NIH GRANT AWARDED to MARINO CENTER

Studies in Patient-based Informatics for Comparative Effectiveness Research (SPICER)

The Marino Center, along with the University of Arizona, has been awarded a grant to study the comparative effectiveness of Integrative Medicine. The entire project award is just under 1 million dollars, with about half allocated to the Marino Center.

With the help of this grant money, we will examine the immense amount of clinical data, created daily at the Marino Center, to generate knowledge on the comparative effectiveness of treatment modalities. We will compare alternative and complementary therapies among themselves, and with conventional medicine. Traditionally medical research has relied on randomized controlled trials (RCTs) with specific focus. While RCTS's remain the gold standard for testing narrowly-focused questions, it has become increasingly clear that not all important questions about the delivery of health care can be answered by RCTs. Looking at real-world clinical encounters is a new way of conducting and thinking about research.

Ours is an observational study using event-stream analysis to provide patient-centered results. We will start by looking at four common conditions: back pain, fibromyalgia, irritable bowel syndrome, and peri-menopause. It is anticipated that further studies will also be done. While we intend to produce important disease-specific results from this project, we consider it a first step toward a much larger enterprise for changing how clinical research articulates with clinical practice. The long-range goal of this project is to create a sustainable model for collaboration of multiple clinical centers for conducting focused observational comparative effectiveness studies within and across multi-modality clinics, including more complex health care delivery systems and a very broad range of modalities.

Potential impact
1. Determine useful clinical treatments by providing patient-centered, evidence based medical information extracted from trajectories of care.

2. Improve research in IM by opening opportunities to mine clinical databases while maintaining scientific rigor.

3. Organize the collective experience and wisdom of medical practitioners in a way that spans medical systems, and bring the best treatment to each individual patient.

4. Create methodology that can develop neglected aspects of health and healing, such as patient choice and patient-practioner interactions.

Steering Committee:
Marino Center
Anne McCaffrey, MD, MPH
Robert DeNoble, MBA
Jennifer Cao, LicAc
Dan Himick

University of Arizona
Mikel Aickin, PhD
Ken Pelletier, MD