Learning Healthcare System

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Targeted intervention research based on patient responses

Director: Jon Tyson, MD, MPH – Jon.E.Tyson@uth.tmc.edu - 713-516-5429

Co-Directors: Charles C. Miller, III, Ph.D. - Charles.C.Miller@uth.tmc.edu; Matthew Rysavy, MD, Ph.D. - Matthew.A.Rysavy@uth.tmc.edu713-500-5651

Contact: Micquelyn “Micky” Titus – Micquelyn.Titus@uth.tmc.edu - 713-500-5651

New knowledge is generated in learning how to best apply research in treating patients and distinguish effective from ineffective or harmful therapies in “real world” clinical settings. Learning Healthcare (LHC) thus constitutes a paradigm shift from traditional views of patient care, quality improvement (QI), and research as separate and distinct activities. To date, the emphasis in LHC has been on observational studies. Such studies are crucial for generating new hypotheses, identifying rare treatment hazards, and assessing therapies that are not feasible or ethical to study in clinical trials. Unfortunately, even the most carefully designed and analyzed observational studies may involve unknown confounders or other sources of bias that result in widespread use of ineffective or even harmful therapies and contribute to repeated cycles of these treatments eventually being retired after more rigorous study. LHC in the CCTS addresses the use of rigorous and innovative interventional studies, particularly comparative effectiveness research (CER) and randomized QI studies, to avoid the confounding and unavoidable sources of bias in many observational studies, to distinguish effective from truly ineffective or harmful therapies in clinical practice, and augment “real world” care. A strength of our LHC program is its broad integration into other Components of our Clinical and Translational Science Award, including our KL2 and Institutional Scholars and Integrating Special Populations Components.

Consultation Services and Training

The CCTS provides consultation to researchers hoping to integrate LHC into their projects. Training and consultation in LHC is also provided through other CCTS programs, including the KL2 and Institutional Scholars and LHC Scholars programs and courses in the Master’s Program and Clinical Research Curriculum.

Examples of LHC Research

The following are just a few examples of research within the LHC component.

  • Raymond Parlar-Chun, MD, Assistant Professor, Department of Pediatrics, Using Social Media to Decrease Healthcare Utilization for Pediatric Asthma. Institutional Scholar, LHC Award, 2021
  • Lindsay Fleig, MD, MS Assistant Professor, Department of Pediatrics, Bilirubin Neurotoxicity and Neurodevelopmental Impairment in Extremely Preterm Infants: Avoidable by Reducing the Usual Intravenous Lipid Administration? KL2 Scholar, 2021
  • Julie Holihan, MD, MS, Assistant Professor, Department of General Surgery, Surgical Repair versus Expectant Management of Occult Inguinal Hernias: Strengthening the Evidence Base and Developing a Decision Tool. KL2 Scholar, 2021
  • Radha Korupolu, MD, MS, Assistant Professor, Department of Physical Medicine and Rehabilitation, Comparison of Mechanical Ventilation with Low and High tTdal Volumes in Acute Spinal Cord Injury: A Pilot Randomized Clinical Trial. KL2 Scholar, 2021
  • Holly Holmes, MD, MS, Associate Professor, Department of Internal Medicine, Team-Based De-prescribing Intervention to Reduce Polypharmacy in Older Adults. Institutional Scholar, 2021
  • Charles Green, PhD, Professor, Departments of Pediatrics and Psychiatry and Paul Cinciripini, PhD, Professor and Chair of Behavioral Sciences (MD Anderson Cancer Center, Precision Implemented Smoking Cessation (an adaptive trial using digital media and telemedicine to assist persons across Texas to stop smoking). LHC Award, 2021.
  • Ricardo Mosquera, MD, MS and Elenir Avritscher, MD, PhD, MBA, A Randomized Trial to Assess the Effectiveness and Cost Effectiveness of Telemedicine for Medically Complex Children,. former KL2 Scholar and LHC Awardees.
  • Luca Giancardo, PhD, Assistant Professor of Biomedical Informatics, Reducing Acute Ischemic Stroke Treatment Delays with Machine-Learning Enabled Process Improvements. 2019 LHC Awards
  • Muhammad Walji, PhD, Professor and Associate Dean, UTHSC-H School of Dentistry, Reducing Opioid Prescribing by Dentists: A Comparative Effectiveness Study of Audit and Feedback. 2019 LHC Award