CTSC.TTIC.minutes.061208

Action Items (details in text):

1. Schedule next meetings (Erin to assist)
2. Read attached White Paper in preparation for next meeting
3. Read attached list of imaging resources; Update your site.
4. Bring suggestions for educational programs to be offered ASAP

Harvard Translational Imaging Consortium Initial Meeting Minutes June 12, 2008

In Attendance:

• Gordon Williams, from Brigham and Women’s Hospital (BWH)
• Bruce Rosen, from Massachusetts General Hospital (MGH)
• Robert Lenkinski, from Beth Israel Deaconess Medical Center (BIDMC)
• Bill Hanlon (attending in place of Gordon Harris), from MGH
• Anne Schlesinger, Research Navigator from the CTSC
• Jeff Yap (attending in place of Annick D. Van den Abbeele), from Dana Farber Cancer Institute (DFCI)
• Ron Kikinis, from BWH
• Stephen Voss, from Children’s Hospital (CHB)
• Randy Gollub, from MGH
• Clare Tempany, from BWH, connected via telephone

1. Brief CTSC Overview (Dr. Gordon Williams) The CTSC provides funding to support science; it is an educational and infrastructure driven program.

Table 1.1 of the submitted grant proposal lists the institutions that participate in Harvard University’s CTSC (all HMS affiliated academic health centers, multiple schools within Harvard, Boston School of Nursing and MIT).

Dr. Lee Nadler, a prominent investigator in translational cancer research from Dana Farber Cancer Institute, is the CTSC Principal Investigator.

The CTSC grant from the government is the largest grant that Harvard has ever received. It includes NIH funds and supplemental funds from all affiliated hospitals, Harvard, and MIT. The grant includes $23.7 million dollars from the NIH. There are no indirects. The Harvard CTSC is the only CTSC program in the country to do this.

80% of the CTSC budget comes from the pooled funds from the collaborating GCRCs (MGH/MIT, BWH, DFCI, BIDMC, Joslin Diabetes Center (JDC), and CHB), including their K30 and K12 educational grants. Each CTSC can request funding equal to this initial sum plus an additional 30-33% more, but funding is capped at $6 million dollars. Harvard has the only CTSC to be capped before receiving this additional 30% increase. By 2010, money for the GCRCs will no longer be available but there will be $.5 billion dollars awarded to the approximately 60 CTSCs. Currently, 38 CTSCs are funded (see the listing at: http://www.ncrr.nih.gov/clinical_research_resources/clinical_and_translational_science_awards/consortium_directory/)

Currently, the Harvard CTSC is flat-funded. Year 5 will be 15% under funded, compared to the first year. Some other CTSCs will get decreased funding until they reach the percentage allowed for them.

As described by Dr. Williams, the Harvard CTSC is a network of 11 related clinical research infrastructure domains (see handout page 1).

The Participant and Clinical Interaction Resources (PCIR), under the direction of Dr. Klibanski, will provide continued support for the functions now covered under the GCRC. It is similar to the existing GCRCs, but has allocated additional money for nurses and coordinators to work outside of the boundaries of the traditional GCRCs at offsite locations. The integrated PCIR will take time to become fully operational. Several GCRCs included a nutrition service and a Core Lab, some of which are being consolidated.

The Biostatistics/Ethical Sciences Program, under the direction of Dr. Ware, representing the statistical services currently offered by the GCRCs, will now become an integrated unit, receiving a two-fold budget increase. The employees of the biostatistics program have varying levels and areas of expertise. (Not discussed but important for our group is how to build a strong connection to this team to improve support for development of image analysis expertise- consulting and education).

The Research Education Program, under the direction of Dr. Golan, currently includes four masters’ degree programs (one at Harvard’s Public Health School, one at MIT, and two at Harvard’s medical school). There is also a PhD program in translational biology offered at Harvard University and medical school. There is an educational infrastructure at the hospitals. The K12 helps in the transition from a fellowship to a K23/K08 for younger investigators. There is also a Continuing Medical Education program.

The Regulatory Program, under the direction of Dr. Bierer, is charged with making it easier to get a study done across multiple sites with a unified IRB and admitting system. Cancer clinical research program is being used as a model for this.

The Community Engagement and Resource Program, under the direction of Dr. Platt, will move cutting edge translational health care treatment developments into the community.

The Diversity Program, under the direction of Dr. Reede, addresses issues of healthcare disparities. It is not a program to recruit minority investigators.

The Informatics Program, under the direction of Dr. Kohane, has been given $100 million dollars. It is a central information resource through the “CONNECTS” web interface. The CONNECTS program will be a central management of resources, courses, and consultation services offered by the CTSC, with Research Navigators coordinating the upload of information into this web interface.

Three programs, Translational Technlogy (TT) under the direction of Dr. Williams, Innovative Technology (IT) under the direction of Dr. Sukhatme, and Pilot Studies under the direction of Dr. Nadler, are closely integrated and fulfill similar functions. The difference between TT and IT is that TT involves well established research interests, while IT deals with interests that are not well established. Imaging and genetics, although they contain some areas that are innovative, are generally well established with mature resources that are already available to the Harvard research community, placing them in the TT program. Biomarkers are not well established and fall under IT.

Pilot Grants allow access to infrastructure support for specific projects. Junior investigators are encouraged to apply for pilot grants, as these grants are primarily intended for young investigators who have partnered with an experienced mentor. These pilot grants are intended to fund studies involving an interaction across institutions or disciplines. For example, if the imaging group wanted to calibrate their image acquisition and analysis methods across five sites, that would be an example of an ideal candidate for a pilot grant. An important goal for this strategic plan is to include faculty from Harvard University, and, to some extent, MIT. The Physics and Engineering departments have a strong potential to provide collaborators. There are three monetary levels of pilot grants: 50K, 100K, and 250K. The award that a study will receive depends on the degree of complexity and interaction.

