly to their work. These journal club sessions can foster collaboration and provide a platform for members to form workgroups leading to subsequent projects (e.g., manuscripts, commentaries, grants, courses, seminars). Each block will conclude with a meeting to discuss potential spin-off ideas to pursue. The project RA will be charged with compiling the readings (the official journal articles and others raised during discussions), slides and presentations used in discussions, and summary of key ideas from each journal club to feed into the teaching modules (see section 3b). The four blocks are:

(1) Complex sampling designs for representative samples will address design and analysis considerations related to clustering and stratification. We begin with this because it is broadly relevant to nearly everyone in health research, as nearly all major surveillance data sets (e.g., NHANES) use a complex sample design and methods such as inverse probability weighting draw on the same ideas. These designs are especially relevant for disparities research since moving beyond simple random sampling is typically essential to support research on smaller population size groups. This block will address statistical issues when analyzing clustered data. 

(2) Sampling for hard-to-reach populations, such as Time-Location Sampling (TLS) and Respondent-Driven Sampling (RDS). Traditional sampling methods rely on an existing sampling frame to draw a representative sample of the target population to generate generalizable knowledge. Many populations of public health importance are socially marginalized (and criminalized) to the extent that an existing sampling frame is infeasible (if not also unethical), e.g., sexual and gender minorities, people who inject drugs, and (in some contexts) women seeking abortion services. This block will discuss recent developments in sampling approaches for hard-to-reach populations, debates concerning the representativeness of these samples, and statistical approaches to derive inference to the underlying target population. We will also discuss how applications of these modern sampling approaches have contributed to health disparities. 

(3) Techniques to estimate the dark figure, i.e. selection bias, refers to data points missing from our analyses that, when incorporated, could change our understanding of the situation. In this block, we will examine methods to quantify this figure, particularly in reference to the “denominator problem”, i.e., what is the size of the population at risk (an essential quantity in order to estimate the burden of disease in any population). We will discuss the strengths and limitations of these methods (e.g. capture-recapture/multiple systems estimation), common applications (e.g. addressing undercounts), and analytic options.

(4) Internal and external validity concerns as they relate to pooled data sources, including tools to address inconsistent sampling strategies fielded for different population subgroups such as racial/ethnic minorities. This will include statistical tools for transporting effect estimates to new populations.

 5. Anticipated Outcomes.

5.a. Participant Learning objectives include: (1) Understand the purpose of sampling tools (e.g., stratified/ clustered designs, capture/recapture methods, time-location sampling) in population health research. (2) Understand how sample designs affect data utility and generalizability for population research. (3) Evaluate the pros and cons of different types of sampling methods used in population research for various research topics. (4) Learn how sampling should guide analytic decisions and statistical analysis appropriate for responding to select sampling challenges (e.g., transporting effect estimates to new populations). (5) Gain insights about health disparities research and opportunities to overcome sampling challenges through collegial discussions

 Table 1. Short-term goals inform the structure, content, and operation of the initiative.

Short-Term Goal

Evaluation Metric(s)

1. Strengthen relationships with experts outside DEB; increase professional network

Number of outside department

speakers and attendees; Number of workgroups formed and number of members/workgroup

2. Provide resources to help DEB members address sampling challenges in scholarly activities (e.g. grants, manuscripts)

Create, circulate and post citable resources, by topic block

3. Strengthen the department’s expertise in modern sampling methods for population research

Number of attendees (by workshop, seminar, workgroup)

4. Increase research rigor

Number of scholarly products (e.g., papers, grants) that apply sampling methods resources

 

5.b. Anticipated subsequent outcomes include grants, education/training, core services.

By investing in this “One Big Idea” our department can enhance the quality of future external grants, develop new future training opportunities, and increase the visibility and marketability of our department.

