UAB 1917 Clinic Cohort
The UAB 1917 Clinic Cohort is a prospective, observational HIV clinical cohort study established in 1992 as a component of the UAB CFAR Clinical Core (Core C) that includes extremely well characterized patients engaged in medical care at the UAB 1917 HIV/AIDS Clinic (>8000 overall, >1900 active). Detailed sociodemographic, psychosocial, treatment, and clinical data are available for patients treated at the UAB 1917 HIV/AIDS Clinic since 1988. Since 2006 clinical and treatment data has been captured at the point-of-care with the locally programmed 1917 Electronic Health Record. A system of 100% quality control of data allows for a high-quality database that contributes to numerous HIV cohort collaborations including the CFAR Network of Integrated Clinical Systems (CNICS), Antiretroviral Therapy Cohort Collaboration (ART-CC) and North American AIDS Cohort Collaboration on Research and Design (NA- ACCORD). The 1917 Clinic Cohort is physically housed at the UAB 1917 Clinic, a world-class, state-of-the-art HIV treatment facility, located in downtown Birmingham, Alabama in the Community Care Building (CCB) occupying 3 floors and 15,795 square feet of clinical, office and laboratory space.
Over the past 5 years the UAB 1917 Clinic Cohort has generated over $20 million in external funding and published over 70 peer-reviewed manuscripts. The UAB 1917 Clinic Cohort Database and the 1917 Electronic Health Record are housed on a Dell PowerEdge 2300 server, which is part of a seven server farm that provides the 1917 Clinic IT infrastructure. This structure allows for flexible and comprehensive data query capabilities. The current storage capability exceeds 500 GB and contingency/disaster recovery procedures are in place with remote real-time back-up of data at two additional sites. Over 100 users utilizing our 93 personal computers regularly access the applications housed in this secured environment. Located on the 2nd floor of the Community Care Building, the patient care area of the 1917 HIV/AIDS Clinic includes 8 exam rooms outfitted with touch screen computers linked to a web-based platform for completion, transmission and secure storage of CNICS Patient Reported Outcomes (PROs) questionnaires completed routinely during clinic visits. The clinic also contains two pharmokinetic rooms, a phlebotomy area, an X-ray suite, a pharmacy and a dental clinic with six operatories. Shared conference rooms, fax machines, scanners, and copy machines are co-located and readily available to UAB 1917 Clinic Cohort personnel on the first floor of the Community Care Building.
Established in 2002 and funded as an R24 research platform (R24AI067039) in 2006 and awarded a 5-year competitive renewal in 2011 (National PI, Michael Saag), the nationally distributed CNICS cohort is a clinic-based research network that reflects the outcomes of clinical decisions and management options used in the care of HIV-infected individuals at 8 CFAR sites: UAB (site PI Michael Mugavero), University of Washington (site PI Mari Kitahata), UCSF (site PI James Kahn), UCSD (site PI Christopher Mathews), Case Western Reserve (site PI Benigno Rodriguez), Fenway Community Clinic (Brown / Harvard, site PI Stephen Boswell), University of North Carolina at Chapel Hill (site PI Joseph Eron), and Johns Hopkins University (site PI Richard Moore). The CNICS project supports a database that serves as a central repository of verified and quality controlled clinical data from the electronic medical records (EMRs) at each site. Clinical data is linked to behavioral patient reported outcome data (Depression: PHQ-9, Anxiety: PHQ-A, Alcohol use: AUDIT-C, Substance abuse: ASSIST, Quality of life: EuroQOL-5D, ART adherence: ACTU-4, VAS, SRS, HIV symptom burden: HIV Symptoms Index, Sexual risk behavior: HRAP) obtained at regular intervals, geospatial data, and to biologic specimens stored in repositories and readily available for use in translational research projects. There are currently 22,317 patients enrolled in the CNICS Cohort with over 20 million clinical observations. The mission of CNICS is to provide access to the specimen and data repository to any investigator who submits an approved concept proposal. In this fashion, CNICS is a 'peer-reviewed open access' research platform available to investigators world-wide. CNICS includes an Administrative Core, Data Management Core and Epidemiology and Biostatistics Core to provide access to data elements and patient specimens. Over the initial 5 years of funding, CNICS supported research has resulted in 73 abstract presentations at national/international meetings and over 50 published manuscripts. The CNICS infrastructure was also the foundation for 21 extramural NIH funded awards, including 1 R01, 1 U01, 3 R21s, 6 supplements, and 3 K awards, among others.
UAB Center for AIDS Research (CFAR)
The UAB CFAR was established in 1988 as one of the original seven charter centers of a new NIH initiative. The mission of the UAB CFAR is to stimulate and support multidisciplinary basic, behavioral, clinical and translational HIV/AIDS research so as to hasten the development of effective treatments and prevention strategies for HIV/AIDS. For over 20 years, the UAB CFAR has played a vital role in supporting cutting edge research activities of its members that have led to paradigm-shifting discoveries. A common thread connecting these discoveries is the proactive participation of the CFAR in facilitating basic, translational and clinical research through effective collaboration between basic and clinical investigators. The aims of the UAB CFAR are to support the mission of the NIH CFAR program and sponsored HIV/AIDS research activities through programmatic leadership and by the provision of essential and enabling services to UAB investigators. The objectives of the UAB CFAR reflect this continuing commitment to innovative, multidisciplinary HIV/AIDS research to meet the challenges of the domestic and international HIV/AIDS epidemics and include:
1. To provide a central institutional focus for HIV/AIDS research activities that emphasize effective communication and collaboration among CFAR members and the wider HIV/AIDS research community.
2. To enhance productivity of ongoing research programs by encouraging interdisciplinary research and by providing critical shared resource facilities and administrative and fiscal management support to Center investigators.
3. To use robust strategic planning methods to identify new research opportunities and priorities, to align them with existing CFAR programs, and to foster new research programs where none are in existence but where faculty interest and University capacity is evident.
4. To stimulate the entry of junior and established faculty into HIV/AIDS research programs. This is accomplished through mentoring young investigators and by a peer-reviewed Developmental Grants Program.
5. To stimulate faculty recruitment and program development in areas that reflect the ongoing evolution of HIV/AIDS research and the global epidemic.
The multidisciplinary membership base of the UAB CFAR enables the rapid translation of fundamental knowledge about HIV/AIDS and its related disorders into clinical treatment, prevention programs, and effective community outreach interventions. The UAB CFAR provides a dynamic environment for collaborative research within the Institution. The UAB CFAR provides infrastructure, designated research space, 7 research core facilities with specialized equipment and trained personnel, and access to developmental research funds to its over 200 Center members from 33 Divisions and Departments within the UAB research community. The Center has played an indispensable role in UAB’s national reputation in HIV/AIDS research and care (ranked 8th in the Nation by U.S. News & World Report in 2013). Current AIDS-related grants and contracts currently supported by the UAB CFAR total more than $75 million.