Advancing Health through Tailored Solutions

A community-based approach toward advancing personalized medicine in underserved populations 

$49K GC Exploratory Research Grant

Co-PIs: Kathleen A. Culhane-Pera, Family Medicine; Robert J. Straka, Experimental & Clinical Pharmacology; Bharat Thyagarajan, Laboratory Medicine & Pathology

Team Members: Jeffrey Bishop, Experimental & Clinical Pharmacology; Muaj Lo, West Side Community Health Services; Heather Zierhut, Genetics, Cell Biology, & Development

The project brings local and statewide relevance to the nationally supported NIH “Precision Medicine Initiative.” The impact of recent advances in the genomic era will be fully realized only if genetic knowledge is equally accessible and fully understandable to all members of our society. By partnering with members of the Minnesota Hmong community, and using community-based, linguistically and culturally sensitive approaches, we aim to increase inclusion and understanding about variations of genes that influence medication effectiveness, called very important pharmacogenes. As these select pharmacogenes modulate response to drug therapy, the overall goal is to mitigate the otherwise growing health disparities of knowledge, significance, and application of this information to members of our Hmong community and the clinicians that treat them. Advancing our knowledge of genomic data in unique populations is expected to improve clinical decision making for the selection and use of common therapeutic medications that impact clinical outcomes.

Development of a clinical precision medicine program in ovarian cancer as a paradigm for 21st-century tailored health care solution

$60k GC Exploratory Research Grant

Co-PIs: Constantin Aliferis, Institute for Health Informatics, Medicine; Joshua Baller, Supercomputing Institute; Pamala Jacobson, Experimental & Clinical Pharmacology; Andrew Nelson, Laboratory Medicine & Pathology; Boris Winterhoff, Obstetrics, Gynecology & Women’s Health

Team Members: Ahmad Abusalah, Institute for Health Informatics; Peter Argenta, Obstetrics, Gynecology & Women’s Health; Subbaya Subramanian, Surgery; Martina Bazzaro, Obstetrics, Gynecology & Women’s Health; Linda Carson, Obstetrics, Gynecology & Women’s Health; Melissa Geller, Obstetrics, Gynecology & Women’s Health; Mahmoud Khalifa, Laboratory Medicine & Pathology; Sally Mullany, Obstetrics, Gynecology & Women’s Health; Steve Shen, Institute for Health Informatics; Tim Starr, Obstetrics, Gynecology & Women’s Health; Gyorgy Simon, Institute for Health Informatics; Zachary Rivers, PhD student in Social and Administrative Pharmacy; Locke Uppendahl, Obstetrics, Gynecology & Women’s Health clinical fellow in Gynecologic Oncology, Obstetrics, Gynecology & Women’s Health; Zenas Chang, clinical fellow in Gynecologic Oncology; Salman Ikramuddin, third-year UMN medical student

A key barrier to developing better treatments for ovarian cancer, the deadliest of all female malignancies, is the ability to stratify the disease into clinically meaningful subtypes. This in part explains why the current therapeutic regimen for treating ovarian cancer has had such a low success rate; we are treating a heterogeneous collection of tumors with a “one size fits all” regimen. Despite significant progress in genomics and disease biology, ovarian cancer has not yet moved into the arena of precision medicine. The aim is to integrate comprehensive genomic platforms into a coherent structure and develop a tool to stratify ovarian cancers into specific biological subtypes. We are proposing to prospectively enroll ovarian cancer patients and stratify them into molecular subtypes to develop a precision medicine program to individualize treatment. This universal clinical precision medicine platform can then be applied to other cancers and disease processes.

Keys to preventing cancer: Unlocking barriers to HPV vaccinations in low-income countries

$50k GC Exploratory Research Grant includes $30k international enhancement award/Global Programs & Strategy Alliance

Co-PIs: Nicole E. Basta, Epidemiology & Community Health

Team Members: Fareed A. Awan, Philosophy; Cecily Banura, Child Health & Development Center, Makerere University; Joseph Rujumba, Department of Pediatrics and Child Health, Makerere University; Shalini L. Kulasingam, Epidemiology & Community Health; Ruby H. Nguyen, Epidemiology & Community Health. Current Students: Kimberly Bonner, PhD student in Epidemiology & Community Health; Katie Gravagna, undergraduate; Daymian Snowden, undergraduate; Alexandra Mueller, undergraduate

Vaccinating against Human Papillomavirus (HPV) is an effective method for preventing infections that can lead to cervical and other HPV-associated cancer. In many resource-limited settings where access to cancer screening and treatment is limited and cancer incidence and mortality are high, preventing HPV infection is a critical step towards reducing suffering. We aim to identify and minimize barriers that prevent adolescents from receiving HPV vaccine in low-income, high-burden settings. Uganda introduced a national HPV vaccination program in 2015. Our research will evaluate the program’s HPV vaccine uptake, identify those at greatest risk of missing vaccinations, and assess the feasibility of implementing novel interventions to increase vaccination. We will contribute to the globalization of the undergraduate curriculum by developing research ethics case studies and datasets to enhance understanding of diverse global perspectives and challenges involving population health and ethics. Ultimately, the goal is to develop tailored solutions to ensure that HPV vaccination reaches those in greatest need.