   (1) Expertise in sampling methods and approaches to overcome sampling challenges can strengthen any grant application. Examples of funding domains include: (a) understanding disparities in Alzheimer’s disease and related disorders (ADRD) given these studies are often based on highly selected samples from clinical populations leading to a biased picture of the biological processes culminating in ADRD and the drivers of racial disparities in ADRD; (b) Scaling successful interventions to communities with high representation by URM. Methods of transportability are an area of active development and hold promise for solving the well documented problems with the gap between efficacy and effectiveness and non-replication of successful interventions. (c) Grants to increase recruitment/participation in clinical trials and cohort studies to improve the representation of communities traditionally under-sampled. (d) Precision medicine/precision public health initiatives would be strengthened by the incorporation of expertise in sampling methodology to address the premise that individuals have heterogeneous treatment responses.

   (2) Training in modern sampling methods is a current gap across UCSF’s educational curriculum. The expertise and content generated by this initiative could efficiently translate to a course, potentially offered online, to fill this gap. Our minimum training goals are to develop teaching modules corresponding with each of the four blocks, generate a list of readings, a recording of the workshop, and problem sets. These resources could be directly applicable to existing courses, e.g., Epi265 (epi methods 3 / chronic disease epi, where sampling is introduced), in the PhD seminar, Bio202 (Intro to Big Data, where public data sets with complex sample designs, such as NHANES, are commonly used), and in BIO215 (where concepts such as IPW, central to classical survey sampling, are used extensively). Other courses may also find these useful. If there is substantial demand, this could be developed into a stand-alone short course offered as part of core epi methods or the Data Science track.

   (3) The combination of increasing all member’s knowledge in modern sampling methods, investing existing expert faculty, and providing a set of free educational seminars to the UCSF community will increase the visibility of our department’s valuable skills. Doing so may allow: new consulting services, co-investigator roles on grants, and core services in sampling to complement existing services focused on recruitment.

   (4) Our proposal is strategically aligned with DEB’s educational mission. First, it will provide a series of lectures and workshops to further develop expertise in this research area. Second, it will support our goals to recruit excellent junior faculty by providing a resource and center of expertise for those who wish to take advantage of it, e.g., those writing independent grants.

 

6. Budget. Our $94,800 budget is detailed below. This increase from our initial submission includes additional support from a trainee, and compensation for meeting facilitation to ensure the project proceeds smoothly.

Budget item

Item Amount

Total

Faculty salary support for Morris, Wesson, and Hoffmann (Glymour in-kind)

$5,000x3

$15,000

Faculty compensation for leading each content block

$10,000x4 blocks

$40,000

Journal club facilitation

$500x10

$5,000

External workshop speakers for workshop honorarium

$1,000x4

$4,000

Workshop leaders travel/hotel (assuming one is local)

$2,000x3

$6,000

Food for workshops and journal clubs

$400x12

$4,800

PhD or Postdoc to direct to support content development and organization

Half stipend

$20,000

Total

 

$94,800

 

7. Timeline. We will organize speakers in 9/19, offer blocks 1/20-12/20, and intense grant-writing starting 6/20.

 8. References available here: https://docs.google.com/document/d/1pgqhjGAht5jKOEciAwAPAjV_lHu5KKxR80IYE_xbSag/edit?usp=sharing

 

 

 

                                                                                                      

Commenting is closed.

UCSF Global Diabetes Initiative

Submitted by Jaime Sepulveda on May 10, 2019 - 12:57pm Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

 Co-sponsors: Jaime Sepúlveda, George Rutherford, Dean Schillinger

Other sponsors: [ALL THE FOLLOWING FACULTY WILL BE INVITED TO PARTICIPATE] Justin White, Alicia Fernandez, Kirsten Bibbins-Domingo, Laura Schmidt, June Chan , Jacqueline Torres, Nadia Diamond-Smith

UCSF Students: Andrea Pedroza, Lucia Abascal, Luis Rodriguez

International collaborators: Simon Barquera (INSP, Mexico), Carlos Aguilar-Salinas (INCMNSZ, Mexico), Cesar Hernandez (PhD Student, INSP)

