Currently Funded Projects
Anticoagulation Treatment and Long-Term Outcomes After Venous Thromboembolism
This project has developed a cohort of adults with VTE that is used to answer numerous research questions about optimal VTE management within real-world practice settings. Treatment patterns and risk factors are used predict recurrent VTE and major hemorrhagic complications.
Funding Source: National Heart, Lung, and Blood Institute
PI: Margaret Fang, MD, UCSF School of Medicine; Site PI: Jeffrey VanWormer, PhD
Central Data Collection Center (CDCC) - Continued Follow-up of PLCO Participants
This project involves ongoing followup of a randomized cancer screening trial of more than 16 years duration involving 74,000 females and 74,000 males aged 55-74 at entry at 10 sites around the country. Individuals in the control group received usual medical care. Individuals in the group randomized to screening received screening examinations for lung, and colo-rectal cancers and, depending on sex, either prostate or ovarian cancer. The screening trial was designed to determine whether: 1) screening with flexible sigmoidoscopy can reduce mortality from colo-rectal cancer; 2) screening with chest x-ray can reduce mortality from lung cancer; 3). screening men with digital rectal examination plus serum prostate-specific antigen can reduce mortality from prostate cancer; and, 4). screening women with CA 125 and transvaginal ultrasound can reduce mortality from ovarian cancer. Secondary objectives included: 1) to assess screening variables other than mortality for each of the interventions including sensitivity, specificity, and positive predictive values. 2) To assess incidence, stage, and survival experience of cancer cases. 3) To investigate the mortality predictive value of biologic and/or prognostic characterizations of tumor tissue as intermediate endpoints. To view publications and results, click here.
Funding Source: Westat/NCI
PI: Robert Greenlee, PhD, MPH
Community-Wide Weight Management Program
This project involves an annual community health challenge as part of the broader Heart of New Ulm Project (based in New Ulm, MN). The Community Challenge program will focus on weight management, and encourage participating residents to improve their nutrition and physical activity behaviors via an incentivized weigh-in system, telephonic coaching, and Internet self-help education.
Funding Source: Minneapolis Heart Institute Foundation
PI: Jackie Boucher, Minneapolis Heart Institute Foundation; Site PI: Jeffrey VanWormer, PhD
CRN Pilot: Are 2 Jars Sufficient for Pathology Examination of Extended Core Prostate Biopsy?
The methodology for submitting extended core prostate biopsy (ECPB) varies widely. There is no currently recommended approach. At present, urologists may process tissue cores into between two and twelve jars. The difference in the number of jars can result in a difference of up to $1000 in costs to insurers. This pilot study will determine the patterns of processing ECPB tissue cores for examination, and determine associations between number of jars and key outcomes (e.g.: rates of prostate cancer detection, equivocal diagnoses). Researchers will accomplish this by using data collected clinically. The goal is to determine the variability in the patterns of number of pathology specimens per biopsy within two sites that have mixed insurance and practice patterns.
Funding Source: Kaiser Foundation Research Institute/NCI
PI: Mara Epstein, University of Massachusetts; Site PI: Robert Greenlee, PhD, MPH
CRN4: Cancer Research Resources & Collaboration in Integrated Health Care Systems
The Cancer Research Network (CRN) is a consortium of research organizations within several non-profit health care delivery systems. Originally, CRN was focused on collaborative research made possible through integrated access to clinical datasets from the participating institutions. This new 5-year cycle uses a different funding mechanism and redefines the role of CRN as a broader resource for cancer researchers at large. The uniqueness of CRN as a cancer resource stems from: (1) the integrated access to clinical data for large, stable, and diverse patient populations that are available through the "parent" HMOs; and (2) the expertise of CRN researchers in conducting clinical cancer research involving large sets of clinical data. Through this, the NCI intends to promote further technical and methodological enhancements of CRN informatics infrastructure as well as efforts to facilitate access of non-CRN-affiliated investigators to CRN data and expertise. The goal is to increase the number and scope of research projects that are based on CRN data and the participation of CRN investigators on such projects. In addition to collaborations on projects funded outside of CRN, CRN will directly support pilot projects that may be initiated either by non-CRN-affiliated investigators or by CRN investigators.
Funding Source: Kaiser Foundation Research Institute/NCI
PI: Larry Kushi, KPNC; Site PI: Robert Greenlee, PhD, MPH
The CVRN-Risks with ICD Placement and Outcomes in Kidney Disease (CVRN-RISK) Study
The aims of this one year bridge award are: 1) to understand the extent to which patients with heart failure with reduced left ventricular ejection fraction and concomitant reduced kidney function receive guideline-based primary prevention ICDs compared with patients with preserved kidney function; 2) to clarify the effect of kidney function level on complications, hospitalization and death among heart failure patients who do and do not receive an ICD.
Funding Source: University of Washington/NHLBI
PI: Nisha Bansal, University of Washington; Site PI: Robert Greenlee, PhD, MPH
ESA Outcomes among Anemic CKD Patients
This retrospective cohort study examines outcomes associated with differential use of Erythropoiesis-stimulating agents in patients with chronic kidney disease who are anemic.
