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Research Data Sources


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Finding Research Data Sources for Populations in Rural Virginia

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Research Data Sources

  1. 1. Finding Research Data Sources for Populations in Rural Virginia Rural Resident Research Symposium UVA-Wise, April 28, 2015 Susan L. Meacham, PhD, RDN Professor of Nutrition Discipline of Family Medicine, Preventive Medicine and Public Health
  2. 2. “The Question” Where do I find data on rural populations to answer hypothesis driven research questions? Appalachia, VA Lewisburg, WV
  3. 3. Public Data Sources for Chronic Disease Study in Central Appalachia, Virginia Appalachian Regional Commission, Centers for Disease Control and Prevention, County Health Rankings and Road Maps, National Center for Health Statistics, U.S. Energy Information Administration,, Virginia Cooperative Extension, Virginia Department of Health, Virginia Diabetes Council, Virginia Rural Health Association, Virginia Tobacco Indemnification and Community Revitalization Commission,
  4. 4. Presentation learning objectives  Identify primary and secondary sources of data  Recognize the procedures needed to obtain approvals to use personal record information in research  Locate common sources of county, district and state level data for rural populations “Case study” - VCOM’s Study of Chronic Health Conditions in Central Appalachia Funding source: “This study is sponsored by Initiative for Environmental Science (ARIES). ARIES is an industrial affiliates program at Virginia Tech, supported by members that include companies in the energy sector. The research under ARIES is conducted by independent researchers in accordance with the policies on scientific integrity of their institutions. The views, opinions and recommendations expressed herein are solely those of the authors and do not imply any endorsement by ARIES employees, other ARIES-affiliated researchers or industrial members. Information about ARIES can be found at”
  5. 5. Quick review of human research process* I. Literature Review (thorough) 1. PubMed, BioMed, Central (free),Clinical 2. CINAHL (Cumulative Index to Nursing and Allied Health) II. Type of research 1. Meta-analysis, Case study or 2. Hypothesis driven vs descriptive report 1. Clinical or Basic science 2. Qualitative (ex: oral histories) or quantitative 3. Plan for statistical evaluation, i.e., power analysis *Research, def. = “careful or diligent search”, is not necessarily slow – but deliberate! Encourage team to be patient…
  6. 6. Quick review of human research process III. Approvals (research is published, adds to body of knowledge; other communications ‘reports’) 1. Certification of training in the protection of human subjects* (NIH, CITI) for personnel 2. Institutional Review Board (IRB) approval for protocol 3. Possibly also: a. Joint or reliance agreement IRBs with partners, - HIPAA privacy compliant if medical record reviews b. Business and regulatory agreements, etc. *subjects vs patients vs clients IV. Network
  7. 7. Network - access local offices, knowledgeable persons
  8. 8. VCOM ARIES Study I. Primary sources of data: A. Data collected, are original and collected for the first time by the researcher – a. Ex: surveys, record reviews, measurements b. Limitations – approvals, costs, time/labor, field visits II. Secondary sources of data: A. Data collected by someone else for their purposes a. Ex: Cancer, Heart, Diabetes organizations, Health Dept., Appalachian Regional Commission, etc. b. Limitation – may not capture everything you want
  9. 9. VCOM Study Information Extracted I. Outputs – from primary and secondary A. Demographic data a. Gender, age (> 18 adults only) b. Geographic – state, health districts, county, zip codes, distressed areas, latitude/longitude of residence c. Temporal - Longitudinal (over 50 yrs, 1960-2012) Cross sectional (point in time, 2011/2012) d. IDC codes for conditions of interest e. Personal/Family histories f. Lifestyle-smoking, physical activity, alcohol, drug use g. Environment – coal, air, water, soil, fast food, access to care
  10. 10. 1980 1980 2008 VA total Buchanan County Wise County (Taber VCOM OMS II, AOF Nominee) Source: U.S. Energy Information Administration, Government Coal production in Southwest VA, 1980 - 2008
  11. 11. 1980 Tobacco production trends in VA, 1980 - 2008 Gordon Groover, PhD, Virginia Cooperative Extension, Department of Agricultural and Applied Economics, 2012
