Current Research Studies

Acute Pulmonary Embolism in the Kaiser Permanente Emergency Department Setting: A Descriptive Study
Goal:
This study aims to increase the understanding of contemporary practice patterns for pulmonary embolism within the emergency departments (EDs) of Kaiser Permanente Northern California and Kaiser Permanente Mid-Atlantic Clinical Decision Units (CDUs).
Funder: KPMAS Community Benefit
Site Principal Investigator: Michael Horberg

ALL/PHASE Evaluation in the Mid-Atlantic Safety Net Clinics
Goal:
This project aims to evaluate the ALL/PHASE implementation in the community health center and free clinic setting.
Funder: Kaiser Permanente Community Benefit, National Program Office
Site Principal Investigator: Michael Horberg

An Investigation into Cross-Generational Inheritance of Cardiometabolic Risks Due to Persistent Psychosocial, Socioeconomic, and Discriminatory Stressors: Pilot Feasibility Study
Goal:
The primary objective of this pilot study is to demonstrate the ability to collect semen samples from a diverse cohort of adult men enrolled in KPMAS and to transport their samples safely to the University of Massachusetts Medical School (UMassMed).
Funder: University of Massachusetts Medical School
Site Principal Investigator: Doug Roblin

Cancer Cohort
Funder:
 KP Research Bank
Co-Investigator
: Monica Ter-Minassian

Center for Effectiveness & Safety Research (CESR)
Goal:
Develop, standardize and improve research infrastructure for inter-regional research studies and perform rapid turnaround research that addresses questions of interest to Kaiser Permanente and the nation.
Funder: KP Operational Funds (National)
Site Principal Investigator: Michael Horberg

Cohort Study of Patients with Disorders of Sex Development (DSD)
Goal:
 The goal of this proposal is to compare DSD (Disorders of Sex Development) Quality of Care Indicators (QCI) against actual DSD management delivered at large nationwide integrated HCSs. We will estimate the percentage of DSD patients who received care according to each QCI, compare incidence and prevalence of co-morbidities in DSD patients to the corresponding measures among frequency matched patients, and assess the proportion of prophylactic gonadectomies that show malignant or precursor lesions on the resulting pathology specimens.
Funder:
 NICHD 
Site Primary Investigator
: Suma Vupputuri

Comparative Effectiveness of Timing and Type of Antiviral Treatment of Patients with HIV
Goal:
 We will identify a cohort of HIV-infected patients and utilize high-dimensional propensity-matching to identify HIV-uninfected adults to assess the complex relationship between HIV and heart failure (HF). We will characterize the association of HIV status with the incidence of HF and HF type; investigate clinically meaningful treatment strategies for the prevention of HF and HF types in HIV-infected adults; and among new HF cases that develop among HIV-infected and HIV-uninfected adults, examine the association of HIV status on HF-related hospitalizations and death.
Funder:
 NIH/NHLBI
Investigator
: Suma Vupputuri

COMpAAAS Tripartite: ART-CC, KP, and VA
Goal:
The purpose of the overall study is to participate in a scientific collaboration across three grant partners to assemble data sets, including electronic health record data. Partners will interpret and disseminate results of the study through conference abstracts and manuscripts.
Funder:
National Institute of Health
Principal Investigator:
Michael Horberg

Database cohort study to assess the risk of serious angioedema in association with LCZ696 (sacubitril/valsartan; Entresto) use in Black patients with heart failure in the United States.
Goal:
This study will provide estimates of the incidence of angioedema among HF patients initiating sacubitril/valsartan and HF patients initiating an angiotensin-converting enzyme inhibitor (ACEI), with a primary focus on Black HF patients. These estimates will quantify the risk of angioedema among HF patients initiating sacubitril/valsartan compared to HF patients initiating an ACEI.
Investigator:
Douglas Roblin

Delayed Treatment Intensification and Risk of Diabetes Complications
Goal:
 The purpose of this study is to assess the impact of delayed treatment intensification on diabetes complications among
patients: 1) newly initiating metformin monotherapy; 2) adding a second oral agent; and 3) initiating insulin (after two or
more oral agents).
Funder:
 Sanofi Inc.
Site Primary Investigator
: Suma Vupputuri

