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Thursday, May 15, 2014

Opening Remarks

Dr. Linda Porter, Office of Pain Policy, NINDS, opened the meeting

Discussion: Co-fund process for overlapping areas of IC interests:

Dr. Linda Porter initiated the discussion of assignments of new applications that are of shared interest across multiple ICs.   Referral guidelines are helpful, but for pain-related research grants in particular, there may need to be more tailored guidelines for initial IC assignments.  The group will organize a meeting on referral guidelines to discuss updates on pain-relevant language to include in the revised NIH referral guidelines. A coordinated effort to update the pain research IC referral guidelines across NIH should provide CSR with helpful information to assign applications to the most appropriate institute or center.  Members also discussed means to establish a standardized process for co-funding of pain related applications that cut across interests of more than one IC.  The upcoming FOA on Chronic Overlapping Pain Conditions may be useful as a model/pilot for the new referral and co-funding process. For example, grants involving multiple chronic pain conditions are of potential interest for multiple ICs, but need a primary assignment and might be appropriate for co-funding pending review.

Update: NIH-Stanford Registry, Dr. Sean Mackey, Stanford University 

Dr. Sean Mackey presented an update on progress of the data registry that is co-funded by the NIH Pain Consortium and Stanford University.  The Health Electronic Registry of Outcomes (HERO) is an open source platform for measuring health outcomes. The goal of HERO is to develop, implement and expand an open source, standard, highly flexible, and free, health and treatment registry.  This registry will be used to collect outcomes data on large numbers of patients suffering from chronic pain.  The registry will have features to facilitate seamless data entry to support clinical decision making.  It is on a flexible platform that uses standard industry tools for ease of use for patients, staff, and physicians.  The HERO framework is linked to NIH PROMIS computer adaptive testing (CAT) surveys. HERO runs on all web-enabled devices, with initial and follow-up surveys taking approximately 22 and 9 minutes, respectively.  , Over 3500 unique patients and over 10,000 longitudinal data assessments currently are included.  HERO may be used as a platform for pain research by generating preliminary data and allowing for dynamic and systems studies of pain.  It may also be used for clinical practice by recording individual patient data and providing information for dynamic treatment of pain.  Among future plans for the registry, specific modules for practice needs and conditions will be created as well as a provider interface to input data. In addition, data integration with electronic medical records is being considered.  Finally, a large goal for HERO is to expand to multiple clinics/sites and partner with other academic centers, with the ultimate goal of changing health care nationally.

Discussion: Portfolio Analysis Coding for 2012

Drs. Linda Porter, Cheryse Sankar, and Tara Schwetz (Office of Pain Policy) opened the discussion on the upcoming data call for 2012 pain-related research grants.  The Interagency Pain Research Portfolio (IPRP) Database is now online and searchable (paindatabase.nih.gov). It currently includes 2011 data, and will be updated on a yearly basis. The 2011 data call involved coders from individual ICs and IPRCC federal agencies that categorized grants by Tier 1 (Basic, Translational, Clinical), Tier 2 (29 detailed secondary categories) and Pain Condition(s). Following analysis of the 2011 data, some secondary categories were re-defined and re-organized to reduce redundancy and clarify categorization. In addition, nine overarching themes were added.  To ensure that coding is uniform and reproducible, the idea was raised to have a small group of coders that would be responsible for coding all of the grants.  This issue was discussed and it was determined that initial coding would stay with the individual ICs, and a small group of quality control coders would then review the grants for any apparent inconsistencies.  The Office of Pain Policy will solicit coders from each IC and provide specific coding instructions.  It is anticipated that 2012 grant coding will begin early this summer.

Discussion: Future Opportunities NIH-Stanford Registry

Dr. Dave Thomas (NIDA) discussed the funding status of the NIH-Stanford Registry.  Funding has been secured for the remainder of 2014.  He stated that there would need to be a plan put in place for subsequent years.

Update: Opioids and Chronic Pain Workshop

Dr. Dave Thomas provided an update on the Pathways to Prevention: Opioids and Chronic Pain Workshop.  The workshop will take place September 29th and 30th, 2014.  Speakers have been invited, and registration will open in June. The draft evidence report for the opioid workshop will be available and posted for public comment in July. The final report will be released the first day of the workshop (Sept. 29th). More information may be found here.

Update: Centers of Excellence in Pain Education (CoEPEs)

Dr. Dave Thomas provided an update on the Centers of Excellence in Pain Education (CoEPEs).   The Pain Education Special Interest Group meeting focused on the CoEPEs was held at the 2014 American Pain Society meeting.   Dr. Thomas announced the release of an online training module created as pain care curriculum by the University of Pittsburgh CoEPE.  The module uses an older woman, “Edna,” with chronic lower back pain as a case study.  The module was shown to greatly improve medical student clinical skills (publication).  More information may be found here.