The late-morning session at our Second Annual DBEI & CCEB Research Day featured talks by our 2017-18 Distinguished Faculty. Alexis Ogdie-Beatty, MD, MSCE, and Alisa Stephens-Shields, PhD, explored how we can revolutionize the design of clinical trials in psoriatic arthritis, enrolling a truly representative population. Russell T. Shinohara, PhD, shared new ways we can measure and study white-matter brain lesions, the hallmark of multiple sclerosis. Douglas Wiebe, PhD, shared his team's latest on sports concussions, including an experimental rule change in Ivy League football that radically reduced the average annual concussion rate. View five highlights from these talks below.
Clinical trial design in psoriatic arthritis (PsA) is hampered by habit: traditionally only a subset of the PsA population—those whose disease resembles rheumatoid arthritis—is enrolled. Alexis Ogdie-Beatty, MD, MSCE, an Assistant Professor of Medicine and Epidemiology, and Alisa Stephens-Shields, PhD, an Assistant Professor of Biostatistics, think we need more information about how to build pragmatic trials that involve a truly representative PsA population.
Drs. Ogdie-Beatty and Stephens-Shields set out to simulate a head-to-head comparative effectiveness trial in psoriatic arthritis, using observational data. They compared a TNF alpha inhibitor (TNFi) with methotrexate (MTX). The primary outcome, in common with an actual trial being conducted at the time, was American College of Rheumatology 20% Response Criteria, or ACR20; and the target parameter was the population causal risk ratio for meeting those criteria. How did their results compare with the actual trial’s—and which are the “truth”?
About one million Americans have multiple sclerosis (MS), a disease of the central nervous system whose hallmark is white-matter lesions that show up in magnetic resonance images (MRI) of the brain. Measuring the number and volume of these legions is essential to diagnosis and to assessing treatment efficacy—but even though we have plenty of pictures, what we see in those pictures is a matter of great debate, Russell T. Shinohara, PhD, an Associate Professor of Biostatistics, told the audience.
Dr. Shinohara’s team has developed a method that meets the gold standard when it comes to counting the white-matter lesions that mark MS, he said—and perhaps they have even pointed to something more important.
In 2011, facing sharp criticism over athletes’ traumatic brain injuries in varsity football, the presidents of the Ivy League launched a system to monitor concussions. Now expanded to all varsity sports and involving the Big Ten as well, the system has become a prospective study with 2600 cases, across 27 different sports. Douglas Wiebe, PhD, a Professor of Epidemiology, and his team member Bernadette D’Alonzo lead the science in this cutting-edge collaboration with athletics—which recently yielded dramatic results in Ivy League football.