The Department of Population Medicine focuses on improving health care delivery and population health through research and education, in partnership with health plans, delivery systems, and public health agencies. This is a brief overview of our research and public health surveillance projects. Please visit the individual research group pages for an in-depth look at our research programs.
CDC Eastern Massachusetts Prevention Epicenter III: Promoting new ways to address problems such as reducing the burden of healthcare-associated infections and antibiotic resistance
PI: Richard Platt, MD, MSc
The Epicenter III project evaluates five strategies for preventing healthcare associated infections. These strategies target common, high morbidity, and high cost complications of medical care, including infections caused by methicillin-resistant Staphylococcus aureus, ventilator associated pneumonia, and hospital-based outbreaks caused by many different kinds of pathogens. We have developed an extensive network of partners in academic and community hospitals, nursing homes, outpatient clinics, and microbiology laboratory data systems that represent local, regional, and national collaborations to address both current and future research needs to reduce healthcare associated infections.
Environmental influences on Child Health Outcomes (ECHO) Program
PI:Emily Oken, MD, MPH
To advance understanding the effects of environmental exposures on child health and development, NIH has launched the seven-year ECHO initiative. ECHO will support multiple, synergistic, longitudinal studies using existing cohorts to investigate environmental exposures on child health and development. The studies will focus on four key pediatric outcomes that have a high public health impact: upper and lower airway, obesity, pre-, peri-, and postnatal outcomes, and neurodevelopment. Project Viva is one of 35 US pediatric cohorts that received an ECHO award and will focus on addressing the question: “What environmental exposures from conception to age 5, singly and as mixtures, influence the separate and co-evolution of obesity, asthma and related dysfunctions?”
MDPHnet: Development of an open source software application that uses EHR data to identify notifiable disease cases and automatically submits identifiable case reports to state health departments
PI: Michael Klompas, MD, MPH, FRCPC
In 2006, Massachusetts Department of Public Health, the Harvard Medical School/Harvard Pilgrim Health Care Institute Department of Population Medicine (DPM/HPHCI), and the Boston Children's Hospital Informatics Program established a Center of Excellence in Public Health Informatics funded by the U.S. Centers for Disease Control and Prevention (CDC). This collaboration developed Electronic medical record Support for Public Health (ESP), an open source software application that uses EHR data to identify notifiable disease cases and automatically submit identifiable case reports using secure protocols to state health departments. The timeliness, granularity, completeness, and accuracy of ESP reports are a tremendous benefit to health departments and will be useful to local boards of health in case investigation and response. They enable resource-strapped departments to rapidly identify the handful of highly actionable, high yield cases from amongst the thousands of undifferentiated cases routinely reported by ELR systems and clinicians.
Oral Targeted Anticancer Medication Trends and Modifiable Use Predictors
PI: Anita Wagner, PharmD, MPH, DrPH
The goal of this study is to investigate how pharmaceutical benefit policies affect oral molecularly-targeted anticancer medications utilization and spending, and to identify patient- and provider-related factors associated with treatment access.
PCORnet: The National Patient-Centered Clinical Research Network
PIs: Richard Platt, MD, MSc; Adrian Hernandez, MD, MHS; Sharon Terry, MA
PCORnet, the National Patient-Centered Clinical Research Network, is an innovative initiative of the Patient-Centered Outcomes Research Institute (PCORI). The goal of PCORnet is to improve the nation's capacity to conduct clinical research by creating a large, highly representative network that directly involves patients in the development and execution of research. PCORnet is made up of 33 partner networks - 13 Clinical Data Research Networks (CDRNs), based in healthcare systems such as hospitals, integrated delivery systems, and federally qualified health centers, and 20 Patient-Powered Research Networks (PPRNs), operated and governed by groups of patients and their partners focused on one or more specific conditions or communities, and interested in sharing health information and participating in research. Initially, these networks will be focused on more than 150 specific conditions and communities of interest. Over time, the intent is for PCORnet to serve as a platform for rigorous research on an even broader array of topics. The scientific expertise, large population size, and diversity of PCORnet make it a unique resource for both observational and interventional studies in these and other areas.
Project Viva: A study of health for the next generation
PI: Emily Oken, MD, MPH
Project Viva is a ground breaking longitudinal research study of mother-child pairs. The goal of Project Viva is to find ways to improve the health of mothers and their children by looking at the effects of mother's diet as well as other factors during pregnancy and after birth on child health outcomes. For example, the information we collect enables us to investigate the effects of diet on child development and obesity, and how diet and the environment influence the development of asthma and allergies in children.
Between 1999 and 2002, 2,128 mothers delivered babies and were officially enrolled in our study. Today, over a decade and a half later, approximately 1,700 mother and child pairs are still involved in Project Viva. For more information about Project Viva and the Project Viva cohort, please refer to the Project Viva Cohort Profile led by Principal Investigator Emily Oken. Project Viva also has a record on ClinicalTrial.gov (record ID NCT02820402).
Sentinel: A national medical product monitoring system
PI: Richard Platt, MD, MSc
Sentinel is an active surveillance system sponsored by the U.S. Food and Drug Administration (FDA) to monitor the safety of regulated medical products using pre-existing electronic healthcare data from multiple sources. The Sentinel System is part of the FDA's Sentinel Initiative, a long-term effort to improve the FDA's ability to identify and access medical product safety issues. The Sentinel Initiative began in 2008 as a multi-year effort to create a national electronic system for monitoring the performance of FDA-regulated medical products. The Initiative is the FDA's response to the Food and Drug Administration Amendments Act (FDAAA) requirement that the FDA work with public, academic, and private entities to develop a system to obtain information from existing electronic health care data from multiple sources to assess the safety of approved medical products. Sentinel's work focuses on drugs, vaccines, and other biologics (such as blood products).
Understanding pathways of fetal metabolic programming to stop the transgenerational risk of diabetes (GEN3G)
PI: Marie-France Hivert, MD, MMSc
Gen3G is a prospective cohort study of mother-child pairs followed from 1st trimester to childhood aimed at identifying which epigenetic adaptations across the human genome are implicated in pathways linking maternal glycemia in utero exposure and fetal metabolic programming of future type 2 diabetes (T2D) risk. This study uses recent technological advances to investigate epigenetic markers across the human genome in an agnostic manner and reveal novel biologic pathways implicated in T2D etiology. Placenta and cord blood samples were collected in 725 newborns. DNA methylation will be estimated using the epigenome-wide array Illumina HumanMethylation450 and analyzed with rigorous methods. Revealing etiologic T2D pathways might help development of early life preventive interventions to reduce rates of diabetes in future generations