Our One Big Idea: To develop a UCSF Global Diabetes Initiative (GDI), an impact-oriented, multi-level and strategic program to confront and reverse the diabetes epidemic locally and globally through collaborative, transdisciplinary and scalable methods

The burden of diabetes is increasing locally and globally | Type 2 diabetes (T2D) has emerged as a driver of premature death and disability worldwide. In California, 1 in 7 adults (~4 million) have T2D, a 30% increase in the last decade. Across the globe, 1 in 11 adults over age 20 has diabetes, and by 2040, this is projected to increase to 1 in 10. In all these settings, T2D disproportionately impacts the poor and disenfranchised, and it is rapidly expanding into young adult and youth populations. Today, three-quarters of all adults with diabetes live in low and middle-income countries, where there is a large unmet need for diabetes diagnosis and care. There is an urgent need for leadership to harness communal resources – financial, intellectual, political and social – to "bend the inexorable diabetes curve" and transform and even reverse the current T2D trajectory, both locally and internationally. It requires that strategies for diabetes focus on four main goals: surveillance, prevention, early diagnosis, and control. Thus, a transdisciplinary approach that considers the study of biological and sociodemographic determinants, health policies, health systems, and implementation sciences is imperative.

UCSF has the potential to develop a multi-level strategic program to confront and reverse the diabetes epidemic | While many universities host centers for diabetes research, no major university has developed a global diabetes initiative whose purpose is to collaborate with a broad range of local and global partners to rapidly reduce the health and economic burdens of T2D. UCSF boasts prominent, interdisciplinary and T2D-focused research, public health, educational and clinical faculty. While many of these individuals are developing essential and impactful programs locally, and in a small set of specific countries, to date there has been no university-wide effort to initiate and sustain what would be an unprecedented, multi-level and strategic program to confront and reverse the diabetes epidemic.

Diabetes needs to be tackled from multiple approaches | We propose to develop a UCSF Global Diabetes Initiative that will serve as a catalyst and thought leader to (1) better understand, confront and reverse the T2D epidemic; (2) communicate about T2D to activate policy-makers and increase public awareness with respect to preventing and controlling T2D; (3) convene and strategize with relevant multi-sector stakeholders to leverage prevention efforts; (4) build local and global capacity by preparing and training the primary care workforce; and (5) discover, innovate and disseminate scalable models for the prevention and control of T2D. We propose building on our firmly established collaborations in safety net health systems and health departments across California and Mexico, as well as expanding nascent UCSF initiatives to collaborate with two additional countries with the largest numbers of people with T2D: China and India. To reach these objectives, we propose the following approaches:

  1. Develop and structure the work of the UCSF Global Diabetes Initiative to reflect its complexity and interdisciplinarity. The structure of the work can be envisioned as a Rubick’s Cube (Figure 1) that uses the "STEPS-to-Impact" domains (Science, Technology, Economics, Policy, and Society) enabled by cross-cutting approaches involving Communication, Collaboration, and Capacity-building through training and other investments in the critical geographies described above. We plan to take advantage of the existing research focused on implementation science of other chronic diseases to design and implement successful strategies for diabetes prevention and diabetes management adherence. 
  2. The GDI will be a mission-oriented initiative that is described with the knowledge triangle framework (Figure 2):

a) Knowledge generation: Creating evidence of cost-effective interventions to tackle the diabetes epidemic, from prevention to early diagnosis to control.

 b) Knowledge transfer: Disseminating the evidence through seminars, presentations in international congress and high-level meetings, as well as training the next generation of leaders on T2D research through academic exchanges between students from UCSF and collaborating institutions worldwide.

c) Knowledge implementation: Working closely with stakeholders and policymakers to transfer the evidence into health policies.