Developing a Prescription Opioid Registry in Diverse Health Systems
Goal:
Building on past research, this project will establish the infrastructure to expand a prescription opioid registry across diverse health systems in the Addiction Research Network. Harmonized electronic health record data elements will be used to examine how changes in opioid use are associated with other patient outcomes, such as emergency department service utilization, benzodiazepine use, and use of other non-opioid medications (e.g., nonsteroidal anti-inflammatory drugs [NSAIDs] and gabapentin), and how this may vary by patient characteristics and across health systems.
Investigator:
Douglas Roblin

Development and Validation of a Health Insurance Claims-Based Algorithm to Identify Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) Events.
Goal:
The objectives of this study are 1) to develop an algorithm to identify AECOPD events in health insurance claims databases, and 2) to validate it using physicians’ reviews of information from electronic medical records as the gold standard.
Funder: GlaxoSmithKline
Site Principal Investigator:
Doug Roblin

Development of Cirrhosis Registry
Goal:
The objective of the Cirrhosis Registry is to support internal, inter-regional and external research related to risk factors for cirrhosis and patient outcomes.
Funder: Kaiser Permanente Community Benefit Program
Principal Investigator:
Carla V. Rodriguez

Development of Chronic Kidney Disease (CKD) and End-Stage Renal Disease Registry
Goal:
The objective of this project is to support internal, inter-regional and external research related CKD and ESRD.
Funder: Kaiser Permanente Community Benefit Program
Principal Investigator:
Carla V. Rodriguez

Development of an Immunization Registry
Goal:
The objective of the Immunization Registry is to support internal, inter-regional and external research related to vaccine surveillance, safety and effectiveness.
Funder: Kaiser Permanente Community Benefit Program
Principal Investigator:
Carla V. Rodriguez

Development of Rheumatoid Arthritis Disease Registry (“CEITH”)
Goal:
The goal of this project is to create resources for future internal research projects, as well as inter-regional and extramural research collaborations.
Funder: Kaiser Permanente Community Benefit Program
Principal Investigator:
Michael Horberg

Development of Virtual Data Warehouse (VDW) and Research Data Warehouse (RDW)
Goal:
The goal of this project is to provide a common set of data elements and structure to increase efficiency of developing and running scripts across different sites, allowing for more seamless research across multiple sites. The goal of the RDW is to create an integrated view from the multiple systems that house the data that constitute the Kaiser Permanante Electronic Health Records.
Funder: Kaiser Permanente Community Benefit Program
Principal Investigator:
Ketan Mane

Enhancement of Hepatitis B & C Registries
Goal:
The goal of this project is to more fully develop the Hepatitis B and C registries to support internal, inter-regional and external research related to surveillance, treatment safety and effectiveness, comorbid conditions and patient outcomes.
Funder: Kaiser Permanente Community Benefit Program
Principal Investigator: Carla V. Rodriguez

Establishing a Cohort to Study Cancers in Organ Transplant Recipients
Goal:
This pilot study will evaluate the feasibility of establishing a cohort of solid organ transplant recipient to study incident cancers in this high risk population.
Funder: National Cancer Institute via the Cancer Research Network Pilot Project Program U24CA171524
Principal Investigator: Michael Horberg

Factors associated with Hepatitis C treatment and response in a large integrated health care system
Goal:The objective of this project is to describe the demographic and clinical history of patients with active hepatitis C virus (HCV) within an integrated care system and the factors associated with HCV prescription and treatment. Among those treated, we will further describe time to undetectable viral load and time to sustained virologic response (SVR).
Funder: Kaiser Permanente Community Benefit Program
Principal Investigator: Carla V. Rodriguez

FEASIBILITY AND ASSESSMENT OF A CASCADE TRACEBACK SCREENING PROGRAM  
Funder: National Cancer Institute
Principal Investigator:Cabell Jonas, PhD, Alanna Rahm, PhD, Nora Henrikson, PhD

Frequency of Screening for HCV Infection in a Large U.S. Health Insurance Network
Funder: NIH
Co-Investigator: Carla V. Rodriguez

FDA Mini-Sentinel Program
Goal:
Develop a national research data infrastructure that supports rapid turnaround queries regarding public health concerns
Funder: FDA
Site Principal Investigator: Michael Horberg