Funding Source: Agency for Healthcare Research & Quality
PI: Dennis Cotter, Medical Technology and Practice Patterns Institute; Site PI/Co-Investigator: Jeffrey VanWormer, PhD
Improving Diabetes Quality Reports for Persons with Multiple Chronic Conditions
The specific aim of this developmental work will be to evaluate the utility of existing health care quality reporting data from 3 healthcare systems in Wisconsin to support a more meaningful assessment of health care quality for subjects with multiple chronic conditions. The specific target for this initial work will be retrospective data from the pool of subjects with diagnosed diabetes.
Funding Source: University of Wisconsin/AHRQ
PI: Maureen Smith, University of Wisconsin; Site PI/Co-investigator: Robert Greenlee, PhD, MPH
Recently Completed Projects
Piloting Strategies for Establishment of the Oral-Systemic Research Project Cohort (Completed February 2014)
The objectives of the study are to define cohort characteristics and demonstrate capacity to enroll subjects with periodontal disease (per current working definition of PD) and controls subjects without PD.
Funding Source: Marshfield Clinic Internal
PI: Murray H. Brilliant, PhD; Co PI: Jeffrey VanWormer, PhD
Sociodemographic Determinants of Aspirin Use for the Primary Prevention of Cardiovascular Disease in the Marshfield Epidemiologic Study Area (Completed January 2014)
This study will examine the association between sociodemographic characteristics and aspirin use among adult residents of the Marshfield Epidemiologic Study Area without a prior history of cardiovascular disease. Study aims to estimate the proportion of the population currently using aspirin for primary CVD prevention, and identify demographic, social, and health-related characteristics associated with regular aspirin use.
Funding Source: Seubert Physician Endowment - Rezkalla
PI: Jeffrey VanWormer, PhD
Health Care Systems Research Network Cardiovascular Research Network (Completed August 2012)
This study leverages the Health Care Systems Research Network (HCSRN) and its broad cardiovascular expertise to create a nationally representative framework to answer critical questions within large community-based populations where the majority of cardiovascular care is delivered. The goals are to: 1) provide more robust cardiovascular disease health care surveillance than is currently available; 2) promote research on clinical practice and quality of care; 3) assess new diagnostic and therapeutic technologies; 4) evaluate clinical guidelines and their impact on CVD incidence, prevalence, clinical care and patient outcomes over time; 5) promote research on determinants of disease for uncommon disease phenotypes; and, 6) create research opportunities for interested non-CVRN investigators. Funding is for 5 years. There are 14 HCSRN sites participating in the governance and infrastructure of the network. There are 3 featured research projects: 1) Hypertension Recognition, Treatment, and Control in Community Practice; 2) Community-Based Control and Persistence of Warfarin Therapy and Associated Rates and Predictors of Adverse Clinical Events in Atrial Fibrillation and Venous Thromboembolism; 3) Implantable Cardioverter Defibrillators for Primary Prevention in Community Practice: Clinical Characteristics, Outcomes, Resource Utilization, and Cost.
Funding Source: Kaiser Permanente/NHLBI
PI: Alan Go, Kaiser Permanente Northern California; Site PI: Jeffrey VanWormer, PhD
Cancer Screening Effectiveness and Research in Community-Based Healthcare (Completed July 2012)
The overall goal of this project is to optimize cancer screening delivery in community-based settings through comparative effectiveness research (CER) in colorectal and cervical cancer.
Funding Source: Group Health/NCI
Co-PIs: Diana Buist, Group Health, Chyke Doubeni, University of Massachusetts; Site PI/Co-Investigator: Robert Greenlee, PhD, MPH
Development of a Cardiovascular Surveillance System in CVRN (Completed July 2012)
The objective of the study is to establish a nationally representative surveillance system for cardiovascular disease in health care delivery systems participating in the Cardiovascular Research Network.
Funding Source: Kaiser Permanente/NHLBI
Co-PIs: Steve Sidney, Kaiser Permanente Northern California; Site PI/Co-investigator: Robert Greenlee, PhD, MPH
A Novel Population Health Approach to Address Cardiopulmonary Health Disparities (Completed July 2012)
This project establishes the Wisconsin Health Equity Network (WHEN), a state-wide resource for comprehensive monitoring of the determinants of disparities in cardiovascular and respiratory health. WHEN will expand and link unique existing resources that assess the health of Wisconsin individuals and communities at multiple levels including: (1) the Survey of the Health of Wisconsin (SHOW): a population based survey of individual health determinants; (2) the Wisconsin County Health Rankings: an annual summary of the health status of the population in all Wisconsin counties; (3) the Wisconsin Collaborative for Health Care Quality: a consortium of health care provider organizations (physician groups, health plans, hospital) sharing health care quality data; and (4) What Works-Policies and Programs to Improve Wisconsin's Health. Through this project, Marshfield Clinic will be added as the northern recruitment center for the SHOW survey.
Funding Source: University of Wisconsin/NHLBI
PI: Javier Nieto, University of Wisconsin; Site PI/Co-investigator: Robert Greenlee, PhD, MPH