To be successful, people from different fields and backgrounds must work together |The GDI will coordinate efforts between researchers and synergize current studies, as well as create comprehensive and transdisciplinary studies. The initiative would strengthen collaboration within DEB faculty across different areas of concentration in which diabetes intersects, such as biostatistics, clinical epidemiology, epidemiology of aging, epidemiology of cardiovascular and neurological disorders (ie. the cardiovascular disease policy model and the PCORnet Blood Pressure Control), genetic epidemiology, implementation sciences, research methods in epidemiology, social epidemiology, and global health.

Within the broader UCSF campus, the initiative would bring together key actors from different departments including DEB, IGHS, the Center for Vulnerable Populations at ZSFGH, the School of Nursing, and the Diabetes Center, Asian American Research Center on Health (AARCH) and the Latinx Center of Excellence.

We also plan to engage external players nationally such as Stanford, and the Biotech industry; other UC campuses and various departments of Public Health. Internationally we will collaborate with institutions in Mexico (National Institute of Public Health, Ministry of Health, National Institute of Nutrition), China (China Medical Board (CMB) and the Peking Union Medical College (PUMC)), India (Public Health Foundation of India, PHFI), and potential collaboration with African countries in which UCSF already has partnerships (KEMRI, Makerere University, Muhimbili University and others).

The GDI will increase the visibility of DEB faculty locally and internationally |We plan to have open sessions, available online, including seminars and global diabetes grand rounds, which would  increase visibility, allow us to receive feedback, and strategically identify people interested in collaborating with our work. We strive to develop rigorous scientific research and find evidence-based solutions to the global diabetes epidemic and disseminate our findings nationally and internationally by publishing and presenting at high-level conferences.

The UCSF Global Diabetes Initiative has the potential to be a major grant recipient | Leveraging our existing portfolio, we have many opportunities to continue to attract new major donors.

Current grants We have begun to develop a successful model for the UCSF Global Diabetes Initiative through our collaborative work in Mexico, with the National Institute of Public Health and the National Institute of Nutrition. We received grants from the World Diabetes Foundation and Fundación Rio Arronte to develop a program in which we screened 12,000 patients for diabetes and 2,500 patients for diabetic retinopathy; the plan is to follow-up these patients. 

We have also received a grant from UC-MEXICO Initiative to develop PRUDENTE study (Prevention of Diabetes through Exercise, Nutrition, and Medication Therapy) in 49 public primary care clinics in Mexico City, where we are also planning to evaluate metabolomic markers of diabetes incidence and renal function.

Grant submissionsWe have formally submitted a $500K grant proposal toFundacion Rio Arronte. Dr. Schillinger has applied for funding to the Clinton Health Access initiative (CHAI), which has recently prioritized T2D in low-resource settings. CHAI has expressed deep interest in Dr. Schillinger’s idea of a holistic diabetes strategy.

Potential donors.The GDI has the potential to receive funding from other donors such as NIH, the World Diabetes Foundation, and Bloomberg Philanthropies.

Expected outcomes | The GDI will become a leader for T2D research, creating evidence for actionable policy changes and scalable interventions for diabetes prevention and control in vulnerable populations.

 Budget

Projects Incubation                          $30,000

Academic Exchanges                      $15,000

Dissemination                                  $10,000

Administrative Support                    $15,000

PhD Dissertation Fund                    $30,000

Total                                                $100,000

Commenting is closed.

Platform Studies

Submitted by Joan Hilton on May 13, 2019 - 12:10am Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

Phase II, new thoughts.  The strengths of platform studies, exemplified by the STAMPEDE trial, are (1) the presence of a vision at the outset of a long-term research agenda that has the capacity to adapt during its conduct, and (2) a breadth of research questions that could be addressed by a cohesive research group working together to achieve a broad goal. Among the 8 “Big Ideas” applications, 3 target research topics (diabetes, PUMA, radiation health) that could be candidates for this approach and the other applications propose infrastructure that could facilitate it. This effort would benefit from all of the Big Ideas submitted!  