HIV Infection, Use of Tenofovir and Other Antiretrovirals, and Risk of Fatal and Non-Fatal Comorbidities: Cohort study in Kaiser Permanente
Goal:
The purpose of the overall study is to primarily compare the incidence rate of fatal and non-fatal comorbidities in HIV patients with incidence rates among matched HIV-uninfected controls, and HIV-uninfected individuals prescribed PrEP.
Funder:
Gilead, Inc.
Multiple Principal Investigator:
Michael Horberg

HIV Status and Incidence and Outcomes of Heart Failure
Goal:
The overall purpose of this study is to work with our clinical and policy leaders in HIV and CHF care to quantify the risk of congestive heart failure (CHF) among HIV-infected patients, which antiretroviral therapy medications have increased risk for CHF and which may be protective, as well as develop care patterns for CHF among our HIV-infected patients.
Funder:
National Heart, Lung, and Blood Institute
Co-Investigator:
Micheal Horberg

Implementing Computerized Substance Use and Depression Screening and Evidence-Based Treatments in an HIV Primary Care Population
Goal:
The purpose of the overall study is to address the important topic of alcohol, smoking and other substance use and comorbidity screening and treatment among HIV-impacted patients. This study represents an important next step in the evolution of our top-quality HIV care in the context of an aging HIV patient population and has important implications beyond the Kaiser Permanente system.
Funder:
National Institute on Alcohol, Abuse and Alcoholism
Principal Investigator:
Michael Horberg

Interregional Utilization of Low-Value Interventions for Cancer Care
Goal:
The goals of this project are to assess the feasibility of measuring adherence with the five American Board of Internal Medicine/American Society of Clinical Oncology “Choosing Wisely” practices for low-value cancer care, and to measure adherence and the system-level factors associated with adherence to these measures within three Kaiser Permanente regions.
Funder: CESR
Site Principal Investigator: Michael Horberg

Investigation of Patient-Reported Outcomes to Inform Diabetic Peripheral Neuropathy Treatment and Research
Goal:
Identify existing patient-reported outcomes for painful diabetic peripheral neuropathy in both the literature and Kaiser Permanente’s data. Work with providers and members to determine how best to obtain this information in future care.
Funder: CESR
Site Principal Investigator: Michael Horberg

Kaiser Permanente HIV Quality Improvement and Performance Program
Goal:
We seek to determine quantitative measures of HIV care and outcomes in Kaiser Permanente. We seek to then initiate quality improvement programs where we determine there are opportunities for improvement.
Funder
: Care Management Institute/The Permanente Federation/Kaiser Health Plans
Project and Overall Clinical Leader: Michael Horberg

Kaiser Permanente Research Bank
Goal:
 The Kaiser Permanente (KP) Research Bank is a nationwide research bank that facilitates studies related to the prevention, diagnosis and treatment of disease.
Funder: Kaiser Permanente Community Benefit, National Program Office
Site Principal Investigator: Michael Horberg

KPMA Hepatitis Registries
Goal:
Development of the hepatitis B and C registries are critical to ongoing research efforts for KPMA. The hepatitis C registry case finding and registry population is ongoing, with development of hepatitis B and cirrhosis registries next. Both epidemiologic and clinical applications are anticipated.
Funder: Kaiser Permanente Mid-Atlantic Community Benefits
Principal Investigator (MAPRI):
Michael Horberg

KPMA HIV Registry
Goal:
Develop the HIV registry that closely aligns with the other KP regions’ case definitions. This registry will be used to identify populations for potential research studies, clinical trials, and clinical applications as required.
Funder:
Kaiser Permanente Mid-Atlantic Community Benefits
Principal Investigator:
Michael Horberg

KPMA Sickle Cell Disease Registry
Goal: Develop a sickle cell disease registry that closely aligns with the other KP regions’ case definitions. The registry will be used to facilitate future IRB-approved research based on known cases within the registry, to improve care, and to enhance clinical decision making.
Funder: Kaiser Permanente Mid-Atlantic Community Benefits
Principal Investigator (MAPRI):
Michael Horberg

