AHRQ Contract and Grant Will Fund Studies to Impact Public Health-Care Policy
NEW YORK (May 1, 2006) — The U.S. Agency for Healthcare Research and Quality (AHRQ) has awarded Weill Medical College of Cornell University a contract and a grant for public health research in outcomes and cost-effectiveness that will help inform decisions made by the Centers for Medicare & Medicaid Services (CMS) and the FDA.
The two AHRQ awards comprise (1) a contract to form a partnership for rapid-cycle, applied research: Accelerating Change and Transformation in Organizations and Networks (ACTION), and (2) a $4 million grant: Centers for Education and Research on Therapeutics (CERT). Both awards have a timeframe of five years and are featured national research initiatives sponsored by AHRQ.
"We are very pleased to be selected for this highly competitive government funding. It will make possible for us to fund rapid, health services research to improve health care for millions of patients," says Dr. Alvin Mushlin, Chairman of the Department of Public Health at Weill Cornell Medical College and Public Health Physician-in-Chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
Both ACTION and CERT stress the importance of collaboration. Projects will be carried out in partnership with several organizations. The Weill Cornell partnership for ACTION includes NewYork-Presbyterian Hospital and Healthcare System, Columbia University College of Physicians and Surgeons, the Visiting Nurse Service of New York, and GHI. CERT collaborators include the Hospital for Special Surgery and The Methodist Hospital (Houston) — both Weill Cornell partners.
ACTION
The ACTION contract — one of 15 given nationally — will enable the Weill Cornell Medical College partnership to compete for projects during the five-year initiative. It will fund one-to-two-year research projects examining how various technologies and strategies may improve outcomes and delivery. Topics of study may include the structure, organization and coordination of care; economic incentives; patient safety; working conditions and quality of care; health care for medically underserved populations; long-term care; health information technology; and readiness for terrorist events and other public emergencies.
ACTION is a continuation of AHRQ's Integrated Delivery System Research Network (IDSRN), a five-year contract awarded to Weill Cornell that was completed in 2005. The IDSRN awarded 13 studies to Weill Cornell for a total amount of $4.3 million, including research on telemedicine technology for intensive care units (electronic ICUs or eICUs), a disease management system for hypertensive patients, coordinated planning for flu and anthrax outbreaks, and an IT system to help ease the transition of long-term-care patients from the hospital to home.
"A substantial number of IDSRN projects have resulted in a change to health policy, whether it is locally, nationally or internationally," says Dr. Mark Callahan, chief of the division of outcomes and effectiveness research and associate professor of public health and medicine at Weill Cornell Medical College and associate attending physician at NewYork-Presbyterian/Weill Cornell. "Even more than IDSRN, ACTION is designed to quickly turn research into practice."
CERT
The CERT grant — one of four new grants of this type given nationally — will fund research into the outcomes and cost-effectiveness of medical devices. "The evaluation of medical devices has lagged behind evidence about drugs and pharmaceuticals. Funding a CERT dedicated to them is an effort on the part of AHRQ and the FDA to correct this," adds Dr. Mushlin.
Orthopedic devices — including shoulder prostheses and joint replacements for the hip and knee — will be pilot projects initially included in this program. Prosthetic joints are among one of the most successful and commonly implanted medical devices developed over the last 50 years, and allow millions of people to remain ambulatory and pain-free. With an aging population, the demand for joint replacements will be even greater.
"Despite their popularity, existing studies do not provide adequate data to evaluate long-term outcomes," says Dr. Callahan. "Additionally, very little is known about predictors of prosthesis failure. Variations in hospital costs, length of stay and functional outcomes among patients implanted with different types of prostheses need to be integrated with clinical outcomes data to develop more complete information to assist decision-makers."
As part of the study, physician-scientists will evaluate the effectiveness of MRI and laboratory markers to identify early osteolysis — the loss of bone calcium — in patients with a hip prosthesis. The study will seek to identify risk factors for osteolysis that may include younger age, higher body mass index (BMI) and increased activity.
"If patients can be identified early in the osteolytic process, treatments may be developed to delay or prevent a second surgery, with its related higher cost and increased risk of complications," says Dr. Callahan.
The study will also seek to identify discrepancies in outcomes across racial and ethnic groups, as well as variations in health-care costs associated with different prosthesis models.
Finally, the CERT grant will fund the dissemination of study results to patients, health-care practitioners and policy makers. Additionally, the group will develop culturally sensitive education outreach materials for patients from diverse and medically underserved backgrounds.
The Joan and Sanford I. Weill Medical College
The Joan and Sanford I. Weill Medical College of Cornell University — located in New York City — is committed to excellence in research, teaching, patient care, and the advancement of the art and science of medicine. The Medical College offers an innovative curriculum that integrates the teaching of basic and clinical sciences, problem-based learning, office-based preceptorships, and primary care and doctoring courses. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research in such areas as genetics and gene therapy, neuroscience, structural biology, AIDS, cancer and psychiatry — and continue to delve ever deeper into the molecular basis of disease in an effort to unlock the mysteries behind the human body and the malfunctions that result in serious medical disorders. Weill Cornell is the birthplace of many medical advances — from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., and most recently, the world's first clinical trial for gene therapy for Parkinson's disease. Weill Cornell's Physician Organization includes 650 clinical faculty who provide the highest quality of care to patients.
Leslie Greenberg
leg2003@med.cornell.edu