Health Services and Outcomes Research

A. Questions about HSR/Outcomes Research and Biostatistics

Our deliberations led to several concerns related to the targeted questions posed in the report outline. We asked ourselves the following questions:

1. How is health services research (HSR) defined?
2. What HSR groups now exist at Vanderbilt?
3. Who are key investigators in currently structured HSR groups?
4. How do we work in HSR to avoid fracturing the integrity of the Department of Biostatistics?
5. What “unstructured” HSR efforts need biostatistical resources?
6. What is the nature of data analysis resources needed to enhance productivity of HSR research ?

The first four questions above are addressed in addenda defining HSR and describing funding and staffing in current HSR groups.

B. Regarding question 4 above

Our group expressed concern that some researchers will hire their own data analysts directly because we can’t fulfill their needs in a timely way. This is already happening.

How can we speed up recruiting (HSR and Outcomes)?

Our group believes that unjoined and unclean data are an especially critical problem in HRS and outcomes research. A part of the solution is to speed up recruiting of data handlers who can make statisticians more productive. At this point statisticians are spending too much time and effort in getting data ready for analysis. Consequently, we propose to recruit data handlers who may not have the biostatistical expertise we desire, but who can augment biostatisticians by getting data in shape for analysis. We submit that such help could be recruited from data savvy personnel with bachelor’s degrees or Masters level people in related fields who have had some experience in the data handling arena. -Specifically, we suggest

• a) sending recruiting brochures to appropriately trained candidates outside of biostatistics programs. (We might consider new graduates from local institutions such as Lipscomb, University of the South, MTSU, WKU, Austin Peay, and prestigious schools such as Birmingham Southern.)
• b) systematically monitoring the ASA job web to solicit desirable candidates.
• c) attending HSR professional meetings to seek out experienced data handlers who may be associated with good research .
• d) targeting and proselytizing qualified personnel in the greater Nashville area who may be seeking better job opportunities or who may be looking for opportunities to build experience. Some specific sources have been mentioned.

All recruiting for non Ph.D. candidates should be centralized through our present staff who can meet frequently to appraise progress and report to the Chairman.

C. How to improve work we do with health service researchers

We need to avoid having experienced statisticians spending large amounts of time doing data preparation work that could be done by non statisticians. Reading the addenda and trying to recruit following the suggestions outlined above will help to improve throughput with HSR and outcome focused researchers.

D. What journal club opportunities exist?

There is a weekly journal club for clinical fellows at the VA and VU HSR. The purpose is to teach how to read and evaluate papers in evidence based medicine. These sessions cover concept in study design and data analysis. Each week a faculty preceptor is chosen to lead discussion. Attendance is required to meet with the preceptor to discuss an assigned paper before each session. Biostatistical input would be welcomed.

VA quality scholar’s program offers a weekly seminar every Wednesday at 11:00 at VA HSR. The purpose of this seminar is to give fellows the opportunity to present their ongoing projects. They are interested in our involvement to introduce statistical tools and concepts.

All professional staff in the Department should be encouraged to read the weekly Reporter to learn what is going on in the Medical Center and throughout Vanderbilt. Anyone can choose to attend meetings of interest and to report back at Departmental meetings Attendance at these meeting will help give Biostatistics visibility and encourage interaction with other groups around campus.

Except for meetings with clients, we need to be sensitive that too many meetings can get in the way of productivity. We discourage formation of a biostatistics journal club except in the context of our regular Wednesday meetings. One suggestion is that each month one of our regular seminar sessions might be devoted to a journal club meeting.