National Diagnostic Performance Dashboard (DPD) to Measure and Track Diagnostic Error Using Big Data
Goal: Develop an operational ‘big data’ DPD prototype to support local tracking and national benchmarking of diagnostic performance, diagnostic error, and misdiagnosis-related harms, targeting measurement of adverse outcomes from key diseases linked to frequent harms from diagnostic error―missed cancers, missed infections, and missed vascular events (e.g., stroke, myocardial infarction).
Funder: Gordon & Betty Moore Foundation
Site Principal Investigator:
Carla V. Rodriguez

North American AIDS Cohorts Collaboration on Research and Design (NA-ACCORD)
Goal:
This is the North America response to IeDEA, and for which Kaiser Permanente Northern California participates. It is a collaborative cohort compendium and analysis for purposes of achieving sufficient power to address issues that could not be adequately addressed by single cohorts.
Funder:
National Institute of Allergy and Infectious Diseases
Site Principal Investigator
: Michael Horberg

Observational Post-Authorization Study of Patients Treated with Raltegravir
Goal:
Five year surveillance data study to assess safety of new antiretroviral medication raltegravir, with comparisons to rates among similar HIV-infected patients taking antiretroviral medications other than raltegravir.
Funder:
Merck
Principal Investigator
: Michael Horberg

Pathways to Care and Health Outcomes Among DSD Patients
Goal:
The goal of this proposal is to develop a longitudinal study of patterns of care and health outcomes among individuals who were diagnosed with disorders of sex development (DSD).
Investigator:
Douglas Roblin

PORTAL Network – Congenital Heart Defect Pilot Study
Goal: To evaluate a natural language processing algorithm for identifying and classifying congenital heart defects. To field a patient survey in collaboration with the Adult Congenital Heart Association on clinical and research topics.
Funder: PORTAL Network
Site Principal Investigator: Cabell Jonas, PhD

Preventative Strategies for Patients at High Risk for Breast Cancer
Funder: Kaiser Permanente Community Benefit
Principal Investigator: Monica Ter-Minassian

Protecting health information in multi-site research
Goal:
Develop workflow and programmatic methods of identifying and reviewing protected health information in research data prior to releasing the data for multi-site analysis. These methods are designed to reduce the accidental disclosure of protected health information.
Funder: CESR
Principal Investigator: Michael Horberg

Racial Disparities in Hypertension (RADISH): Decomposing the effects of risk factor distribution and risk factor impact on racial disparities
Goal:
 The purpose of this study is to determine the extent to which the overall disparity in uncontrolled hypertension between
Whites and Blacks can be explained by a comprehensive list of pre-specified covariates from KP databases; to calculate the percent contribution of each covariate to the total racial disparity in uncontrolled hypertension; and to calculate the percent contribution of the impact of each covariate to the total racial disparity in uncontrolled hypertension.
Funder:
 Kaiser Permanente/Johns Hopkins Research Collaborative
Primary Investigator
: Suma Vupputuri

Realizing the Health Benefits of Rehabilitation Programs for Cardiopulmonary Disease: What Can Healthcare Systems Do to Improve Patient Engagement and Participation?
Goal:
The goals of this study are: 1) to understand patient, healthcare provider, and community stakeholder perspectives on barriers to, and facilitators of, participation in post-acute, exercise based outpatient cardiac rehabilitation (OCR) and pulmonary rehabilitation (OPR), and 2) to determine if community-based OCR and OPR can increase patient participation, completion, and maintenance compared to facility-based programs.
Funder:
Kaiser Permanente/Johns Hopkins University Collaboration
Investigator:
Douglas Roblin

Sickle Cell Disease Quality Measures and Outcomes
Funder:
 Kaiser Permanente Community Benefit
Co-Investigator
: Monica Ter-Minassian

Socioeconomic Circumstances and Asthma Medication Management in the Baltimore Area: Learning How to Identify Care Gaps and Target Interventions
Goal:
The goal of this study is to demonstrate how existing HER data can be assembled to address disparities in asthma medication management and outcomes and to target future interventions to mitigate disparities. Hierarchical models will be used to identify hot spots of sub-optimal asthma medication management in the Baltimore metropolitan area.
Funder:
Kaiser Permanente/Johns Hopkins University Collaboration
Investigator:
Douglas Roblin

