Pan and Granger Submit PCORI Application

Kudos to Wei Pan, associate professor; Bradi Granger, professor; and their entire team for the submission of their PCORI application entitled "Leveraging Electronic Medical Records to Improve the Assessment of Pharmacological Treatment Options." This proposal requests funding for a three-year period with a June 1, 2020 start date.

Heart disease is the leading cause of death in the United States with more than 6 million adults having heart failure. A half of heart failure patients have diastolic heart failure, that is, their heart muscle contracts normally but the ventricles do not relax as they should when the ventricles relax. This condition is called preserved ejection fraction (HFpEF). The other half of heart failure patients have systolic heart failure, that is, their heart muscle does not contract effectively and, therefore, less oxygen-rich blood is pumped out to the body. This condition is called reduced ejection fraction (HFrEF). Clinical research has shown that certain drug treatments (e.g., angiotensin-converting enzyme inhibitors / angiotensin receptor blockers, beta-blockers, and mineralocorticoid receptor antagonists) for HFrEF are effective on patient outcomes, such as death rate and rehospitalization; but the effectiveness of the drug treatments for HFpEF is less conclusive. More research is needed for the effectiveness of drug treatments for HFpEF on patient outcomes. 

Thus, the overarching goals of this proposed study are to better understand the effectiveness of drug treatments for patients with HFpEF and improve patient outcomes, with the following two specific aims: (1) to compare the clinical effectiveness of major drug treatments for patients with HFpEF on death rate and rehospitalization, and (2) to evaluate the weaknesses (or sensitivity) and strengths (or robustness) of the comparison study in Aim 1.

To achieve the desired outcomes of the aims, we planned to conduct a comparative effectiveness observational study using the information-rich electronic medical records. The use of electronic medical records will help researchers and clinicians understand which drug treatment benefits the most to which type of patients in real-world settings, such as older patients with high blood pressure. The evaluation of the sensitivity and robustness of the comparative effectiveness observational study will help patients and clinicians build confidence in making informed decisions in selecting effective drug treatments for patients with HFpEF. The stakeholders consisted of researchers, patients, and clinicians will be engaged in the entire course of the proposed study, from drafting the proposal to carrying out the research to disseminating study findings, through quarterly patient feedback sessions and stakeholders' advisory meetings, with the ultimate goal of improving patient outcomes.