VA RESEARCH IN THE NEWS
COVID-19 Trials at the Minneapolis VA Health Care System
January 15, 2021
In response to the COVID-19 pandemic, the Minneapolis VA Health Care System participates in clinical trials aimed at identifying new treatments for COVID-19. These trials are supported by the National Institutes of Health and Department of Veterans Affairs. ITAC (Inpatient Treatment with Anti-Coronavirus Immunoglobulin; ClinicalTrials.gov NCT04546581) tests the efficacy of a COVID-19 antibody infusion prepared from multiple antibody donors who have recovered from COVID-19. Therapeutics for Inpatients with COVID-19 (TICO; ClinicalTrials.gov NCT04501978) tests the efficacy of COVID-19 monoclonal antibodies, which are specific antibodies made in the laboratory rather than collected from patients. Both studies have research sites in multiple locations (both VA and non-VA) in the US and other countries around the world. The data coordinating center for these studies is at the University of Minnesota School of Public Health. The Minneapolis VA COVID research team, led by Dr. Ken Kunisaki continues to assess new studies that seek to improve the prevention, treatment, and successful recovery from COVID-19.
COMPASS - A Study on the Treatment of Veterans with Co-Occurring Posttraumatic Stress Disorder and Substance Use
May 1, 2020
Minneapolis VA Health Care System’s Center for Veterans Research and Education Approved for $5,000,000 in Research Funding for Study on Treatment of Veterans with Co-Occurring Posttraumatic Stress Disorder and Substance Use.
Funds awarded by the Patient-Centered Outcomes Research Institute
A research team at the Minneapolis VA Health Care System (MVAHCS) has been approved for a $5 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to study the comparative effectiveness of two psychotherapies for veterans with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders. The team is led by Dr. Shannon Kehle-Forbes, a research investigator at MVAHCS and the Women’s Health Sciences Division of VA’s National Center for PTSD, and Dr. Hildi Hagedorn, a MVAHCS research investigator.
Patients with co-occurring PTSD and substance use disorders prefer that their PTSD be treated alongside the substance use disorder, but little is known about how to best treat PTSD among those with impairing alcohol or drug use. This newly approved study will test two psychotherapy approaches for treating PTSD that have been shown to be effective for those without co-occurring substance use but have not been widely studied among those with both conditions: trauma-focused therapy and non-trauma-focused therapy.
Trauma-focused therapy addresses thoughts or memories related to one’s trauma, while non-trauma-focused therapy involves learning about how PTSD relates to one’s current difficulties and problem solving of current life problems. The project will test which approach is better for reducing symptoms of PTSD and which is more likely to be completed by 420 patients at 14 VA Health Care Facilities nationwide. It will also test whether veterans with varying substance use patterns and preferences for treatment respond differentially to the two approaches.
The project, titled Comparative Effectiveness of Trauma-Focused and Non-Trauma-Focused Treatment Strategies for PTSD among those with Co-occurring SUD (COMPASS), will be the largest study to date examining psychotherapy treatment options for patients with both PTSD and substance use. The findings will guide patients and providers in making individualized treatment decisions about how to best treat symptoms of PTSD for those with co-occurring substance use, such that more veterans will experience meaningful improvement in their PTSD symptoms and their overall quality of life.
A patient panel comprised of veterans with personal experience with co-occurring PTSD and substance use will be engaged in all phases of the project to ensure study findings are relevant, accessible, and actionable to patients.
“Although as many as 50% of patients with PTSD also have a substance use disorder, those struggling with both conditions have typically been excluded from studies evaluating treatments for PTSD. This has left these patients and their clinicians to make treatment decisions with limited information about whether our evidence-based therapies for PTSD will work as well for them. We are excited to be able to answer this important clinical question to ensure that the care offered to veterans who are struggling with multiple treatment needs meets their preferences and gives them the best possible chance at improvement,” said Dr. Kehle-Forbes, the project’s principal investigator.