Stage one feasibility test of the Cancer Survival Query System
Goal:
The Cancer Survival Query System is a second generation prototype cancer prognostic tool developed by NCI to help physicians better understand and communicate with their patients valid estimates of their cancer survival within the context of all causes of death. The goal of this project is to move this prototype closer to market readiness and to enhance future adoption and dissemination.
Funder: National Cancer Institute Cancer Research Network (CRN) Cancer Communication Research Center Grant Number: 1P20 CA137219
Co-Investigator: Michael Horberg

Study of Primary Biliary Cholangitis (PBC) of the Fibrotic Liver Diseases (FoLD) Consortium
Goal:
 The long term goal is to establish a multi-site, longitudinal cohort study of patients with PBC drawn from a geographically and demographically diverse U.S. population. The aims of this study will be to study the epidemiology, natural history, patterns of treatment, outcomes, and healthcare resource use patterns of patients with PBC.
Funder:
 Intercept Pharmaceuticals
Co-Investigator:
Carla V. Rodriguez

Terry Beirn CPCRA Clinical Trials Unit: A City-wide DC Cohort of HIV Infected Persons in Care in the District of Columbia
Goal:
The overall purpose of this study is to establish a clinic-based city-wide longitudinal cohort that will describe clinical outcomes in outpatients with HIV/AIDS receiving care in Washington, DC, with the goal of improving HIV/AIDS care in DC.
Funder:
National Institute on Drug Abuse
Site Principal Investigator:
Michael Horberg

The effect of health information exchange on the duplication of radiological services
Goal:
Determine if comprehensive health information exchange through the electronic health record reduces the rate of follow-up x-rays for simple bone fractures.
Funder: KPMAS Community Benefit
Principal Investigator: Michael Horberg

The Impact of HCV Infection on Health Care Utilization and Outcomes Among CKD Patients
Goal: 
The objective of this study is to characterize incidence of Chronic Kidney Disease in patients with and without HCV in the Kaiser Permanente Southern California and Mid-Atlantic health plans; and to describe their health care utilization and risk for adverse outcomes.
Funder: Merck
Site Principal Investigator: Carla V. Rodriguez

The Role of Patient Portals in Ameliorating or Exacerbating Disparities in Maternal Health
Goal:
The purpose of this study is to explore whether, for pregnant/postpartum women at risk for disparities in care and health outcomes, reliance on the personal health record (e.g., kp.org) for patient-provider communication may exacerbate disparities in the occurrence of maternal morbidity and mortality. Using retrospective data from KPMAS, and parallel data from Johns Hopkins Medicine, analyses will establish whether personal health record use increases or decreases the risk for maternal morbidity and mortality among women of differing races/ethnicities, incomes, or insurance types.
Funder:
Johns Hopkins Medicine/Kaiser Permanente Research Collaborative
Principal Investigator:
Nancy Weinfield

Transgender Health Care Quality From the Patient Perspective: A Qualitative Study
Goal: 
The purpose of this study is to identify barriers to quality transgender care, patient expectations, and overall satisfaction at KPMAS from the patient perspective.
Funder: KPMAS Community Benefit
Principal Investigator: Suma Vupputuri

Using electronic health records effectively: the influence of advanced training on the use of key EHR features
Goal:
Determine if training on electronic health records workflows improves the use of features such as problem lists and medication lists that are important for meaningful use of EHRs.
Funder: KPMAS Community Benefit
Principal Investigator: Michael Horberg

Using Values Affirmation to Reduce the Effects of Perceived Discrimination on Hypertension Disparities
Goal:
 The primary outcome is 6-month change in adherence to antihypertensive therapies with the secondary outcome of change in blood pressure. We will also explore possible mechanisms of the intervention effect and formally evaluate for dissemination.
Funder:
 NIH/NHLBI 
Co-Investigator/Site Primary Investigator
: Suma Vupputuri

Validation of COPD Exacerbation Definitions in US Healthcare Utilization Databases
Goal:
The objective of this retrospective observational study is to collect and analyze KPMAS electronic medical record (EMR) data to development and validate an EMB-based algorithm to identify acute exacerbation of chronic obstructive pulmonary disease events.
Funder:
Analysis Group LLC (via GlaxoSmithKline)
Principal Investigator:
Douglas Roblin

Virtual Tumor Registry
Goal:
The goal of of this project is to create resources for future internal research projects, as well as inter-regional and extramural research collaborations.
Funder:Kaiser Permanente Community Benefit Program
Principal Investigator: Michael Horberg