Obesity Archives - The National Patient-Centered Clinical Research Network

With access to coordinated heath data from more than 70 million people across the United States, PCORnet®, the National Patient-Centered Clinical Research Network, is a key resource in the fight against COVID-19. To maximize its utility, the Patient-Centered Outcomes Research Institute (PCORI) offered enhancement funding for nine existing PCORnet-enabled research studies. The idea behind these enhancement awards is to leverage existing infrastructure from PCORI-funded research to more efficiently expand understanding of COVID-19 and address this public health crisis.

One of many lessons learned from the COVID-19 pandemic is that good public health decisions in times of crisis require fast analysis of diverse patient data. While many healthcare organizations across the U.S. have the capacity to use their electronic health records (EHRs) and claims data as tools for horizon-scanning and disease surveillance, few offer the infrastructure to support the large-scale integration needed in the pandemic. The coordinated, interoperable infrastructure of PCORnet supports that needed speed and efficiency.

Following are a few snapshots of how PCORI-funded enhancement awards are supporting the use of PCORnet to combat the pandemic:

The Identifying and Predicting Patients with Preventable High Utilization project initially set out to use PCORnet to better understand and support people who frequently visit health care systems. With a COVID-19 enhancement award from PCORI, the research team will use the project’s existing infrastructure to develop prediction models to plan for resource needs and improve outcomes for patients hospitalized with COVID-19.
Variation in Case Management Programs and Their Effectiveness in Managing High-Risk Patients for Medicare ACOs, a project using PCORnet resources to improve case management programs in health systems, is expanding its scope to understand how the pandemic-driven shift to telehealth is affecting care and health outcomes for older patients with multiple chronic health problems.
Comparing Ways for Patients and Clinics to Improve Blood Pressure Control seeks to monitor how well clinics and patients are controlling blood pressure. With its enhancement award, it will use the same PCORnet-enabled cohort of patients to examine how taking different types of blood pressure medicines affects patients’ risk for contracting COVID-19 and severity of infection.
As patients with type 2 diabetes may have a higher risk of severe COVID-19 infections, the project team for Comparing Medicines for Treating Type 2 Diabetes among Patients with Chronic Kidney Disease is using its established data resources enabled by PCORnet to look at whether people with type 2 diabetes have a higher risk of COVID-19-related hospital stays. The team is also comparing rates of COVID-19 hospital stays for people who take different diabetes medicines.
Improving Methods for Extracting Data from Clinicians’ Notes in Electronic Health Records is working to create better methods for obtaining data from PCORnet-accessible EHR notes using natural language processing, or NLP. With NLP, computer programs interpret written language and make it easier to sort and study. With its enhancement award, the project team will use that same NLP technology to examine unstructured clinician notes for COVID-19 patients in an effort to glean new insights that may not be captured in a structured EHR record.
Understanding How Health Policy Affects Weight Loss Counseling and Diabetes Care set out to use PCORnet data resources to understand how the Affordable Care Act’s policy for insurance companies to pay for obesity screening and counseling affects the health of people with, or at risk for, diabetes. Now, it has expanded its scope to better understand outcomes related to the transition to virtual visits for patients with, or at high risk of, diabetes before, during, and after COVID-19.
An established PCORnet-enabled study was working to answer the question: Does Paying Doctors to Virtually Provide Chronic Care Management Improve Health for People with Diabetes Who Have Medicare Coverage? PCORI’s enhancement award is now allowing the team to also look at COVID-19 outcomes for people with type 2 diabetes who have at least one additional chronic disease and are covered by Medicare.
The scope of the Comparing Two Ways to Promote Healthy Weight Gain and Prevent Obesity in Early Childhood project expanded with a COVID-19 enhancement award. Now, the team is also using PCORnet to look at the impact of COVID-19 on families in the study who are participating in the Greenlight and Greenlight Plus programs, two interventions to support parents with low health literacy.

For more information about PCORI’s enhancement awards for COVID-19 research, check out the PCORI funding website.

There were no differences in all-cause mortality between patients who had sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB), but operations, hospitalizations, and other longer-term problems were more often associated with RYGB than sleeve gastrectomy, according to a new JAMA Surgery paper reporting results from the PCORnet® Bariatric Study.

The paper describes how researchers used resources from PCORnet, the National Patient-Centered Clinical Research Network, to build a diverse cohort of over 33,000 patients who underwent one of these two different types of bariatric surgery. Researchers were able to investigate the rates of longer-term problems up to five years after patients had their bariatric surgeries.

In an audio interview, study author Anita Courcoulas, MD, MPH, FACS, said that this research was different from past studies in that, by using PCORnet, researchers were able to leverage real-world clinical data from electronic health records and link that data to insurance claims data and other sources.

This information will help guide patients and their doctors in making important decisions about bariatric surgery as they weigh the rates of potential risks associated with each procedure and the average amount of weight loss produced by each, she noted. Study findings on how much weight patients lost and kept off were published in an earlier paper in the Annals of Internal Medicine.

Courcoulas also discussed the important role that bariatric patients, including co-investigator Neely Williams helped in shaping and guiding the study at every step.

Obesity

PCORnet is Delivering Important COVID-19 Answers

Results from PCORnet® Bariatric Study Published in JAMA Surgery

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