  12. 12. Geographic areas in VA Regional Data Poverty Percentage (%)Diabetes Obesity Southwest (SW), Southside (SS), Eastern VA Source: Virginia Rural Health Association, Data Portal, 2012 (discontinued)
  13. 13. Environmental/Economy data – 1999-2012 - Tobacco commission gave $458.5 million to farmers; Communities given $131 mil for agribusiness, education, economic development, added research and development. VA counties in Appalachian Regional Commission,1963 (left)
  14. 14. All cause age-adjusted mortality rates for males and females in SW and SS VA plotted for each decade, 1960-2012 (95% CI)(VCOM, VDH, UPITT). Results: County Data, Aggregated by decade Males Females What went ‘right’ in tobacco counties?
  15. 15. Diabetes Trends US, VA and Appalachian VA A. Snyder, OMS III, VCOM Summer Research Award, 2012; AOF Nominee 7.6 20.9 VA Adult (%) Diagnosed Diabetes, 1994 – 2011, CDC US Adults (%) Diagnosed Diabetes, 1980–2011, CDC Virginia Diabetes Association, State Plan for Diabetes Management 2008=2017
  16. 16. VDH Vital Statistics Birth Defects Data 1998 Similar data, different outcomes presented
  17. 17. County Data, secondary Coal (N=8) Mean + SD Tobacco (N=12) Mean + SD Compare (N=12) Mean + SD VA total Air Quality 12.7 + 0.3 12.7 + 0.3 12.9 + 0.2 12.7 Water Violations 6.4 + 15.4 4.0 + 11.5 + 18.9 6 Poor Mental Health Days 4.0 + 1.1 4.4 + 4.5 + 1.2 3.1 Mental Health Provider Ratio 5005 + 2093 93297 + 4298 + 6277 1027 Motor Vehicle Crashes 26.6 + 9.3 23.6 + 6.7 21.3 + 4.7 11 VCOM Environmental Factor Results – note variability and large standard deviations
  18. 18. Facility #1 Coal – Dependent Community Hospital Chronic Disease < 99% Male/Female 52%/47% Caucasian 99% Coal Miner 31% Individual Data, primary VCOM Phase III Preliminary Results Electronic Medical Record Review (EMR) N = 200 records from 2012 admissions, systematic randomization
  19. 19. Diagnosis Confirmed bySelected Clinical Condition Numbers of Records Phys’ Note ICD # Lab Results Clinical Exam Diabetes Mellitus (ICD9, 250) 62 62 62 61 Other Metabolic and Immunity Disorders (ICD9, 270-279) 111 110 111 108 Mental Disorders (ICD9, 300-316) 96 92 64 92 Ischemic Hrt Dis (ICD9, 410-414) 66 65 66 65 Chronic Bronchitis (ICD9, 491) 86 85 83 85 Other ICD 9 Codes… 155 153 151 149 VCOM EMR Diagnosis Confirmation Individual Data
  20. 20. EMR review will provide individual level data and location information with improved geographic specificity, to provide for improved future health care programming. VCOM Phase III Outcome expected Visualization of data
  21. 21. I. Visualization and data display a.Figures/Tables b.Maps c. Video (from D. Meisha, VCOM, Research Statistician) NGE&qs=n&form=QBVR&pq=ted%20talk%20data%20visualizaition%20of%20country%20population%20change&sc=0-29&sp=- 1&sk=#view=detail&mid=1D351C9B4D1BE67595361D351C9B4D1BE6759536
  22. 22. Summary of Future Directions for VCOM Phase III complete continuing medical record reviews with: - established relationships in hospital facilities - geographic, rural, economic comparable disparate health areas of southern and eastern VA - further study of VA – WV prevalence rates of chronic disease, i.e. income comparisons - expand study of physical environment factors; focus on air, soil and water quality and links to biochemical mechanisms - continue focus on VDH birth data proposal - continue focus on mental health
  23. 23. Conclusions/Discussion Our current data confirms inadequate evidence to support previous publication results on MTM effects on chronic conditions Need for multidisciplinary, collaborative approaches to study mechanisms of cause – effect relationships Need to know what’s ‘right’ in positive trends in health disparities
  24. 24. - Medical facilities administration and staff! - VCOM Students - VCOM OMS III 2015 – A. Snyder, Elective Summer Research - VCOM OMS II 2016 – T. Taber, A. Whitener, D. Metzger - VCOM OMS I 2017 – Katie Kennedy, Kristy Atkinson - Western Illinois University – C. Goessl, Public Health Intern, VT PH - C. Hall - VCOM Staff – Calvin, Kelly, Angie, Annette….etc… - Development/Outreach – D. J. Sutphin, M. Harris, L. Liechtner, M. Breeding, K. Yancy - Office of Research – K. Nicewander, G. Reaves, D. Bennett, - NCAHD – A. Peton, S. Richards , K. Price - VRHA – B. O’Connor - OMNEE staff – W. Stevens, T. Maddy, J. Lucas - VCOM Faculty (DO/MD/PhD/DVM/DDS) - S. Sukpraprut, R. Hendershot, S. Olgun, H. Misra, J. Mahaney, D. Meisha - VCOM Administration, D. Tooke-Rawlins, J. Mahaney, D. Sutphin - ARIES, VA Center for Coal /Energy Research, M. Karmis, J. Craynon - Virginia Department of Health – D. Woolard, C. Reynolds, J. Rainey - University of Pittsburgh, J. Buchanich, E. Talbott, A. Potter Acknowledgements Thanks to all !