The Quantitative Evaluation of the Clinical and Translational Science Awards (CTSA) Program Based on Science Mapping and Scientometric Analysis

The Clinical and Translational Science Awards (CTSA) program is one of the most important initiatives in translational medical funding. The quantitative evaluation of the efficiency and performance of the CTSA program has a significant referential meaning for the decision making of global translational medical funding. Using science mapping and scientometric analytic tools, this study quantitatively analyzed the scientific articles funded by the CTSA program. The results of the study showed that the quantitative productivities of the CTSA program had a stable increase since 2008. In addition, the emerging trends of the research funded by the CTSA program covered clinical and basic medical research fields. The academic benefits from the CTSA program were assisting its members to build a robust academic home for the Clinical and Translational Science and to attract other financial support. This study provided a quantitative evaluation of the CTSA program based on science mapping and scientometric analysis. Further research is required to compare and optimize other quantitative methods and to integrate various research results.     

The Critical Need for Academic Health Centers to Assess the Training,Support, and Career Development Requirements of Clinical Research Coordinators: Recommendations from the Clinical and Translational Science Award Research Coordinator Taskforce

Clinical Research Coordinators (CRCs) are a vital component of the clinical research enterprise providing a pivotal role in human subject protection through the numerous activities and responsibilities assigned to them. In 2006, the National Institutes of Health’s National Center for Research resources (NCRR) implemented the Clinical and Translational Science Awards program (CTSA) to advance biomedical research. As a part of this endeavor, many workgroups were formed among the Consortium to support translational research. The Research Coordinator Taskforce was created as part of the Regulatory Knowledge group of the Clinical Research Innovation Key Function Committee, and focuses on enhancing CTSA capabilities to provide support and training for CRCs. In the spring of 2008, this taskforce conducted two surveys of the then 24 CTSA Consortium members to better understand the current expectations and responsibilities of research coordinators in addition to the mechanism for providing education, training, and support in order for CRCs to successfully meet the study responsibilities placed upon them. The results of these surveys are summarized in this article and provide context to the recommendations of the Research Coordinator Taskforce for institutional considerations, approaches, and best practices for providing education, training, and support the expanding role of CRCs in fulfilling their responsibilities delegated to them by investigators. Clin Trans Sci 2012; Volume 5: 470–475     

The CTSA Mentored Career Development Program: Supporting the Careers of Child Health Investigators

Training translational scientists is a priority of the Clinical and Translational Science Award (CTSA) consortium. Objectives: 1) Describe the landscape of CTSA Mentored Research Career Development Awards (CDA) and 2) evaluate participation and outcomes of child health investigators in these programs. Design: Survey of the CTSA Child Health Oversight Committee (CC‐CHOC) and review of nonresponders'' CTSA Websites. Results: Thirty‐two of 53 CC‐CHOC members (60%) responded and all nonresponder Websites were reviewed. Institutions supported 1,166 CDA positions from 2006 to 2011, with 134 awarded to child health investigators (11.5%). Respondents reported a mean of 29.8 KL2 positions (95% CI 17.5–42.2) during their award period, with a mean of 2.8 (95% CI 1.8–3.8) awarded to child health investigators. The proportion of child health awardees varied from 0% to 50% across institutions. We identified 45 subsequent National Institutes of Health (NIH) awards to the 134 child health investigators (34%). Conclusions: The CTSA program contributes substantially to training the next generation of translational investigators. One‐third of child health investigators obtained subsequent NIH awards in the short follow‐up period demonstrating success of the CTSA CDA programs. Child health investigators are represented variably across the consortium. Pediatric institutions can partner with the CTSA program to further support training child health investigators.     

Developing the Translational Research Workforce: A Pilot Study of Common Metrics for Evaluating the Clinical and Translational Award KL2 Program

Purpose

This pilot study describes the career development programs (i.e., NIH KL2 awards) across five Clinical and Translational Science Award (CTSA) institutions within the University of California (UC) system, and examines the feasibility of a set of common metrics for evaluating early outcomes.

