Research Activity

Research programs in the division of general internal medicine are focused on a number of areas and units within the Division as noted below.

Extramural funding by full-time faculty is derived from the National Institutes of Health, foundations, U.S. Department of Veterans Affairs, American Medical Association, and industry.

RADICAL Lab

The Research in Assessment Designed to Improve Care and Learning (RADICAL) Lab has members from across both the division, the department, and the college.  This collaborative group have conducted a number of studies examining the impact of various educational and operational innovations in the residency program, particularly related to the EIP (Educational Innovations Program) award granted by the ACGME. Other research foci have included predicting performance of house staff on standardized certifying examinations, and medical student self-assessment using matrix evaluation, and the effect of changes in duty hours on resident education and patient care.

Decision Analysis, Patient-Centered Decision Making, and development of Decision Support Tools

A major goal of the division has been the development of a suite of decision analytically driven decision support tools. These will take a variety of forms, including interactive web pages, and ultimately integration into the electronic health record and computerized physician order entry. The tools will be designed to help clinicians as well as patients and their families grapple with complicated therapeutic and diagnostic decisions.

Decision analytic models can synthesize comparative effectiveness data from multiple clinical studies, as clinical trials seldom perform head-to-head comparisons of all the treatment alternatives clinicians have for any particular disorder. In addition, these tools can incorporate patient preferences and values for health outcomes, which are of particular importance for preference sensitive decisions in which patients are trading off significant treatment side effects and adverse outcomes in the hopes of preventing further disease progression.

One example of such a decision support tool (DST) is an interactive Web page-based DST providing recommendations for anticoagulation therapy for patients with non-valvular atrial fibrillation. In a related project, investigators in the Center have active funding to develop adjuncts to atrial fibrillation practice guidelines that allow the incorporation of patient values for health outcomes in the decision regarding antithrombotic therapy.

Another area of investigation is the development of decision support tools to aid obese patients in making decisions regarding bariatric surgery. This work has also focused specifically on patients with diabetes. Projects are also investigating psychosocial, clinical, and socio-demographic determinants of decision-making and satisfaction with decisions about bariatric surgery.

Faculty in the division teach courses in the University of Cincinnati’s Master’s degree program in Clinical and Translational Sciences on Decision Analysis and Cost-Effectiveness Analysis.

The division also hosts a weekly Decision Modeling Seminar in which a multi-disciplinary group of faculty, fellows, and residents interested in performing decision analyses meet to work on their modeling projects.

Other areas focused on clinical and implementation research include:

Sickle Cell Disease

Medicine-Pediatrics faculty in the Division have received HRSA funding to establish a medical home for patients with sickle cell disease who are transitioning from pediatric to adult care. Infrastructure is being developed to coordinate care between the medical home, pediatric and adult sickle cell centers at Cincinnati Children's Hospital Medical Center and The University Hospital, and between community primary care sites, and address patients' educational needs about sickle cell disease and its complications.

Migraine Headache

Faculty in our division have made pioneering advances in investigating the impact of hormonal fluctuations in the pathogenesis of migraine headaches. This has resulted in numerous clinical trials investigating among other topics, hormonal manipulation therapy in the control and prevention of migraine headache.

Mentoring & Teaching

Senior faculty of the division have been training students and fellows and mentoring faculty and residents for more than 20 years in this division and across the University.