Departmental Research Projects

UT Southwestern Center for Patient-Centered Outcomes Research
Principal Investigator: Ethan Halm, M.D., M.P.H.
Funding Source: Agency for Healthcare Research and Quality
Objective: This proposal aims to enhance and expand the research infrastructure, databases, training programs, personnel, natural laboratories and collaborative relationships needed to conduct high quality patient-centered outcomes research (PCOR) and comparative effectiveness research (CER) at the University of Texas Southwestern Medical Center in Dallas (UTSW), Parkland Health and Hospital System (Parkland), Children's Medical Center (Children's), and the North Texas Veterans Administration Health Systems (Dallas VA). All of the proposed infrastructure activities and research projects are focused on conducting PCOR and CER in underserved patients, populations, and settings, including those served by safety-net systems, people who are economically disadvantaged, racial/ethnic minorities, immigrant populations, and those lacking health insurance or access to care.

Safety and Effectiveness of Metformin
Principal Investigator: Carlos Alvarez, Pharm.D.
Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases
Objective: This pharmacoepidemiology study will use national VA data to evaluate the safety and effectiveness of metformin use v. other drugs among patients with diabetes and chronic kidney disease.

Harnessing the EMR to Reduce Delays in the Diagnosis of Type 2 Diabetes: A Systems-based Decision Support Approach
Principal Investigator: Michael Bowen, M.D., M.P.H.
Funding Source: University of Texas System Grant
Objective: This proposal leverages laboratory data on abnormal glucose values in the EMR to improve the detection and follow-up testing rates of abnormal glucose values.  It will characterize the epidemiology of abnormal random glucose measurements and failures in timely follow-up and conduct a cluster randomized, pragmatic trial comparing the effectiveness of a decision support intervention to increase timely follow-up of abnormal glucose values.

Predicting Diabetes Risk Using Glucose Data
Principal Investigator: Michael Bowen, M.D., M.P.H.
Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases
Objective: This K23 award will harness data in the EMR to detect patterns of abnormal random glucose that identify patients with suspected but undiagnosed diabetes/pre-diabetes, conduct a prospective diabetes/pre-diabetes screening study in those at high risk, and develop EMR-enabled decision support to flag and prompt definitive testing of those at high risk.

Population-Based Research Optimizing Screening through Personalized Regimens (PROSPR)
Principal InvestigatorsEthan Halm, M.D., M.P.H. and Celette Skinner, Ph.D.
Funding Sources:  National Cancer Institute
Objective: This five-year, $6.3 million grant from the National Cancer Institute examines the processes and outcomes of colorectal cancer (CRC) screening in an EMR-enabled, population-based safety net health system, and also includes: 1) a comparative effectiveness trial of two system-based CRC screening outreach programs, 2) study of a personalized, clinic-based in-reach programs; 3) examination of the impact of organizational factors and social disadvantage on screening. We are one of seven sites in this NCI PROSPR cancer screening consortium.
Study website:  PROSPR

Post-acute Care in the Elderly: The Role of Long-term Acute Care Hospitals
Principal Investigator: Anil N. Makam, M.D., M.A.S.
Funding Source: National Institute on Aging
Objective: This 5-year K23 grant will examine variation and outcomes of care of comparably sick elderly individuals discharged to long-term acute care hospitals (LTACs) versus those discharged to skilled nursing facilities. It will use national Medicare data, EHR data from a regional hospital network, and prospective data collection to understand patterns of post-acute care, the patient, provider and system factors influencing LTAC use, and their associated clinical outcomes and costs.

The Role of Long-term Acute Care Hospitals in Caring for Non-ventilated Older Adults
Principal Investigator: Anil N. Makam, M.D., M.A.S.
Funding Source: National Institute on Aging
Objective: This GEMSSTAR R03 grant will use national Medicare data to: 1) examine why hospitalized older adults are discharged to long-term acute care hospitals (LTAC) versus remaining in the acute care hospital, the principal alternate to LTACs; and 2) comparatively assess the effectiveness of LTACs versus continued care in the acute care hospital on outcomes, utilization, costs, and spending.

Comparative Effectiveness of Patient-Centered Strategies to Improve Pain Management and Opioid Safety for Veterans
Principal Investigator: Una E. Makris, M.D., M.S.C.S.
Funding Source: Patient-Centered Outcomes Research Institute
Objective: The overall objective of this research is to improve effectiveness and safety of pain management among patients with chronic pain. This 12-month pragmatic randomized trial will compare two systems of care strategies, which differ substantially in comprehensiveness and resource intensity, to improve pain and reduce opioid use among Veterans.

Improving Outcomes for Older Veterans with Chronic Back Pain and Depression
Principal Investigator: Una E. Makris, M.D., M.S.C.S.
Funding Source: VA Health Services Research and Development
Objective: During this VA HSRD CDA-2 award Dr. Makris will develop a non-pharmacological, behavioral intervention, using stakeholder input, that will be delivered by health coach via telephone and then conduct feasibility pilot testing to improve outcomes in older Veterans with chronic back pain and comorbid depression.

