Current SORCE Projects
While SORCE started in the surgical outcomes research arena, it has grown into a full service administrative hub for multicenter collaborative research and quality improvement at the regional and national level, a learning healthcare system, and a provider of services such as registry building and collaborative development.
Comparison of Intravesical Therapy and Surgery as Treatment Options for Bladder Cancer (CISTO)
Funder: Patient-Centered Outcomes Research Institute (PCORI)
CISTO is a prospective observational cohort study comparing intravesical therapy with removal of the urinary bladder, or radical cystectomy, for patients with non-muscle-invasive bladder cancer (NMIBC) that recurs after treatment with intravesical Bacillus Calmette-Guerin (BCG). This study is responsive to the PCORI Priority Topic: Studies of patients with NMIBC who failed first-line treatments. We will evaluate our research question on a large scale in real world practice settings and examine patient-centered outcomes including quality of life (QOL), survival, progression to muscle-invasive bladder cancer, patient preferences, and caregiver burden. This study aims to compare patient-reported and patient-centered clinical outcomes between patients undergoing radical cystectomy and those receiving bladder-sparing intravesical therapies for NMIBC that have failed first-line BCG and to characterize the heterogeneity of treatments received and corresponding patient and caregiver preferences for NMIBC that have failed first-line BCG.
The Comparison of Surgery and Medicine on the Impact of Diverticulitis (COSMID)
Funder: Patient-Centered Outcomes Research Institute (PCORI)
COSMID is a pragmatic, patient-level randomized superiority trial of elective colectomy vs. best medical management for patients with quality of life (QoL)-limiting diverticulitis. The COSMID trial focuses on both patient-reported outcomes and clinical outcomes that matter to patients. The results are expected to establish an evidence-based approach to the care of millions of patients per year in the United States and help people impacted by this common condition make more informed treatment decisions. The goal of the COSMID trial is to answer the question: For patients with QoL-limiting diverticulitis, is elective colectomy more effective than best medical management? The study will aim to investigate and complete the following objectives: Compare patient-reported outcomes such as quality of life in patients with QoL-limiting diverticulitis randomized to elective colectomy vs. best medical management; compare clinical outcomes such as number of subsequent episodes of diverticulitis between patients with QoL-limiting diverticulitis randomized to elective colectomy vs. best medical management; and compare healthcare utilization between patients with QoL-limiting diverticulitis randomized to elective colectomy vs. best medical management.
Comparing Outcomes of Drugs and Appendectomy (CODA)
Funder: Patient-Centered Outcomes Research Institute (PCORI)
For the past 130 years, appendectomy (the surgical removal of the appendix) has been the standard treatment for appendicitis. However, recent studies from Europe have challenged the notion that surgery is the best option by showing that antibiotics alone can work to treat appendicitis. Five randomized trials involving over 1000 patients have now shown that using antibiotics alone to treat appendicitis can result in acceptable outcomes without the need for surgery in most people. These results are starting to change the way surgeons in Europe treat appendicitis. For example last October, Rafael Nadal, the tennis superstar, was diagnosed with appendicitis at the start of the Shanghai Open. Hoping to go on playing in the tournament, he tried a course of antibiotics instead of surgery. Although he eventually went on to have an appendectomy, the decision he and his doctors made about antibiotics instead of surgery indicates just how influential these studies have been in Europe. Alternatively, US surgeons have pointed to problems with these studies and are reluctant to change their practice until a large-scale, rigorous trial is conducted. As of 2014, less than 1.5% of all people with appendicitis in the US were treated with antibiotics. This 5-year grant will determine if it time to change our approach to treating appendicitis from offering appendectomy-first to antibiotics-first.
The Effectiveness, Safety, and Costs of Guideline-Concordant Lung Nodule Care
Funder: National Cancer Institute (NCI)
This study examines the varying intensities of diagnostic evaluation for incidentally detected lung nodules at multiple sites and aims to: (1) compare rates of early-stage lung cancer; (2) compare rates of harm (radiation exposure and procedure-related adverse events); and (3) compare two-year total costs of care.
The Diverticulitis Examination of Patient Burden, Utilization & Trajectory (DEBUT)
Funder: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
To determine if the observed, dramatic increase in the use of elective surgery for diverticulitis is consistent with recommendations about delayed intervention, this study will (1) use a national claims data for a population-level assessment of current patterns of care related to numbers of episodes of treated diverticulitis prior to elective resection; (2) compare how often patients undergoing early versus delayed resection and young vs old report clinical and non-clinical factors as the reason for elective resection; and (3) assess how often patients have symptoms related to diverticulitis, patient-reported outcomes, and the burden of the disease over time. Addressing these evidence gaps using national and statewide data should help inform patient and clinician decision-making and will be critical in the development of future comparative studies of strategies related to elective colon resection and other novel treatments for diverticulitis.
Assessing Surgical Site Infection Surveillance Technologies (ASSIST)
Funder: Centers for Disease Control and Prevention
Visit our website to read Health Technology Assessment report.
The increasing use of mobile devices by patients to send images and text messages to surgeons and care teams after surgery presents new opportunities for both clinical and public health practice. Used wisely, this rapidly evolving application of information technology can produce enormously important benefits for individual patients, ambulatory surgical centers and hospitals, practitioners, and infection surveillance and prevention of surgical site infection (SSI).
Assessing Surgical Site Infection Surveillance Technology (ASSIST) is a project funded by the Centers for Disease Control and Prevention SHEPheRD program to evaluate the use of patient-generated health data (PGHD) and mobile devices in post-operative SSI surveillance. This evaluation has culminated in a Health Technology Assessment (HTA) report which presents our findings. The HTA outlines best practice recommendations and gaps in current knowledge on the use of mobile devices and PGHD in SSI surveillance in several areas, including practice, research, and public health surveillance to address CDC’s clinical and public health priorities.
