June 21, 2023
HSR&D Announces Best Research Paper of the Year Award Recipients
This year there was a three-way tie for the 2022 HSR&D Best Research Paper of the Year Award, which honors an article or collection of articles resulting from one or more HSR&D- or QUERI-funded investigations. Research studies also must involve Veterans, with results that are applicable to Veterans’ health and care, and to the VA healthcare system. This year’s Best Research Paper awardees include Kritee Gujral, PhD, David Oslin, MD, and John Piette, MSc, PhD.
Video Tablets: Effect on Suicidal Behavior among Rural Veterans
Kritee Gujral, PhD
Dr. Kritee Gujral, from the HSR&D Center for Innovation to Implementation (Ci2i) and VA’s Health Economics Resource Center in Palo Alto, CA, along with colleagues, authored the paper titled “Mental health service use, suicide behavior, and emergency department visits among rural U.S. Veterans who received video-enabled tablets during the COVID-19 pandemic.” Published in JAMA Network Open, the article describes the impact of VA's initiative to distribute video-enabled tablets to Veterans with access barriers. Using a novel event study design that exploits differential timing of when tablets were issued to Veterans, this article found that Veterans who received VA video tablets (compared to those who did not) experienced increased mental health service use and a 36% reduction in the likelihood of a suicide-related emergency department (ED) visit. This study is one of the first to suggest that care offered via telehealth is effective for reducing suicidal behavior among a high-risk patient population. These findings are informing VA’s Office of Rural Health and Office of Connected Care’s discussions about the impact of VA’s tablet distribution and VA’s Office of Mental Health & Suicide Prevention’s discussions about whether to embed virtual care and tablet considerations within VA’s routine suicide screening processes. This study has been presented at national VA seminars and highlighted by media outlets such as Reuters, Politico, and Military.com.
Pharmacogenomic Testing: Better Outcomes in Depression Treatment and Fewer Drug-Gene Interactions
David Oslin, MD
Dr. David Oslin, part of HSR&D’s Center for Health Equity Research and Promotion (CHERP) and Director of the VISN 4 Mental Illness Research, Education, and Clinical Center (MIRECC), in Pittsburgh and Philadelphia, PA, along with colleagues, authored the paper titled “Effect of pharmacogenomic testing for drug-gene interactions on medication selection and remission of symptoms in major depressive disorder: The PRIME Care Randomized Controlled Trial.” Published in JAMA, the article describes their study of pharmacogenomic testing in clinical practice. Focusing on antidepressants—prescribed to more than two million Veterans yearly—the Precision Medicine in Mental Health Care (PRIME Care) study demonstrated that pharmacogenomic testing resulted in fewer prescriptions of antidepressants with adverse drug-gene interactions and higher depression symptom remission rates. Dr. Oslin’s article is in the top 5% of research outputs scored by Altmetric. He has discussed the findings on NPR’s Science Friday podcast, and it has been highlighted by more than 30 news outlets, including the Philadelphia Inquirer and Medscape, as well as many blogs and tweets. The article was also listed among 2022’s 10 most significant advances in genomic medicine in the American Journal of Human Genetics. Further, the authors have presented their results to VA’s Under Secretary for Health and various clinical program offices. An overview was also provided to staffers for the Senate Committee on Veterans’ Affairs.
Patient-centered Pain Care Using AI and Mobile Health Tools
John Piette, PhD
Dr. John Piette, an HSR&D Research Career Scientist and part of HSR&D’s Center for Clinical Management Research (CCMR) in Ann Arbor, MI, and colleagues, authored a paper titled “Patient-centered pain care using artificial intelligence and mobile health tools: A randomized comparative effectiveness trial.” Published in JAMA Internal Medicine, the article reports findings from an HSR&D-funded study that evaluated a novel approach to delivering cognitive behavioral therapy (CBT) for chronic pain. The authors found that AI-based CBT achieved equivalent pain outcomes compared to standard CBT, but it did so with significantly less resource use (less than half the therapist time). This study suggests that personalizing VA pain therapy using AI could dramatically increase access to evidence-based alternatives to opioids, treating up to twice as many patients with the same number of therapists. This paper has been viewed 3,363 times, downloaded 604 times, and tweeted in 8 countries. In addition, Dr. Robert Kerns, founding Director of the VA Pain Research, Informatics, Multimorbidity, and Education (PRIME) Center called this “the most important paper in the field of pain research in 2022.” This innovative approach has implications for other behavioral interventions where Veterans go unserved because therapists are unavailable and treatment is unacceptably intensive (e.g., psychotherapy for mood disorders or substance abuse counseling).
HSR&D thanks Drs. Gujral, Oslin, and Piette for their outstanding work and contributions to the literature, which help VA improve the quality of healthcare for all Veterans.
HSR&D also thanks the following Best Research Paper of the Year Nominees for their very important work and contributions to the field of health services research.
- Samantha Connolly, PhD, part of HSR&D’s Center for Healthcare Organization and Implementation Research (CHOIR), for the article “Perceptions and use of telehealth among mental health, primary, and specialty care clinicians during the COVID-19 pandemic.” JAMA Network Open. June 2022.
- Matthew Crowley, MD, MHS, part of HSR&D’s Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), for the article “Effect of a comprehensive telehealth intervention vs telemonitoring and care coordination in patients with persistently poor type 2 diabetes control: A randomized clinical trial.” JAMA Internal Medicine. September 2022.
- George Ioannou, PhD, MS, part of HSR&D’s Center of Innovation for Veteran-Centered & Value-Driven Care, for the article “COVID-19 vaccination effectiveness against infection or death in a national U.S. health care system: A target trial emulation study.” Annals of Internal Medicine. March 2022.
- Ann-Marie Rosland, MD, MS, HSR&D’s Center for Health Equity Research and Promotion (CHERP), for the article “Effectiveness of a health coaching intervention for patient-family dyads to improve outcomes among adults with diabetes: A randomized clinical trial.” JAMA Network Open. November 2022.
- Amal Trivedi, MD, MPH, HSR&D’s Center of Innovation inLong-term Services and Supports (LTSS), for the article “Association of disability compensation with mortality and hospitalizations among Vietnam-Era Veterans with diabetes.” JAMA Internal Medicine. July 2022.
- Salim Virani, MD, PhD, HSR&D’s Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), for the article “Utilization rates of SGLT-2 inhibitors and GLP-1 receptor agonists and their facility-level variation among patients with atherosclerotic cardiovascular disease and type 2 diabetes mellitus: Insights from the Department of Veterans Affairs.” Diabetes Care. February 2022.
- Alexander Young, MD, MSHS, HSR&D’s Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), for the article “The effectiveness of a specialized primary care medical home for patients with serious mental illness.” Journal of General Internal Medicine. April 2022.