MEDICAL TECHNOLOGY AND PRACTICE PATTERNS

Programs

1. Researching barriers to arteriovenous fistula use in black hemodialysis patients in collaboration with the university of alabama at birminghamin the final year of the 5-year r01 project we conducted two major research tasks. The first major task was to examine the avf and avg maturation and maintenance procedural burden among patients who initiate with a cvc with a longer follow-up than had previously been published and that incorporates all subsequent accesses and procedures (if the first one failed). Specifically, in 2024 we examined four clinical scenarios in the first year after surgical access creation: (1) maintain primary patency, (2) primary patency loss, (3) secondary patency loss after avf/avg use, and (4) avf/avg nonuse. We also included costs associated with all surgical and percutaneous vascular access procedures for the duration of patient follow-up, including procedures occurring after the first access failed. Vascular access costs, including the cost of the index avf creation, were calculated for years 1, 2 and 3 after the index avf/avg creation date and total 3 years after initial va creation. This study - which we are currently in the process of writing up --…

   $44,588 spent
   6% of program spending

2. Gilead co-us-998-7081 evaluating gender specific disparities in the viral hepatitis cascade:in this period the primary objective was to examine timely treatment of chronic hepatitis b (chb) given the reduction in risks of cirrhosis and hepatocellular carcinoma. Gaps in timely treatment have historically persisted, especially among underserved safety-net populations. We aimed to evaluate gaps and disparities in chb treatment in the united states. Adults with treatment-naive chb without human immunodeficiency virus were identified from 2010 to 2018 across 3 safety-net health systems. Chb treatment eligibility was assessed using american association for the study of liver diseases (aasld) criteria and alternative criteria, including the simplified approach for hepatitis b algorithm. Differences in chb treatment between groups were evaluated using ?2 methods, adjusted kaplan-meier methods, and adjusted cox proportional hazards models.we found that among 3749 patients with treatment-naive chb (51.5% women, 38.7% white, 33.7% african american, 19.6% asian, 24.6% cirrhosis), 30.0% were aasld treatment eligible, among whom 31.0% were treated. Men were more likely than women to be treated…

   $135,573 spent
   18% of program spending

3. Nimhd r01 md017063-01 racial and ethnic disparities in hcc surveillancein 2024, we focused on two research aims: aim 1 was to evaluate gaps and disparities in hcc surveillance among adults with cirrhosis across four safety-net health systems in the u.s. We identified adults with cirrhosis from march 1, 2017 to february 28, 2022 across four safety-net health systems in california, florida, ohio, and texas. Cirrhosis was identified using established definitions based on icd-9/10 codes. Patients with baseline hcc diagnosis were excluded. The primary outcome was receipt of hcc surveillance imaging (ultrasound, ct, or mri scans of the abdomen) within first 6 months (hcc6mo) of cirrhosis diagnosis during the study period. Among a multi-center safety-net cohort of cirrhosis patients, over 70% received some form of abdominal imaging within 6 months, but less than 30% received imaging specifically for an indication of hcc surveillance. We concluded that significant disparities in hcc surveillance were observed across sociodemographic factors. These findings were presented at the 2024 american association for the study of liver diseases (aasld) conference: gaps and disparities in…

   $129,853 spent$71,596 earned by the program
   18% of program spending

4. Hospital acquired infections in hemodialysis populationmtppi researchers worked as subcontractors to lifespan health to research hospital acquired infections in hemodialysis patient population.

   $309,228 spent$125,263 earned by the program
   42% of program spending

5. Amgen 16465587169 cadaveric kidney transplantation outcomes among dialysis and gout patientsin 2024, mtppi continued its collaboration with amgen examining the role of gout across the dialysis-waitlist-transplant continuum in the united states. Specifically, using usrds standard analytic files from 2016-2021 linked with medicare claims and transplant registry data, the team finalized construction of three national longitudinal cohorts representing incident dialysis patients, transplant waitlist candidates, and first kidney transplant recipients. Monthly expanded data structures were developed to model gout as a time-varying exposure based on validated icd-10 codes, while capturing contemporaneous changes in hospitalization patterns, cardiovascular events, and comorbidity burden. These data supported implementation of marginal structural models with stabilized inverse-probability weights to address confounding from both baseline and time-varying clinical factors.the analyses performed in 2024 revealed that gout is associated with consistently adverse outcomes across the kidney failure and transplant continuum. Among patients initiating dialysis, gout was linked to substantially…

   $84,581 spent
   11% of program spending

6. Write off uncollected receivable

   $36,000 spent
   5% of program spending

The 6 programs described on its FY2024 Form 990, listed largest first by expense. Program spending in total: $739,823.