Methods

A survey of program administrators provided data related to the institutional environment within which each KL2 program was implemented. Application and progress report data yielded a combined data set that characterized KL2 awardees, their initial productivity, and early career outcomes.

Results

The pilot project demonstrated the feasibility of aggregating common metrics data across multiple institutions. The data indicated that KL2 awardees were an accomplished set of investigators, both before and after the award period, representing a wide variety of disciplines. Awardees that had completed their trainee period overwhelmingly remained active in translational research conducted within an academic setting. Early indications also suggest high rates of success with obtaining research funding subsequent to the KL2 award.

Conclusion

This project offers a model for how to collect and analyze common metrics related to the education and training function of the CTSA Consortium. Next steps call for expanding participation to other CTSA sites outside of the University of California system.     

Accomplishing Technology Transfer: Case-Based Lessons of What Works and What Does Not

This paper presents lessons drawn from technology transfer case studies that Address the persistent question: “What works, what does not, and why?” Each lesson highlights critical factors determining success or failure and is substantiated by case studies that exemplify the lesson. The case examples involve either the commercialization of prototype inventions (supply-push technology transfer) or the acquisition of desired technologies from other fields of application (demand-pull technology transfer). The cases present the chronology of events as they actually occurred, including supporting information from the other participants. Applying the lessons should help avoid common mistakes while increasing the likelihood of accomplishing the desired outcomes.     

Assistive Technology and AAC: An Industry Perspective

This article reviews the fields of assistive technology in general and augmentative and alternative communication (AAC) in particular from the perspective of a manufacturer and service provider. Issues that could facilitate the greater use of assistive technology by people with disabilities are identified, which include awareness, professional preparation and ethics, service delivery, and funding. The current situation is described, a desired situation is presented, and the reader is challenged with action to move in that direction.     

Students Supported by Medical Technology: Making the Transition From School to Adult Life

Transition planning for young adults with disabilities has been identified as a critical element if students are to successfully move from the safety-net of high school into adult life. Focusing on transition has become a priority for two disciplines: education and medicine. Yet, despite the importance these two fields have placed on it, few studies have addressed the transition planning issues specifically related to students with disabilities supported by medical technology. This research employed longitudinal interview techniques to gather information regarding the transition experiences of family members and students supported by medical technology. Three major themes emerged: (a) future expectations of students and parents; (b) implementation of transition planning; and (c) participation and involvement in transition planning. The unexpected factor of a student's level of cognitive impairment appeared to impact several of the findings. Overall, results of this study indicated that the majority of students supported by medical technology appeared to be receiving minimal planning during transition. The findings are discussed in terms of implications both for planning for the transition from school to adult life as well as the transition to adult health care systems.     

Assessing consumer profiles of ‘ideal’ assistive technologies in ten categories: An integration of quantitative and qualitative methods

This paper focuses on two trends in the field of disability and rehabilitation: (a) the desire to conserve resources and yet provide consumers with the highest quality assistive technologies that they find personally appealing and useful; and (b) the involvement of the consumers of rehabilitation services in key decisions regarding the products and services they receive. The Rehabilitation Engineering Research Center on Technology Evaluation and Transfer (Buffalo, NY, USA) has endeavoured to accomplish both by employing a mixed methods approach to consumer-identified needs and preferences regarding several categories of assistive technology. The purpose of this paper is to describe the methods used in sufficient detail for replication by other researchers.     

The Emergency Physician and Knowledge Transfer: Continuing Medical Education, Continuing Professional Development, and Self-improvement

A workshop session from the 2007 Academic Emergency Medicine Consensus Conference, Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake, focused on developing a research agenda for continuing medical education (CME) in knowledge transfer. Based on quasi-Delphi methodology at the conference session, and subsequent electronic discussion and refinement, the following recommendations are made: 1) Adaptable tools should be developed, validated, and psychometrically tested for needs assessment. 2) "Point of care" learning within a clinical context should be evaluated as a tool for practice changes and improved knowledge transfer. 3) The addition of a CME component to technological platforms, such as search engines and databases, simulation technology, and clinical decision-support systems, may help knowledge transfer for clinicians or increase utilization of these tools and should, therefore, be evaluated. 4) Further research should focus on identifying the appropriate outcomes for physician CME. Emergency medicine researchers should transition from previous media-comparison research agendas to a more rigorous qualitative focus that takes into account needs assessment, instructional design, implementation, provider change, and care change. 5) In the setting of continued physician learning, barriers to the subsequent implementation of knowledge transfer and behavioral changes of physicians should be elicited through research.     

