The Abstract: July 25, 2022
July 25, 2022
Whether you’re local or global, student or alumni, the Abstract’s weekly news digest will help you stay in the loop with our amazing Gillings School community.
Stürmer receives $3M award for research on prescription drug use among elderly
Til Stürmer, MD, PhD, the Nancy A. Dreyer Distinguished Professor and chair of epidemiology, recently received a $3 million award for competing continuation of a research project titled “Propensity Scores and Preventive Drug Use in the Elderly.”
A central feature of the care of older adults is the use of prescription drugs to prevent chronic conditions and minimize their sequelae. Randomized controlled trials (RCTs) are the gold standard to assess treatment efficacy but are very costly, take a long time to design and implement, and may be of limited generalizability due to selection of participants for factors that may affect the benefit and harm of treatments, such as age itself, frailty, multiple chronic conditions and comedications/polypharmacy. Real-world evidence (RWE) or nonexperimental studies of these questions do not have these limitations but may be subject to confounding by indication and frailty.
Since 2005, Stürmer’s interdisciplinary team has assessed the limitations and advantages of propensity scores (PSs) using a combination of empirical studies based on real-world (mostly Medicare) data and extensive simulation studies. The team has developed novel analytic techniques to reduce the potential for unmeasured confounding, including PS trimming and PS calibration, and has assessed and highlighted the often largely reduced potential for confounding with active comparators (clinical treatment alternatives). They have successfully implemented nonexperimental active comparator study designs to assess benefit and harm of novel treatments in older adults with cancer, diabetes and hypertension.
Results have been disseminated through oral presentations and symposia, commentaries and invited primers, and in a series of 127 publications, including 26 in the top epidemiologic journals, 25 in the top pharmacoepidemiologic journal, 11 in Medical Care, and 32 in top medical journals, cited more than 6,000 times. A landmark paper on PS variable selection has been cited more than 1,000 times, and 36 papers have been cited at least 36 times. Fifteen papers have been cited at least 100 times and 29 papers at least 50 times. The team has written 19 highly cited primers, editorials and practical guidance papers on PSs that have been cited more than 2,000 times. Five papers of the team have recently been listed among the “Thirty must-read papers for newcomers to pharmacoepidemiology,” evincing the impact the work of the team has on pharmacoepidemiology training and practice.
The interdisciplinary research team includes researchers from UNC, NC State University, Harvard, McGill (CA) and the University of Manchester (UK), with expertise in pharmacoepidemiology, pharmacy, geriatrics, biostatistics, health services research and social epidemiology.
Gillings researchers contribute to new book on leading systems change in public health
Leading Systems Change in Public Health: A Field Guide for Practitioners is the first resource written by public health professionals for public health professionals on how to improve public health by utilizing a systems change lens. Edited by leaders from the de Beaumont Foundation and the University of Illinois Chicago School of Public Health with chapters written by a diverse array of public health leaders, the book provides an evidence-based framework with practical strategies, processes, and tools for enacting meaningful change. Complete with engaging stories and tips to illustrate concepts in action, this book is the essential guide for current and future public health leaders working within and across individual, interpersonal, organizational, cross-sector and community levels.
The book addresses subjects such as change leadership, health equity, racial justice, power sharing, and readiness for change. It addresses best practices for enacting change at different levels, including at the personal, interpersonal, organizational, and team or cross-sector level, while describing the factors, the processes, skills, and tools required for leading complex change. It not only covers the process of leading systems change but also the importance of community organizing and coalition building, identifying a shared understanding of the problem, how to leverage the lessons of implementation science, and how to understand the relationship between sustainability and public health. Practical examples and stories highlight challenges and opportunities, systems change in action, and the importance of crisis leadership – including lessons learned from the COVID-19 pandemic.
Gillings researchers who contributed to this publication include Brian Castrucci, DrPH (alumnus), Amy Mullenix, MSPH, MSW, Rebecca Wells, PhD, Kristen Hassmiller Lich, PhD, W. Oscar Fleming, PhD, and Dorothy Cilenti, DrPH.
NBC news features Paerl’s work on aerosolized toxins from algal blooms
An NBC Bay Area affiliate recently produced a video feature on the Bay Delta Science project led by Hans Paerl, PhD, who is a distinguished professor jointly in the Department of Earth, Marine and Environmental Sciences and in the Department of Environmental Sciences and Engineering. He is collaborating with doctoral student Haley Plaas and Adjunct Assistant Professor Karsten Baumann, PhD, among others.
The team is looking for toxins in airborne particles (aerosols) that result from algal blooms. These blooms are “fed” by nitrogen pollution from human waste, farm animals and fertilizer runoff. They are exacerbated by climate change-induced warming waters.
Mulhern receives Paul V. Roberts Outstanding Doctoral Dissertation award
Riley Mulhern, PhD, a recent graduate from environmental sciences and engineering, was recently awarded the Paul V. Roberts Outstanding Doctoral Dissertation Award by the Association of Environmental Engineering and Science Professors (AEESP). AEESP is a national association that honors one dissertation across the country each year with this award “to recognize a rigorous and innovative doctoral thesis that advances the science and practice of water quality engineering for either engineered or natural systems.”
Mulhern’s dissertation was titled “Point-of-use water treatment for private wells in North Carolina: Risks and Solutions for Lead, Per- and Polyfluoroalkyl Substances (PFAS), and Microbial Contaminants.” Jackie MacDonald Gibson, PhD, served as dissertation advisor.