Are networks key to solving America’s healthcare crisis? 

$50k GC Exploratory Research Grant

Co-PIs: Barbara Daniels, Medicine; Russell Funk, Strategic Management & Entrepreneurship; Aks Zaheer, Strategic Management & Entrepreneurship

Total U.S. healthcare expenditures are the highest in the world, at 17 percent of GDP, or roughly $3 trillion. But U.S. healthcare outcomes are ranked no better than 37th in the world. Understanding how to “bend the curves” of ever-increasing cost and diminishing quality outcomes consequently emerges as a most complex and difficult conundrum for society today.
The Affordable Care Act of 2010 introduced an organizational innovation—the Accountable Care Organization, or ACO—which combines incentives for cost reduction with incentives for healthcare quality. Within this context, we ask: How can ACOs overcome clinical and administrative complexity in the process of delivering lower cost and higher quality care? Using large Medicare datasets of up to 60 million and fixed effects models over the period 2013-2015, we seek to demonstrate that when the network of relationships among ACO member organizations is stronger and better integrated, cost and quality outcomes are superior.

Toward a Minnesota model for brain health in youth sports 

$48k GC Exploratory Research Grant

Co-PIs: Bharathi Jagadeesan, Radiology; Christophe Lenglet, Radiology; Toben F. Nelson, Epidemiology & Community Health; Francis Shen, Law

This Grand Challenges project is a new collaboration between six researchers across five different units, all focused on various aspects of traumatic brain injury. In 2011, Governor Dayton signed into law a new set of protocols to govern the treatment of concussions experienced by youth athletes in Minnesota. But we know little about the quality of information and effectiveness of treatment provided to student-athletes, including potential disparities of treatment across ages, sports, or regions. Nor do we know if students are receiving the care they need to succeed in the classroom (i.e., “Return to Learn”) after concussion incidents. The University of Minnesota is well poised to provide an interdisciplinary response to fill these research gaps, inform policy, and improve the health of Minnesota’s youth athletes. The project has four interrelated objectives: (1) to establish a campus-wide working group on traumatic brain injury (TBI); (2) to conduct a pilot study on the implementation of Minnesota’s 2011 sports concussion law and on current practices in the identification, evaluation, and treatment of youth sports concussions; (3) to host a statewide summit, in partnership with community partners, to disseminate best practices and identify statewide needs; and (4) to develop grant proposals to secure funding in order to create a Minnesota Model for addressing the challenge of youth sports TBI.

Minnesota Precision Medicine Collaborative: Transforming health and advancing equity 

$500k GC Interdisciplinary Work Group Collaboration

Co-PIs: Constantin Aliferis, Institute for Health Informatics; Pamala Jacobson, Experimental & Clinical Pharmacology; Catherine McCarty, Family Medicine and Biobehavioral Health; Kingshuk Sinha, Supply Chain & Operations; Susan M. Wolf, Law, Medicine & Public Policy; Douglas Yee, Hematology, Oncology and Transplantation

Team Members: Bonnie LeRoy, Genetics, Cell Biology, & Development; Logan Spector, Pediatric Epidemiology & Clinical Research; Sophia Vinogradov, Psychiatry; Gerald August, Family Social Science; Abbie Begnaud, Pulmonary, Allergy, Critical Care & Sleep Medicine; Jeffrey Bishop, Experimental & Clinical Pharmacology; Joseph Gaugler, Nursing; Dorothy Hatsukami, Psychiatry; John (Riley) McCarten, Neurology; Ahmad AbuSalah, Institute for Health Informatics; Susan Berry, Pediatrics; Marilyn Bruin, Design, Housing & Apparel; Milton (Mickey) Eder, Family Medicine & Community Health; Patricia McCarthy Veach, Educational Psychology; Heather Zierhut, Genetics, Cell Biology, & Development; student researchers: Anna Wagner, Kelsey Moriarty, Lilly Zhong

The Minnesota Precision Medicine Collaborative (MPMC) is a transformative initiative to use 21st century technologies – including genomics, informatics, bioengineering, analysis of environmental exposures, and behavioral sciences – to tailor health care to the challenges facing individuals and their communities. This ambitious approach will fundamentally alter our understanding of health, disease prevention, and treatment. Core to this project is partnering across the state of Minnesota with citizens, patients, and healthcare providers to understand and effectively address major health problems.

MPMC will create a living laboratory, starting with demonstration projects on Alzheimer’s disease, lung cancer, and depression. All three are diseases whose incidence, burden, and mortality rates reveal disturbing health disparities. This focus will enable us to leverage University of Minnesota research strengths across many disciplines and to engage with partners in the health industry and Minnesota’s underserved communities. Together we will create affordable, mobile tools to speed research, better deliver health information, and advance health for all.

By investing in the development and delivery of precision medicine, the University of Minnesota will contribute to the national effort to transform science, medicine, and public health through more precise understanding of the factors contributing to health and disease. MPMC aims to make a unique contribution through collaborative research, cutting-edge innovation, responsible policy, and sustained commitment to improving health equitably across our communities.