Chronic Disease and Mobile Technology: An Innovative Tool for Clinicians

Chronic disease is common, costly and the epidemic of the 21st century. Primary care providers seek new and innovative approaches to prevent chronic illness. Since the majority of chronic illness management occurs outside a physician's office, providers must use different techniques to support daily self‐management of any chronic illness. Assisting the individual to develop life skills to support self‐management is one way to improve patient outcomes. Technology, that is easily accessed, may provide an additional method to develop and individual's self‐management skills to prevent diabetes.     

An Analysis of the Safety of Medication Ordering Using Typo Correction within an Academic Medical System

Objectives  Spelling during medication ordering is prone to error, which can contribute to frustration, confusion, and, ultimately, errors. Typo correction can be utilized in an effort to mitigate the effects of misspellings by providing results even when no exact matches can be found. Although, typo correction can be beneficial in some scenarios, safety concerns have been raised when utilizing the functionality for medication ordering. Our primary objective was to analyze the effects of typo correction technology on medication errors within an academic medical system after implementation of the technology. Our secondary objective was to identify and provide additional recommendations to further improve the safety of the functionality. Methods  We analyzed 8 months of post-implementation data obtained from staff-reported medication errors and search query information obtained from the electronic health record. The reports were analyzed by two pharmacists in two phases: retrospective identification of errors occurring as a result of typo correction and prospective identification of potential errors with continued use of the functionality. Results  In retrospective review of 2,603 reported medication-related errors, 26 were identified as potentially involving typo correction as a contributing factor. Six of these orders invoked typo correction, but none of the errors could be attributed to typo correction. In prospective review, a list of 40 error-prone words and terms were identified to be added as stop words and 407 medication synonyms were identified for removal from their associated medication records. Conclusion  Our results indicate, when properly implemented, typo correction does not cause additional medication errors. However, there may be benefit in implementing further precautions for preventing future errors.     