As part of our work we are inviting public comment on the HTA, which will be posted on our website between January 7th and February 28th, 2019. We invite you to come to https://assisthta.wixsite.com/project/blog to review the HTA report and provide comment. Feedback will inform revisions to the HTA submitted to CDC.
Thank you,
The ASSIST Project Team
Clinical Learning, Effectiveness And Research (CLEAR) Center
Funder: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
The UW Center for Clinical Learning, Effectiveness And Research (CLEAR Center) was established as a Core Center for Clinical Research (CCCR) by the National Institutes of Health (NIH)/National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) to establish a research center to promote musculoskeletal clinical research and accelerate the implementation of new diagnostic and therapeutic approaches. The CLEAR Center will initially focus on common musculoskeletal conditions such as the diagnosis and treatment of back pain, including interventions such as imaging tests, physical therapy, opioids, spine injections, and spine surgery. The CLEAR Center will catalyze high-quality, multi-institutional collaborations by developing new approaches and methods for conducting clinical musculoskeletal studies and by providing analysis-ready data for scientific investigators.
Vascular Ehlers-Danlos Syndrome Collaborative
Funder: Patient-Centered Outcomes Research Institute (PCORI)
To establish a formal infrastructure for a stakeholder community (VEDS patients, caregivers, and clinicians) to advise research intern teams on questions that matter most to patients.
Developing Design Principles to Integrate PROs into Clinical Practice Through HIT: Data, User Experience, and Workflow Requirements for PRO Dashboards
Funder: Agency for Healthcare Research and Quality (AHRQ)
Utilizing systems engineering methods, human-centered design, and mixed-method approaches, the proposed studies assess healthcare practitioner (physicians, physician assistants, advanced practice providers, nurses, and allied health professionals) perspectives and workflow needs to inform design principles for the meaningful integration of PROs into clinical practice through HIT platforms. This study will (1) evaluate the information needs and healthcare decision making processes regarding the integration and interpretability of PRO data; (2) specify healthcare practitioner user requirements for interactive PRO visualizations through human-centered methods; and (3) characterize clinical workflow needs and impact associated with integration of PROs into clinical care activities through HIT platforms.
Institute of Translational Health Sciences (ITHS) Community Engagement
National Center for Advancing Translational Sciences (NCATS)
The Institute of Translational Health Sciences (ITHS) is dedicated to speeding science to clinic practice for the benefit of patients and communities throughout Washington, Wyoming, Alaska, Montana, Idaho, and beyond. ITHS promotes this translation of scientific discovery to practice by fostering innovative research, cultivating multi-disciplinary research partnerships, and ensuring a pipeline of next generation researchers through robust educational and career development programs. As part of the NIH Clinical and Translational Science Awards, ITHS was recently renewed for an additional 5-year cycle. CERTAIN’s Patient Advisory Network was brought on to the Community Engagement Program within ITHS, to better support how patients and other stakeholders are integrated into ITHS research and services.
Practice Transformation Network Patient-Reported Outcomes (PTN PROs)
Funder: Centers for Medicare and Medicaid Services (CMS)
This project aims to improve health outcomes for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries, to reduce hospitalizations and unnecessary healthcare utilization, and to help practices complete the phases of transformation to ready them for shared-risk and incentive-based contracting.
Gastrointestinal Surgery Outcomes Research Fellowship
SORCE has a T32 training grant from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) that funds two new fellows per year in health services and outcomes research training. Trainees work with a mentor on a wide variety of projects that expose them to several areas of health services research and complete coursework to obtain a Masters in Public Health (MPH) degree over the course of the two-year training program.
Undergraduate Practical Research Education Program (U-Prep)
The mission of the U-Prep internship program is to provide interns with a rigorous, high-quality supervised practical research experience that complements the academic foundation presented in the classroom. Interns will be actively involved in outcomes research projects, developing and applying technical skills, and exploring career options in the professional setting - in preparation for postgraduate studies and employment.
OB/GYN Outcomes Research
Begun in 2014, SORCE and the Department of Obstetrics (OB) and Gynecology (GYN) invested in building an outcomes research program for early-stage OB/GYN researchers. Early career faculty are supported through the development of their research programs with SORCE project leads, analysts, grant writers, and more. We currently have three faculty participating in this partnership. Already, this partnership has led to one faculty member applying for and being awarded the opportunity to represent UW on the American Urogynecologic Society Junior Faculty Network.
Orthopaedic and Sports Medicine Outcomes Research
Begun in 2017, SORCE and the Department of Orthopaedics and Sports Medicine invested in building a health services and outcomes research program for orthopaedic surgery. Early career faculty are supported through the development of their research programs with SORCE project leads, analysts, grant writers, and more. We currently have one faculty member participating in this partnership who has extensive experience with the SORCE group and is developing research in the areas of shared decision making and patient reported outcomes measures.
National Surgical Quality Improvement Program (NSQIP) and Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)
NSQIP is a risk-adjusted data collection mechanism that collects and analyzes surgical clinical outcomes data. SORCE partners with several local medical centers for abstraction of general, bariatric, and gynecologic surgical cases.
Surgical Care and Outcomes Assessment Program (SCOAP)
SCOAP is a physician led, voluntary Washington State collaborative for quality improvement for surgical procedures. SORCE partners with several local medical centers for abstraction of general, vascular, and spine surgical cases.