“We were excited to hear that PCORI plans to fund Dr. Kehle-Forbes’ 4-year, $5 million clinical trial comparing the effectiveness of 2 different treatment approaches for Veterans with PTSD and substance use disorder, an important but under-studied population,” stated Hanna E. Bloomfield, MD, MPH Associate Chief of Staff for Research. “Results of this study will likely change clinical practice and ultimately improve outcomes for Veteran and non-veteran patients suffering from these co-morbid conditions”
“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge and give people information to help them weigh the effectiveness of their care options,” said PCORI Interim Executive Director Josephine P. Briggs, MD. “We look forward to following the study’s progress and working with the Minneapolis VA to share the results.”
The Minneapolis VA Health Care system study was selected for PCORI funding through a highly competitive review process in which patients, clinicians and other stakeholders joined clinical scientists to evaluate the proposals. Applications were assessed for scientific merit, how well they will engage patients and other stakeholders and their methodological rigor among other criteria.
PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org.
January 15, 2020
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Minneapolis VA takes part in study on chronic low-back pain in veterans
September 24, 2019
Palmer Center for Chiropractic Research leads $7 million study to address chronic low-back pain in U.S. veterans
(Davenport, Iowa) – U.S. veterans suffering from chronic low-back pain will be the focus of a $7 million study that will examine the role of chiropractic care in addressing pain without the use of pharmaceuticals. The Palmer Center for Chiropractic Research (PCCR), the largest chiropractic research institution in the nation, will execute the study in collaboration with the Yale Center for Medical Informatics, The Dartmouth Institute for Health Policy & Clinical Practice, and the University of Iowa.
The study, called VERDICT, is funded by the National Center for Complementary and Integrative Health and the Office of Research on Women’s Health at the National Institutes of Health (NIH: UH3AT009761).
VERDICT is part of an $81 million federally funded NIH-DoD-VA Pain Management Collaboratory which is an initiative designed to support large-scale pragmatic clinical trials focused on the use of non-drug pain management approaches among active-duty and veteran populations. VERDICT is one of only 11 studies being conducted through the Collaboratory.
“As opioid dependency continues to rise in the U.S., so does the need for effective, non-pharmacological care options to address chronic pain. Our outstanding multidisciplinary team has been laying the groundwork for this important study for several years and is excited to begin recruiting patients,” said Cynthia Long, Ph.D., dean of research, Palmer College of Chiropractic.
“Pragmatic studies such as VERDICT allow us to answer real-world questions about optimal chiropractic care for our nation’s Veterans and beyond. I look forward to seeing this work influence future health-care policy that impacts both doctors of chiropractic and the patients we serve,” added Christine Goertz, D.C., Ph.D., who is joining Duke University’s Department of Orthopaedic Surgery as professor and the director of system development and coordination for Spine Health on Oct. 1.
The four-year study will be carried out within four Veteran Administration clinics across the country: VA Connecticut Healthcare System; Iowa City VA Health Care System; Minneapolis VA Health Care System; and VA Greater Los Angeles Healthcare System.
The study plans to recruit 766 veteran patients, including a minimum of 20% women, to answer two questions: “Does the number of chiropractic visits have an impact on pain management?”; and “What impact does ongoing care have on pain management?”
Veterans experience higher rates of low-back pain, which negatively impacts quality of life and increases risk of opioid addiction. In 2017, the American College of Physicians announced that non-pharmacological therapies should be the first line of defense for patients with chronic low-back pain.
An estimated 20 percent of U.S. adults suffer from low-back-pain, and 23% of low-back pain patients report high-intensity pain that leads to disability. Inadequately managed chronic pain results in loss of productivity, high medical expenses and costly out-of-pocket patient expenses.
The Palmer Center for Chiropractic Research is a part of Palmer College of Chiropractic, the first and largest college in the chiropractic profession. Palmer College of Chiropractic has campuses in Davenport, Iowa; San Jose, Calif.; and Port Orange, Fla.
