Previous posts described future directions in epidemiology research and opportunities to further team science. Building on transformative approaches described on this forum (November 1, 2013 and December 20, 2013), the Multi-Ethnic Study of Atherosclerosis invites interested investigators to develop investigator-initiated grant applications for innovative research that involve new data collection from current study participants. The next MESA contract is anticipated to begin in 2015 and welcomes research that will complement an NHLBI-supported core exam. If you are interested, contact the MESA investigators now to coordinate the process and scientific components. Interested investigators should consider the following as they begin this process:
• MESA Ancillary Study Committee will begin reviewing proposals in February in order to meet a June NIH submission deadline. The study has policies, procedures, and timelines for reviewing and approving ancillary study proposals before a grant application may be submitted for funding.
• Please contact the MESA Coordinating Center as soon as possible to ensure that the proposed research is appropriate for the study population, and to ascertain existing data availability and determine resource needs.
• Submission of applications proposing new data collection in study participants should be coordinated so the participant exam components can be conducted in a single participant visit, in order to minimize participant burden and cost.
If you are interested, please visit the study web site via the links provided above, or contact the study directly.
Prepared by the Epidemiology Branch
Since the beginning of this Digital Forum in March 2012 we have raised questions and encouraged discussion on how to improve the population based studies of heart, lung, and blood diseases. As an Institute, we are facing increasing pressures to re-engineer our strategies for supporting “big science” along with Institute-initiated projects. In a recent post (“Transformation is in the air…”), we noted that the NHLBI would establish a working group on these issues and to consider how best to direct population and clinical epidemiology during this time of big data and small budgets.
That working group, which includes various members of both the NHLBI Advisory Council and the Board of Extramural Experts, has begun meeting to advise the Institute on the creative transformation of epidemiology. For your information, the working group roster and the charge are included on this post. If you have any comments, please feel free to share them with us through this Digital Form.
As described in the previous post, “Transformation is in the air…future directions in epidemiology,” the NHLBI described a planned limited contract renewal of the Framingham Heart Study. The new contract, to start in 2015, will begin the transformation of epidemiology and will have a different structure and format from the previous scientific work scope. Consequently, Framingham Heart Study investigators are encouraging collaboration with interested outside investigators to assemble a portfolio of investigator-initiated grant applications for innovative research that involves new data collection from the participants. If you are interested, now is the time to contact the Framingham Heart Study.
Interested investigators should consider the following as they begin this process:
• The study has its own policies, procedures, and timeline for reviewing and approving ancillary study proposals before a grant application may be submitted for funding.
• Consultation with the study is necessary to ensure the proposed research is appropriate for the study population, ascertain existing data availability, and determine resource needs.
Submission of applications proposing new data collection in study participants should be coordinated so the participant exam components can be conducted in a single participant visit, in order to minimize participant burden and cost.
If you are interested, please visit the study web site via the links provided above, or contact the study directly. The study has announcements regarding this collaborative application process and can provide the necessary information to proceed.
Prepared by the Epidemiology Branch
As the NHLBI moves to advance the state of epidemiology of heart, lung, blood, and sleep diseases and disorders, several new steps were announced at the recent National Heart, Lung, and Blood Advisory Council (NHLBAC) meeting. These initiatives include the establishment of a working group to be led by Dr. Veronique Roger that will include members of both the NHLBAC and the Board of External Experts.
As we address the challenges brought by big data and small budgets, the NHLBI is convening this working group to propose recommendations to the NHLBI director on future directions with existing cohort studies, longer-term epidemiology strategy, and practical clinical trials. The working group will consider the “LEVI’S” concepts – L for large and leveraged; E for external and embedded; V for valuable for informing scientific thought, medical practice, or public policy; I for inexpensive, integrated, and able to preserve/enhance existing investments; and S for scientifically sound.
To provide sufficient time for the working group to address the future direction of cohort studies while preserving the value of existing investments, the NHLBI plans a limited renewal of two cohort studies (the Framingham Heart Study and the Multi-Ethnic Study of Atherosclerosis) to begin at the end of their current project periods in 2015. The working group and the NHLBI aim to strengthen epidemiology by developing a dynamic, state-of-the art program that is achievable and affordable.
