GME-AHEAD Research Training Program

1. Trainees will gain an understanding of the clinical research process, described in the CITI micro-course “Medical Residents and Fellows: Basic Principles of Research.”
2. Trainees will acquire the vocabulary and conceptual knowledge to discuss research and work effectively with a collaborative research team that includes mentors, methodologists, and biostatisticians. 
3. Trainees will learn to summarize literature in a scientific literature review, providing the context necessary for a new study.
4. Trainees will learn the formal process of study design by creating a workflow, creating a timeline, writing research questions in the PI(E)COT format that follow the FINER criteria, organizing study design elements, and operationalizing pertinent study variables and concepts.
5. Trainees will learn to interpret research outputs from the perspective of a clinician and accurately present findings to other clinicians. 

Appropriate data source selection is essential for the success of all research projects, and the AHEAD Institute is committed to helping all trainees select the data source that best answers their research question. 

Trainees will be encouraged to use the SLUCare-SSM Virtual Data Warehouse (VDW) or the Healthcare Cost and Utilization Project (HCUP) data, with exceptions. These data sources offer a unique opportunity to answer clinically relevant questions in de-identified, research-ready databases from a large number of patients.

The SLUCare-SSM VDW captures electronic health record data from rural and urban settings from all clinical encounters from approximately 5-million patients in St Louis, MO; mid-Missouri; southern IL; Oklahoma City, OK, and surrounding areas; and southern WI regions. Trainees can generate research questions using full years of VDW data from 2016-2023. There is a lag of 1-year at the beginning of each calendar year, meaning that at the start of the calendar year 2025, the available data will range from 2016-2023. The data includes encounter types and dates, ICD-10 diagnoses and dates, procedure codes and dates (CPT/ICD9/ICD10), prescription orders, laboratory orders and results, vital signs, and demographics.

The Healthcare Cost and Utilization Project data includes:

1. Nationwide Inpatient Sample (1998-2017): The NIS is the largest publicly available all payer inpatient care database in the US, containing data on more than 7 million hospital stays. Its large sample is ideal for developing national and regional estimates and enables analyses of rare conditions, uncommon treatments and special populations.
2. Kids’ Inpatient Database (1997-2016): The KID is the largest publicly available all-payer pediatric inpatient care database in the United States, containing data from 2-3 million hospital stays. Its large sample size is ideal for developing national and regional estimates and enables analyses of rare conditions, such as congenital anomalies, as well as uncommon treatments, such as organ transplantation. The KID has been produced every three years.
3. Nationwide Readmissions Database (2016-2019): The NRD is a unique and powerful database designed to support various types of analyses of national readmission rates for all patients regardless of the expected payer for the hospital stay. The NRD includes discharges for patients with and without repeat hospital visits in a year and those who have died in the hospital. Repeat stays may or may not be related. This database addresses a large gap in health care data: the lack of nationally representative information on hospital readmissions for all ages.

Exceptions: The VDW and HCUP are well-suited for research across all medical specialties. Joanne Salas will review and approve exceptions to the use of other data sources and methodologies, given the scope of the project and the overall goals of the educational requirement.

All GME-AHEAD projects begin with an application. Following the approval of an application by the Office of Graduate Medical Education, trainees will meet monthly with Joanne Salus and AHEAD personnel to strengthen their research skills through exercises and assignments that contribute to a high-quality study design. All trainees are expected to be engaged in their project, willing to learn from AHEAD personnel, actively participate in meetings, and complete assignments in a timely manner.

Once the project design is established, Joanne Salas will assign a biostatistician to execute the project’s agreed upon Scope of Work. At the project’s conclusion, the biostatistician and Joanne Salas provide a preliminary interpretation of results.

Project scopes will be designed to satisfy the GME residency research requirement. Submission of results as conference abstracts will be encouraged, if applicable. Any extension of scope or additional in-depth analyses for a manuscript are beyond the scope of this program. Project timelines vary and are subject to change. The typical GME-AHEAD project requires six months to complete.

• Zachary Stanley, M.D., maternal fetal medicine: "Maternal Cytokine Production and Fetal Congenital Heart Defects"
• Katelyn Dugan, M.D., deramtology: "Investigating Cosmetic Outcomes in Purse-string of Upper Triangle Cutaneous Lip Defects"
• Georgeanne Cornell, D.O., dermatology: "The Appropriateness of Direct Immunofluorescence Use in Dermatology"
• Angela Gallardo, D.O., pediatrics: "Implementation of an Anxiety Screening Tool in a General Academic Pediatric Clinic"
• Ayaka Tsutsumi, M.D., pediatric surgery: "Machine Learning and Traditional Statistical Approaches to Predict Surgical Site Infections in Pediatric Appendectomy: Impact of Missing Data Handling"

• Adam Streicher, M.D., internal medicine: "Can a Five-Digit Number be Linked to Health Outcomes: The Impact of ZIP-Code and Insurance Status on 30-day Re-Admission Rates at SLUH"
• Michelle Petrich, M.D., maternal fetal medicine: "Predictors of Maternal and Neonatal Outcomes Among Pregnant Women with Substance Use Disorder"
• Sheetal Sethupathi, M.D., dermatology: "Assessing the Efficacy of a Novel Cosmeceuticals Educational Pamphlet in Improving Patient Education and Skincare Practices"
• Peter Chow, M.D., dermatology: "Demographics of Dermatopathology Fellowship Applicant Interviewees: A Single Institution Descriptive Analysis"