国际辅助技术服务的政策架构、核心内容和发展研究

目的 研究联合国和世界卫生组织(WHO)辅助技术服务的政策架构与核心内容,比较不同经济发展水平国家辅助技术发展现状,探讨未来辅助技术政策与服务发展。方法 基于联合国和WHO辅助技术的相关政策与理论架构,运用WHO健康服务体系构成要素的理论,分析国际辅助技术服务的政策架构与主要内容,比较全球不同经济发展水平国家辅助技术服务政策、辅助产品和服务发展,探讨国际辅助技术的政策与创新技术发展热点。结果 辅助技术服务是康复服务的重要组成部分,发展辅助技术服务是实现联合国可持续发展目标三“确保健康的生活方式,促进各年龄段人群的福祉”的关键步骤。联合国和WHO发布的辅助技术服务相关指南提供了辅助技术服务政策,其核心架构是基于联合国《残疾人权利公约》有关辅助技术内容,并具体表现在WHO《世界残疾报告》《全球残疾行动计划》《健康服务体系中的康复》和《健康服务体系中的康复：行动指南》以及WHA 71.8号有关辅助技术的决议《改善获得辅助技术的机会》等核心文件中。国际辅助技术政策核心内容旨在构建以人为本的综合保健服务,强调将辅助技术纳入公共卫生医疗体系和康复服务范畴,根据WHO健康服务的六大核心构成要素建立和发展辅助技术服务,从而提高获取优质辅助技术机会,以实现全民健康覆盖,并且在辅助产品和辅助技术服务领域,倡导技术和服务创新,形成5P辅助技术模式。高收入国家和中低收入国家在辅助技术服务政策、辅助技术产品提供以及服务覆盖率方面都面临诸多困难,存在着较大差异。未来各国辅助技术发展热点主要是采用WHO提出的5P模式进行政策和服务提供以及技术变革,辅助技术产品开发、辅助技术服务模式的创新将是未来发展的热点。结论 国际社会有关辅助技术的政策是以联合国《残疾人权利公约》为核心,并以联合国及WHO发表的辅助技术服务的相关政策文件为基础形成的,其主旨在于发展辅助技术服务,为残疾人、老年人和其他功能障碍者提供及时、适当和可负担的辅助技术服务,改善他们的健康并提升生活质量和福祉。要将辅助技术纳入全民健康覆盖,并通过初级卫生保健加强服务提供,以实现联合国可持续发展目标三全民健康覆盖的目标,实现辅助技术服务全覆盖。发展辅助技术,要将辅助技术纳入康复服务的范畴,在WHO健康服务体系的六大构成要素架构下,完善辅助技术服务的治理,通过多种机制为辅助技术服务进行筹资,培训康复人才从事辅助技术工作,改善辅助技术的服务提供,提升服务的质量,将辅助技术纳入基本医药技术,建立适应辅助技术发展的健康信息系统并对辅助技术服务提供监测。在世界不同地区,由于经济和社会发展水平的差异,辅助产品和技术服务的发展水平存在着很大差异,在获得辅助技术服务时遇到很大挑战。需要制定相关的政策、规划,并进行技术和服务创新。未来辅助技术发展将围绕辅助技术的5P模式进行产品和服务提供领域的改革以及技术创新,以提升辅助技术服务的覆盖率、有效性、可及性和可负担性,在全民健康覆盖架构下,将辅助技术服务融入健康服务体系,实现全民辅助技术服务全覆盖,提升辅助技术服务的质量和辅助技术消费者的福祉。     

全方位现代医学教育技术与人性价值观之探讨

目的学生学习历程管理系统是阳明大学医学系在医学教育领域全力开发的创举,同时也是本系从过去到未来对本系学生、台湾社会以及全球人类历史充分履行的教育使命。本研究为一多层面、多方位的动态学习历程数据库,以特殊的主动式监测系统与及时自动介入之方式,深入并分层调查、解剖、发掘并研究医学生的内部与外部环境与压力,是否影响医学生学习与精神状态,以资我们做为辅导与资源分配工作之参考。以下报告为本系统计划中分析学生压力来源以及危险因子的一部分结果,并从微观(精神医学与心理之分析)与宏观(社会与历史背景之建构)之角度,阐述此科学结果的意义。方法本历程计算机数据库重点为把每一点时间发展与环境各因素都纳入监测、评估与分析。本研究为学生学习历程管理系统计划的第一步任务:寻找并确立“红旗子”。分析方法以学生自我报告之压力为结局指标变量,了解学生最基本的社经环境因素,尤其是家庭中有无危险因子影响学生学习与精神状态。结果统计结果显示学生学习成就与父母受教育程度有关,其中母亲的教育成就与职业更影响学生的精神压力、人生态度与学习成就。医学生父母的教育程度随年提升,显示医学生入学的家庭社经状态逐年升高,亦呈现社会中个人家庭的婚配状况随大环境与时代改变。结论学生认知过程之间的关连性、家庭情况、社会价值观、精神状态以及学习行为等,皆与周遭时空的变动紧密缠结,然而针对此长期而多面向的研究却十分贫乏。身为医学教育领袖,我们需要培养鸟瞰百里视野之格局,也需有细致锐利之目光。确立红旗子之后,我们更需以阻断危险因子或加强保护因子的方式,实时协助青年学生在成长过渡时期必须同时经历世界全球化与国际化的迅速脉动、社会与家庭环境种种变革的冲击,让学生能够随时重新省思与改变学习方法,在心理上做必要的调适,以培养永续之竞争力。