Steve Cummings’ proposal mentions Kirsten's interest in “planning a Center for Public Health (PH) that would work with local communities to provide accurate information on effects of environmental exposures and, potentially, initiate new studies.” Along these lines, I found inspiration at the U of Wisconsin-Madison website describing their “Institute for Research on Poverty,” https://www.irp.wisc.edu/. At the home page, we see their focus is on Wisconsin and on rural poverty; we could provide complementary focus on urban poverty. Under the “people” link, we see that they team with representatives of foundations and the private sector as well as with academics from other institutions -- including UC Davis, UCLA, UCSD, and Stanford; surely they need insights from UCSF biostatisticians and epidemiologists to round out their approaches. Under the “training” link, their 2018 ‘Teaching Poverty 101 Workshop’ provides a lot of valuable background information – indeed, the whole website is valuable.

It would like to see DEB not only conduct research that explains underpinnings of our selected problem – say, Kirsten’s idea – but also studies best approaches to preventing and reducing the problem and works with community partners to implement effective strategies in a sustainable way.

Objectives for Year 1:

  1. Reach out to the UWM IRP group to see if we can join them and benefit from their infrastructure and organizational approaches.
  2. Establish a working group of interested DEB members to refine target topics, and weigh their feasibility and interest to members, and select a final topic. Identify relevant readings, podcasts, and experts; meet regularly to review and discuss these.
  3. Outline a strategic plan for the coming years, identifying many side options (to allow adaptation). Identify personnel needs and emerging leaders within DEB. Identify resources that could provide support.    

Budget:

My initial thought is that at least 3-4 faculty members would have 5%-10% of their time covered to launch this effort.   

Your thoughts on this agenda are most welcome.

~ ~ ~

Phase-I submission. While teaching Biostat 226 this year, I was reminded of STAMPEDE, a multi-arm multi-stage randomized controlled trial cancer protocol that was selected as 1 of 2 RCTs of the year by the Society for Clinical Trials. Per doi:10.1093/annonc/mdx410: "...opening to recruitment with five research questions in 2005 and adding in a further five questions over the past 6 years, it has reported survival data on 6 of these 10 RCT questions over the past 2 years [1–3]. Some of these results have been of practice-changing magnitude [4, 5]." It appears that STAMPEDE also caught the eye of HDFCCC leadership, who sent this solicitation on May 10: "As part of a strategic planning process, the Cancer Center is conducting a broad scientific strategic review termed Cancer Research in 2030. Essentially, we are asking each of you to predict what cancer research will look like in 2030, and accordingly, what we will need to do to get there. [...This is] an effort to present scientific gap analyses and white papers to help Center leadership plan resource allocation and program design. I would like to meet with the leadership and members of your Site Committee at an appropriate time..."

Although STAMPEDE is tailored to research questions relevant to cancer that call for randomized assignments, I believe that whether randomization is employed or not, (i) a strategic visionary research plan that encompasses a range of linked individually led studies could move every clinical field forward very effectively, and (ii) DEB faculty could be valuable partners -- for example, with epidemiologists contributing expertise in behavioral measures and interventions and biostatisticians contributing expertise in study design, conduct, and analysis methods (as in STAMPEDE). Matching budgets from partner departments could cover time of faculty developing such an umbrella protocol. 

As we collectively gain experience in developing strategic plans, we also will identify specific areas of our own fields that need further development. Clinical research is moving toward use of Common Data Elements and PROMIS measures (doi: 10.1037/hea0000752); similarly, there is a need for standardization of many behavioral measures and methods to analyze them and need for implementation studies to optimally operationalize the platform protocols (Campbell MK et al, Health Technol Assess. 2007 Nov;11(48):iii, ix-105).

I foresee a potentially wide application of this visionary approach, with DEB faculty partnering with clinical colleagues to accomplish the goals.  

Commenting is closed.