Selected Publications
In Fiscal Year 2024 our investigators published 151 manuscripts in peer reviewed journals. Here is a select sample of those publications. Our investigators are designated in bold.
Ackland PE, Hagedorn HJ, Kenny ME, Salameh HA, Kehle-Forbes SM, Gustavson AM, Karimzadeh LE, Meis LA. Using brief reflections to capture and evaluate end-user engagement: a case example using the COMPASS study. BMC Medical Research Methodology. 2024 May 2; 24(1):103. doi: 10.1186/s12874-024-02222-5
Impact or significance: A growing area of implementation research is the incorporation of participatory research methods. Specifically, implementation and other research trials are engaging end-users in the research process to increase the applicability and implementation of study findings. As part of the “Comparative Effectiveness of Trauma-Focused and Non-Trauma-Focused Treatment Strategies for PTSD among those with Co-Occurring SUD (COMPASS)” study (PI/Co-PI: Dr. Shannon Kehle-Forbes/Dr. Hildi Hagedorn), Dr. Ackland led an innovative application of qualitative methods that improved the incorporation of end-user feedback into the study procedure. The “brief reflections” process is a qualitative method that allows the research team to appraise end-user recommendations and make timely improvements to the execution of a study.
Burgess DJ, Calvert C, Hagel Campbell EM, et al. Telehealth mindfulness-based interventions for chronic pain: The LAMP randomized clinical trial. JAMA Intern Med. 2024;184(10):1163–1173. doi:10.1001/jamainternmed.2024.3940.
Impact or significance: Although mindfulness interventions (MBIs) are evidence-based treatment for chronic pain and conditions that often accompany pain, like anxiety and depression, many MBIs are difficult to implement at scale in healthcare systems. The results of this study suggest low-resource, telehealth-based MBIs could help accelerate and improve the implementation of non-medication pain treatment in VA healthcare and beyond. Dr. Burgess has presented these results at two international academic conferences, at the VA Patient Care Services Senior Manager Meeting, and the Fall 2024 Interagency Pain Research Coordinating Committee Fall Meeting, and at two VA Cyber Seminars, She additionally will be presenting at an upcoming NIH workshop and the Whole Health VA-ECHO webinar, and she is working closely with the Office of Patient Centered Care and Cultural Transformation to implement LAMP within the VA. This article was accompanied by an Invited Commentary, “Overcoming Challenges to Implementing Mindfulness-Based Pain Interventions,” and was featured in 24 news stories from 18 media outlets and 3 blogs, and the NCCIH and University of Minnesota Medical School website.
Danan ER, Sowerby C, Ullman KE, Ensrud K, Forte ML, Zerzan N, Anthony M, Kalinowski C, Abdi HI, Friedman JK, Landsteiner A, Greer N, Nardos R, Fok C, Dahm P, Butler M, Wilt TJ, Diem S. Hormonal treatments and vaginal moisturizers for genitourinary syndrome of menopause: a systematic review. Annals of Internal Medicine. 2024 Oct 1; 177(10):1400-1414. doi: 10.7326/ANNALS-24-00610.
Impact or significance: This article reported the primary findings from a systematic review of genitourinary syndrome of menopause (GSM), funded by AHRQ and PCORI, for the UMN Evidence-based Practice Center. The review found evidence to support the short-term effectiveness of vaginal estrogen, DHEA, moisturizers, and oral ospemifene for some GSM symptoms, and found few long-term data on efficacy and safety. In addition to this article and the full AHRQ report, results were disseminated via Annals Video Summary, were discussed in an accompanying editorial, and were covered by NEJM Journal Watch, JAMA Medical News in Brief, and multiple media outlets, including Medscape (Altmetric score 88, top 5% of all research outputs). The findings were also presented to the American Urological Association guidelines committee, who plan to use them to inform clinical practice guidelines for GSM.
Drekonja DM, Shaukat A, Huang Y, Zhang JH, Reinink AR, Nugent S, Dominitz JA, Davis-Karim A, Gerding DN, Kyriakides TC. A randomized controlled trial of efficacy and safety of Fecal Microbiota Transplant for preventing recurrent Clostridioides difficile infection. Clinical Infectious Diseases: an official publication of the Infectious Diseases Society of America. 2024 Sep 13. doi: 10.1093/cid/ciae467
Impact or significance: This study is among the largest randomized controlled trials assessing the efficacy of fecal microbiota transplantation (FMT), a treatment used for the prevention of recurrent Clostridioides difficile infection (CDI). A novel strategy was used whereby potential participants were identified by a team at a single center (Minneapolis VA Health Care System), with enrollment occurring via a coordinator traveling to the patient, or (during COVID19 pandemic) a video visit with shipping of study medications. This enabled recruitment of a geographically diverse population, including nearly 40% rural or highly-rural participants. The study was stopped after a pre-planned interim analysis met criteria for futility, with FMT conferring no benefit vs. placebo for the outcome of definite or probable recurrence, or death, at 56 days.