CVRE Investigator Award Recipient June 2019
June 14, 2019
We are pleased to announce that Dr. Snežana Urošević has been awarded the first CVRE Investigator Award. Dr. Urošević is a staff psychologist at the Minneapolis VA Health Care System whose research focuses on neural and behavioral etiological factors in bipolar disorders across the lifespan, such as abnormalities in reward processing and cognitive control. This pilot study to be funded by the CVRE Investigator Award will explore the feasibility of investigating effects of aging on brain functioning in older adults with bipolar disorders using functional magnetic resonance imaging, an area of research underexplored to date.
For more information about the CVRE Investigator award and to apply, follow the article link below.Article
Research Day 2019 - "Science of Hope"
May 1, 2019
Clues to Parkinson's and Alzheimer's From How You Use Your Computer
May 29, 2018
The Wall Street Journal
Studies by Dr. Adriana Seelye of the Minneapolis VA Medical Center suggest that monitoring how people use their computers and their driving habits may help detect early Alzheimer’s Disease. For example, Dr. Seelye and her team have shown that people with mild cognitive impairment make fewer “mouse” movements and have longer pauses between the movements than people with normal cognitive function. A follow-up study is underway in which more than 100 patients’ driving habits, medication use, and computer use will be monitored by sensors to determine the best way to diagnose early Alzheimers.The Wall Street Journal Article
2018 Research Day a Huge Success
May 16, 2018
An enthusiastic crowd of over 200 people attended this year’s VA Research Day on May 16 to recognize the accomplishments of Minneapolis VA researchers and to thank the many veterans who participate in research.
The day began with award presentations. Dr. Erin Krebs won the first annual Frank Lederle Paper of the Year award for her article in JAMA: Effect of opioids vs. non-opioid medications on pain-related function in patients with chronic pain. Dr. Arianne Baldomero won the Zieve Award for best research by a physician-in-training for her project on the relationship between oral health and COPD exacerbations.
The plenary session concluded with a fascinating presentation entitled “Venture science in regenerative medicine: Cloning to clinic” by Jakub Tolar, MD, PhD, Dean of the University of Minnesota Medical School.
Participants then proceeded to the flag atrium balcony, where they could snack on freshly popped popcorn while checking out cool new devices under development such as a therapeutic gaming system for use by stroke patients, an arm cycle ergometer, and pressurized pants to facilitate gait training.
Attendees also browsed through more than 80 posters describing studies on topics as diverse as the molecular and genetic basis of disease to clinical investigations of interventions to treat PTSD, heart disease, pain, alcohol use disorder, cancer and other conditions. One of these posters, describing Dr. J Irene Harris’ work, caught the attention of a Star Tribune reporter who filed this story a week later on treating moral wounds in soldiers.
CVRE-funded investigators take Gold and Bronze!
March 31, 2018
The University of Minnesota Dermatology group, under the leadership of Dr. Erin Warshaw, swept the awards for resident/trainee research presentations at the 2018 American Contact Dermatitis Society Meeting in San Diego in February.
Two of the winning projects were funded by CVRE…
GOLD MEDAL Goodier M, Siegel P, Zang L-Y, Warshaw EM. “Chemical Analysis of Isothiazoliones in U.S Residential Wall Paints.”
BRONZE MEDAL Boyd A. Ericson M, Warshaw E. “Formaldehyde release from textiles and personal care products.”
…and one by Hennepin County Medical Center
SILVER MEDAL Boyd AH. Warshaw E. “Allergic contact dermatitis to slime.”
Opioids no better than Tylenol
March 7, 2018
Minneapolis Star Tribune
A groundbreaking randomized clinical trial led by Dr. Erin Krebs of the Minneapolis VA Medical Center, found that opioids were no better than over the counter painkillers for back, hip, and knee pain. The study which was published in JAMA on March 6, 2018, enrolled 240 patients and followed them for 12 months. Improvements in pain-related function and pain intensity were no better in the group that received opioids than in the group that received Tylenol or aspirin-like medications.
Results of this study were mentioned by more than 50 news outlets including the New York Times, Washington Post, CBS News, CNN, FOX, and NPR.JAMA Article