There is $2.5 million set aside for pilot grants for the first year. It will increase to $9 million by year 5. Additional funds may come from donors. Pilot grants provide a good source of fundraising.

Application submissions for CTSC pilot grant funds can be for basic or clinical research as long as the relation to translational efforts are made clear. The imaging group is a strong candidate to receive pilot grant funds, with the patient derivative as well as the availability of open source and readily shared resources in the imaging group serving as an advantage. Members of this group are strongly urged to suggest ideas for shared proposals to be developed in time for submission when applications are first accepted for consideration (~in September 2008).

The group then shifted attention to another potential funding source for our work. Drs. Williams and Rosen suggested that all members of the Translational Imaging consortium read Harvard Medical School’s Strategic Plan on Technology Platforms Education (the White Paper), which is available on Harvard medical school’s web site (see the attached article, also available at http://hms.harvard.edu/public/strategy/TNTreport.pdf). An understanding of this document may stimulate ideas from this group for a proposal to submit to HMS to obtain additional funding for shared imaging hardware and/or software. Since the CTSC funds can’t be used for major purchases of equipment, if this group believes such an investment would be crucial for robust delivery of imaging technology to the Harvard clinical translational research community, this might be a potential source of funds. Members of the imaging consortium are encouraged to discuss their ideas and possible projects with Steve Harrison and Elazer Edelman, the committee chairs. This topic will be an agenda item at our next meeting since the deadline is fast approaching.

It was suggested that members of the imaging consortium draft a 1-2 page description of proposed research, and submit it to Dr. Williams. These drafts will then be forwarded to Lee Nadler, and subsequently to Dean Flier, who coordinates with the committee chairs.

2. The Proposed Imaging Consortium Plans and Discussion (Bruce Rosen)

The CTSC grant text outlined the services to be provided by this Consortium with the goal of helping others use the existing resources. The Imaging Consortium is charged with the responsibility to have the following three services planned and launched by September 1st, 2008.

a. Consultation service The imaging consortium must design a plan for implementing this consulting service, draft a list of available resources for the consultation service, and provide education regarding these resources. Funding for the consultation service is available through the CTSC. Navigators are responsible for linking people to the imaging consortium consultants.

Each institution has support for a representative/point person to provide these consulting services. A senior member of the faculty is listed as the consultant, but a more junior faculty member, a person specifically hired as a consultant, or a consulting triage group may be assigned to provide the consultations.

b. Educational Offerings The proposal is for us to develop a web based educational program (via CONNECTS eventually, but not immediately) with possible workshops and 3-4 nanocourses a year.

CTSC leadership is urging the various Consortium groups to consider offering “nanocourses”. Nanocourses are short courses on the basics of a topic, meant for the more novice investigators. They can discuss the general research tools that are available. These are meant to educate the populous of clinical translational investigators. Each course should be held at least twice, once at the MGH main campus and once in the Longwood area.

CTSC will have a “meeting planner” who will be hired soon to assist in organizing the nanocourses, but until then Laura Weisel will fulfill this duty. We are being asked to please organize one soon so that a schedule can be made and rooms can be booked. We need to assign people to develop this nanocourse. Continuing Medical Education requirements can be fulfilled through these nanocourses. Can a nanocourse be held electronically or through a teleconference?

Advanced workshops- Could we organize one for the fall? Need to identify the topic, presenters and length of time. The focus is to be on innovative imaging technologies (or analysis methods) that are ripe for translational applications. The workshops as envisioned bring together the technology developers with the potential clinical translational investigators. The group discussed the idea of Optical Imaging as one that might have a strong interest within the community with natural connections to pediatric applications. One idea is that the workshops could lead to new collaborations and proposals for pilot grants.

The Navigator will handle creating and updating an inventory or resources and will compile these on a website. Dr. Gollub has an existing list of resource descriptions, including web links (attached) that she compiled for use of the CTSC leadership as they prepared the grant proposal. This group can use this as a starting point if they wish for their site or start from scratch. Each of us needs to compile materials from our own site- can be description of imaging acquisition hardware, image analysis software and tutorials, or other materials. The Navigator is responsible for getting these imported into CONNECTS.

c. Operational budget to accomplish the above by September 1st. No details were discussed on this item.

Additional notes: The group spent time considering the following questions and expects to continue in future meetings: How can we take advantage of this opportunity to foster collaboration? What are appropriate clinical driving projects? Can we pool data from across institutions? How can we establish cross-site mentoring relationships? Some cross-institutional projects are the BIRN and tumor projects; how can they be leveraged to facilitate the work of the CTSC?

3. Outcomes The group agreed upon the need and commitment to have regular face-to-face meetings (once per month), as well as weekly teleconferences over the next few weeks to achieve the above goals. The location of the face-to-face meetings will be rotated to each of the partner sites and will include a tour of the available facilities. Then we will decide whether to maintain the rotation or settle on a fixed site for future meetings. We will request assistance from CTSC or Dr. Williams in setting up these meetings.

There was a suggestion that we form the following Subcommittees:

• Consultation services- Clare and Stephen
• Informatics- Ron will head it, with Bruce, Bill, Stephen, and Jeff Yapp
• Education- Randy will head and Bob will help
• Resources- The Navigator is in charge of assessing what to post on the web and ensuring that it is posted. Bruce and Zeke will help. CONNECTS architect is Douglas MacFadden he is aware of our interest in working with him.

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