We strongly encourage your comments and suggestions, and hope you will consider sharing with us your thoughts on the future directions of epidemiology.
Posted by Michael Lauer, M.D., Director of the NHLBI’s Division of Cardiovascular Sciences.
Reporter Ron Winslow posted an article in the March 18, 2013 issue of The Wall Street Journal about a privately-funded University of California, San Francisco (UCSF) effort to track heart disease risk in over 1 million adults using mobile technology.
The project, called “Health eHeart” is described by Dr. Jeffrey Olgin, UCSF’s chief of cardiology, as “a large-scale digital version of the Framingham Heart Study.” The researchers plan to engage participants by encouraging them to enter their own data (e.g., brief surveys), be available for digital follow-up, and to use digital apps and sensors to record certain biological measures like blood pressure.
Questions for consideration:
- Are “eCohorts” the wave of the future for epidemiology? For what types of research questions are they best suited?
- What steps are needed to enable the widespread use of mobile technology for data collection in research studies?
- What are the new challenges that arise with the use of “eCohorts”?
We look forward to an engaging discussion on these issues.
Posted by the Epidemiology Branch, NHLBI
A year ago, the NHLBI launched this forum in an effort to open an active discussion with the larger epidemiology research community about the future of epidemiology as it relates to cardiovascular disease. We want to thank everyone for their thoughtful contributions to the forum and look forward to further engaging with the research community on this important topic.
We are pleased to welcome guest contributor, David C. Goff, Jr., M.D., Ph.D., chair of the American Heart Association (AHA) Council on Epidemiology and Prevention, and dean of the Colorado School of Public Health, who will help us mark the one-year anniversary by sharing his perspective on the future of epidemiology:
Strong epidemiology has been a critical component of advances in public health over at least the past half-century and will remain important in the future. The potential contributions of strong epidemiology include further elucidation of the social determinants of health, the molecular determinants of health, and the comparative effectiveness of various interventions, whether based on changes in policies, systems, environments, behaviors, or the use of pharmacologic, biologic, or device-based therapies.
We need better science regarding the social influences that constrain healthy behaviors and the policy changes that can redress those constraints. The best science will likely come from strong collaboration between epidemiologists and social scientists. We need better science regarding the molecular basis of health, including how environmental exposures and behavioral patterns interact with the genome and microbiome to influence biologic systems, that can be examined with increasingly complex methods, such as epigenomics, proteomics, and metabolomics. The best science will likely come from strong collaboration between epidemiologists and systems biologists.
We need better science regarding the impact of various interventions on population health. In some instances, randomized trials will be the best approach, but for many policy-based interventions, other approaches may be needed. For example, cross-sectional observational studies have shown associations between density of public food advertisements (e.g., billboards) and obesity prevalence, but association is not necessarily causation. Evaluation of natural experiments in public food advertising could clarify this issue.
Strong epidemiology has contributed greatly to advances in cardiovascular health over the past half-century, and will be critical to efforts to advance global cardiovascular health for decades to come.
David C. Goff, Jr., MD, PhD
Chair, AHA Council on Epidemiology and Prevention
Dean, Colorado School of Public Health
2012 was a gratifying year, filled with discussions on future directions in epidemiology that were open, productive, and creative. The NHLBI Digital Forum has been one avenue of discussion and we appreciate all of the contributions that we received. Several of the discussions led to specific actions within the NHLBI’s Epidemiology Branch. A workshop is being planned for 2013 that will focus on the value, strengths, and weaknesses of embedding clinical trials within observational studies. A second workshop is being planned for 2013 assessing the role of existing medical data collection systems in surveillance of cardiovascular diseases. There will be additional emphasis on developing methods to obtain higher quality data at lower costs.
In this post, we now ask an open question to our readers: for 2013, what do you think should be a high priority Funding Opportunity Announcement for observational studies that could be proposed by the NHLBI?
Posted by the Epidemiology Branch, NHLBI