Addressing Social Vulnerabilities to Prevent Readmissions in Adults with Cardiovascular Disease: Derivation and Validation of Readmissions Prediction Models
Principal Investigator: Oanh Nguyen, M.D., M.A.S.
Funding Source: Department of Internal Medicine, UT Southwestern
Objective:  This study will use EHR data to develop predictive models to identify hospitalized patients with congestive heart failure and ischemic heart disease at high risk for readmission, and to stratify individuals by medical severity and social vulnerabilities. This project is a critical first step towards designing a patient-centered enhanced intervention strategy building on evidence-based transitional care interventions to address health-related social vulnerabilities in addition to medical needs to prevent readmissions.

Assessing the Comparative Effectiveness of Scheduled Versus Emergency Dialysis in End-stage Renal Disease
Principal Investigator: Oanh Kieu Nguyen, M.D., M.A.S. 
Funding source: UT Southwestern Center for Translational Medicine Translational Pilot Program
Objective: This translational research pilot study will establish a cornerstone of the foundational evidence base that is needed for a robust, definitive cost-effectiveness analysis of dialysis strategies for ESRD. This knowledge will enable the translation of evidence into policy to enable universal access and use of the most cost-effective and evidence-based dialysis strategy for all individuals with ESRD.

Building Capacity for Effective, Equitable Implementation of a Social-health Information Exchange for the Underserved in Dallas
Principal Investigator: Oanh Kieu Nguyen, M.D., M.A.S.
Funding source: Program for Development and Evaluation of Model Community Health Initiatives in Dallas (PDEMCHID)
Objective: This community-based research pilot study will provide Parkland and Dallas community partners with critical information for successful implementation of a social-health information exchange portal to better tailor existing health and social services to client needs, coordinate care across sectors, and promote delivery of complementary health and social services through use of the information exchange.

Reducing Readmissions and Improving Outcomes in HIV-Infected Patients
Principal Investigator: Ank E. Nijhawan, M.D., M.P.H., M.S.C.S.
Funding source: National Institute of Allergy and Infectious Diseases
Objective: This K23 project aims to better predict 30-day readmissions in HIV-infected patients utilizing electronic health data, to understand reasons for readmissions using both quantitative and qualitative methods and to reduce 30-day readmissions through a multi-component intervention.

The Fair Park Cancer Prevention Pilot Study: A Community-Academic Partnership
Principal InvestigatorSandi Pruitt, Ph.D., M.P.H.
Funding Source: Program for the Development and Evaluation of Model Community Health Initiatives in Dallas (PDEMCHID)
Objectives: Researchers aim to develop and validate measures of neighborhood socioeconomic deprivation representing neighborhood features important for cancer screening behavior. Researchers will also test the feasibility of recruiting research participants from Community Crossroads Services' food bank, a critical entry point into safety net services for the most vulnerable Fair Park residents. Project collaborators include the University of Texas at Dallas' Economics and Geospatial Science departments.

A Multisector Solution to Build a Culture of Health Among Food Insecure Populations in Dallas County
Principal Investigator: Sandi Pruitt, Ph.D.
Funding Source: Robert Wood Johnson Foundation
Objective: This is a mixed methods study, combined with quality improvement, designed to better understand the health of clients receiving charitable food from a food distribution center, patterns of client receipt of food assistance, and to evaluate the impact of a new food distribution model on clients’ health and economic outcomes.

Harms of Hepatocellular Carcinoma Screening in Patients with Cirrhosis
Principal Investigator:  Amit Singal, M.D., M.S.
Funding Source: National Cancer Institute
Objective: This study leverages a multi-center randomized controlled trial in a socioeconomically and racially diverse population of 3,000 patients with cirrhosis in 3 healthcare settings (academic tertiary care center, safety-net health system, and Veterans Affairs system).  The study will assess the effect of HCC screening on: a) physical harms due to follow-up tests, b) financial harms, c) over-diagnosis, and d) screening-related psychosocial harm through electronic medical record data, manual chart review, and validated survey measures.

Implementation of an Evidence-based Colorectal Cancer Screening Outreach Program Among Socioeconomically Disadvantaged Patients in a Safety Net Health System
Principal Investigator: Amit Singal, M.D., M.S.
Funding Source: Cancer Prevention Research Institute of Texas
Objective:  This is a large scale dissemination and implementation study of a mailed FIT kit outreach intervention to increase uptake of colorectal cancer (CRC) screening in 18,000 community primary care patients. An embedded RCT will also compare the impact of a CRC screening “choice” invitations where patients have their choice of FIT testing v. colonoscopy (vs. usual care).

STOP-HCC
Principal Investigator: Amit Singal, M.D., M.S.
Funding Source: Cancer Prevention Research Institute of Texas and Gilead Sciences
Objective: The goal of this project is to reduce the incidence and mortality of hepatocellular carcinoma (HCC) by implementing an evidence-based Hepatitis C Virus (HCV) screening and treatment program for low-income populations coupled with a continuum of care for HCC prevention and control. This study will characterize rates of HCV screening, follow-up testing, treatment among baby-boomers receiving their primary care at Parkland Hospital, and surveillance among at-risk patients.

Cardiovascular risks of prescription amphetamine use in adults
Principal Investigator: Arthur Westover, M.D., M.P.H.
Funding Source: National Institute of Drug Abuse
Objective: This K08 award will conduct a pharmacoepidemiology study to assess the impact of amphetamine prescription on long-term cardiovascular events using a national VA database of 8 million patients.