What is the future of clinical research at Duke?
More than 300 faculty, staff and students attended Clinical Research Day on May 17, 2018, to explore this driving question. The event, which included a resident and fellows poster session, inaugural Innovation keynote speaker, and faculty talks, took place in the Trent Semans Center on Duke’s campus and was co-hosted by the School of Medicine, Duke Clinical Research Institute, and Duke Graduate Medical Education.
“Approximately 740,000 patients were treated at Duke in the past year, and 15,583 people were enrolled in clinical trials,” said Adrian Hernandez, MD, vice dean of clinical research in the School of Medicine. “Compared to other places across the nation, that’s really good. But we know that the environment here is really ripe for doing even more.”
Hernandez referenced a 2013 Perceptions & Insights Study from the Center for Information and Study on Clinical Research Participation which showed that 87 percent of people surveyed globally—and 93 percent of people in North America—indicated willingness to participate in clinical research.
“And if you think about what Duke offers, we think that it can be like this, or even better, in part because we have cutting edge science, we deliver great care, and we’re aiming to help people answer the questions that they’re desperately needing to answer,” said Hernandez.
He highlighted several entities that are already dedicated to advancing clinical research at Duke, which include the Duke Clinical Research Institute, the largest academic clinical research organization in the world, Duke’s Clinical Translational Science, and Duke Forge, a new data science center led by former FDA commissioner Robert Califf. Duke is one of approximately 50 institutions to receive a Clinical and Translational Science Award from NIH. The award was renewed earlier this month.
One of the most important drivers for advancing clinical research is the use of new technologies, said Hernandez, which is why Duke invited neuroscientist and entrepreneur Tom Insel, MD, to be the keynote speaker for Clinical Research Day and the first speaker in the new Innovation Speaker Series, co-sponsored by Duke Innovation & Entrepreneurship, LaunchBio and the School of Medicine. Insel, co-founder and president of Mindstrong Health, served as the director of the National Institute of Mental Health for thirteen years before branching into the private sector, first to lead the mental health initiative of Google’s life sciences company Verily, and most recently, as co-founder of Mindstrong.
In his talk, entitled “How will Digital Technologies Transform Health Care?” Insel said, the explosion of technology in the past ten years, and specifically Smart phone use, opens up new and exciting opportunities for clinical researchers.
With patient permission, Insel and other co-founders of Mindstrong have leveraged Smartphone use by collecting data about how a person uses his or her Smartphone in his or her natural environment.
This data—which includes everything from speed of use to focus on certain apps—can give a clinician a more accurate reading of a person’s behavior than an individual assessment form or prescribed wearable, Insel said, and these behaviors can help to identify patterns that are markers of mental illness.
“This is a sample of how we’ve been thinking about the problem about how to use technologies so they’re not part of the problem, but part of the solution,” Insel said. He encouraged academic researchers to think outside the box about how they might address gaps they see in research by partnering with industry to develop or utilize new technologies. Technologies, however, are meant to be complementary and not to replace clinical excellence, he said.
Following Insel’s talk, four Duke researchers shared examples of their own projects that delve into clinical research, with an overriding theme of technology. Gary Bennett, PhD, the Bishop-MacDermott Family Professor of Psychology and Neuroscience, discussed his work in developing digital obesity treatments. Heather Whitson, MD, MHS, associate professor of medicine (geriatrics) and ophthalmology and deputy director of the Duke Aging Center, discussed the connection between patients with vision and cognition issues in late life, and the importance of developing treatment that recognizes this connection. Yousuf Zafar, MD, MHS, associate professor of medicine and public policy, and director of the Center for Applied Cancer Health Policy, discussed how doctors might engage more with patients about how much their care will cost. Charlene Wong, MD, MSHP, assistant professor of pediatrics, spoke about her experience incorporating accessible glucose monitoring tools and apps in treatment of adolescents with Type 1 diabetes.
After their talks, the speakers participated in a panel discussion moderated by Eric Peterson, MD, MPH, executive director of the Duke Clinical Research Institute.
Winners of the poster session were announced by Dean Mary E. Klotman. Of the 40 posters presented by residents, fellows, and students in the School of Medicine, the first-place winner was Christopher Pirozzi, PhD, Department of Pathology, for “Mutant IDH1 Disrupts the Mouse Subventricular Zone and Alters Brain Tumor Progression.” Second place winner was Kristin Corey, Duke Institute for Healthcare Innovation, for “PYTHIA: Automated Surgical Outcomes Data Pipeline and Prediction Engine.” Third place winner was Morgan Cox, MD, Department of Surgery, for “Documenting or Operating: Where is Time Spent in General Surgery Residency?”
Christopher Pirozzi, PhD
Morgan Cox, MD
“Clinical research day is our tradition to share new advances in clinical research at Duke and how to continue to lead the way,” said Hernandez. “As we go forward, it’s really clear that here at Duke, we have all the components to continue to be a leader in clinical research.”