Gustavson AM, Morrow CD, Brown RJ, Kaka AS, Sowerby C, Wilt TJ, Diem SJ. Reimagining how we synthesize information to impact clinical care, policy, and research priorities in real time: examples and lessons learned from COVID-19. Journal of General Internal Medicine. 2024 Oct 1; 39(13):2554-2559. doi: 10.1007/s11606-024-08855-y
Impact or significance: This work demonstrates the critical importance of real-time evidence synthesis to address urgent healthcare needs, as exemplified during the COVID-19 pandemic. It outlines ongoing challenges to evidence synthesis and solutions found to be effective in the context of the COVID-19 pandemic. Reimaging how we synthesize evidence ensures that healthcare systems, like the Veterans Health Administration, can adapt swiftly to emerging challenges, improving outcomes for Veterans and guiding resource allocation effectively.
Kehle-Forbes SM, Baier AL, Ackland PE, Spoont M, Polusny MA, Schnurr PP, Galovski T, Meis L. "It made me feel more alive": A qualitative analysis of quality of life improvements following completion of trauma-focused therapy for posttraumatic stress disorder. Journal of Traumatic Stress. 2024 Aug 2. doi: 10.1002/jts.23091
Impact or significance: While prior research has demonstrated that evidence-based PTSD treatment improves trauma-related symptoms and leads to improvements in quality-of-life, little is known about the specific benefits that Veterans experience following a full course of these therapies. This qualitative study provides rich descriptions regarding the quality-of-life improvements noted by a national sample of Veterans. These findings were shared in the National Center for PTSD’s Clinician’s Trauma Update which is distributed to over 76,000 trauma therapists and can be used by therapists during shared decision-making regarding PTSD treatment.
Melzer AC, Campbell ME, Hagedorn HJ, Fu SS. Clinician views of proactive tobacco treatment programs: a qualitative evaluation. Journal of General Internal Medicine. 2024 Aug 1; 39(11):2079-2086. doi: 10.1007/s11606-024-08834-3
Impact or significance: Proactive tobacco treatment programs have a strong evidence base but are rarely implemented even for groups with high rates of tobacco use and tobacco-related comorbidities. This study used qualitative methods to examine clinician views of these programs and identify potential barriers to implementation. It found that while clinicians support these programs in theory, limited resources, competing demands from other ‘mandated’ programs, and a perception that technology-based interventions are low-yield for these patients limit implementation. These results directly inform Dr. Melzer’s current proposal implementing tobacco treatments in lung cancer screening programs and were shared with leaders in pulmonary medicine at the American Thoracic Society International Meeting.
Sayer NA, Kaplan A, Nelson DB, Wiltsey Stirman S, Rosen CS. Clinician burnout and effectiveness of guideline-recommended psychotherapies. JAMA Network Open. 2024 Apr 1; 7(4):e246858. doi: 10.1001/jamanetworkopen.2024.6858
Impact or significance: Dr. Sayer’s JAMA Network Open article on impact of clinician burnout on PTSD psychotherapy efficacy was featured in a HSR Publication Brief for VA Central Office (April 2024). This article reported results of a secondary data analysis from the SCORE PTSD study (IIR 17-178) that sought to identify sources of systematic variation between therapists in outcomes from evidence-based psychotherapies for PTSD. Researchers found that therapist burnout was prospectively associated with reduced effectiveness of guideline-recommended psychotherapies for PTSD. This finding underscores the effect of therapist-level factors in delivering trauma-focused therapies for PTSD. The publication brief was forwarded to VHA Central Office leadership. The article was also featured in four media articles and the VA National Center for PTSD’s Clinician’s Trauma Update publication (June 2024), which is disseminated to over 76,000 trauma clinicians.
Sides TL, Jensen AC, Argust MM, Amundson EC, Thomas GR, Keller R, Mahaffey M, Krebs EE. Experiences and lessons learned from a patient-engagement service established by a national research consortium in the U.S. Veterans Health Administration. Learning Health Systems. 2024 Jul 1; 8(3):e10421. doi: 10.1002/lrh2.10421
Impact or significance: This article provides a successful example of how a national research consortium developed and deployed patient-engagement infrastructure to facilitate Veteran-engaged research and build community between Veterans and VA researchers. The work aligns with VA’s commitment to be a Veteran-centered health care system and has been actively disseminated to the field through a video interview with Dr. Sides, promoted by VA HSR, that contained a link to the publication and by the NIH-VA-DoD Pain Management Collaboratory through an email from the director encouraging this influential research community to distribute the article among their teams. In the first six months since publication, the article received more than 800 full text views.
Vardeny O, Desai AS, Jhund PS, Fang JC, Claggett B, de Boer RA, Hernandez AF, Inzucchi SE, Kosiborod MN, Lam CSP, Martinez FA, Shah SJ, Mc Causland FR, Petrie MC, Vaduganathan M, McMurray JJV, Solomon SD. Dapagliflozin and mode of death in heart failure with improved ejection fraction: a post hoc analysis of the DELIVER Trial. JAMA cardiology. 2024 Mar 1; 9(3):283-289. doi:10.1001/jamacardio.2023.5318
Impact or significance: This trial was the largest to date with randomized data in patients with heart failure with improved ejection fraction (HFimpEF), a growing population on which there is limited data to inform clinical management, especially regarding potential benefits of starting new cardiac medications. A previous analysis suggested that these patients may benefit from the addition of dapagliflozin to further reduce morbidity and mortality. The current analysis in JAMA Cardiology suggests that the benefit of sodium-glucose transport protein 2 inhibitor therapy may be related to reducing deaths from cardiovascular causes, and in particular sudden cardiac deaths in patients with HFimpEF.
