|The PEER Group uses large administrative databases for epidemiological and economics research. A team of 15 program managers, doctorate-level statisticians and system analysts currently support the work of more than 20 UAB investigators and would like to add more to their body of work.|
Meredith Kilgore, Ph.D. believes diversity is vital to any research enterprise.
“You have to be diversified,” says Kilgore, professor of Health Care Organization and Policy and co-director of the Pharmaco-Epidemiology and Economics Research (PEER) Group along with Jeff Curtis, M.D., associate professor of Immunology & Rheumatology. “You never know where the next national priority for research is going to be, and when it reveals itself, you have to be ready to jump in. If you’ve never done it and don’t have a team together, you’re never going to be competitive for that type of money.”
When investigators work together on their common interests, perhaps write some papers or receive a small grant or two, says Kilgore, UAB can be positioned to be a major player when the next priorities are established. That’s why the PEER Group is aiming to diversify its research portfolio — and seeking other investigators on campus who want to do the same.
The PEER Group has evolved for the past seven years in connection with a variety of projects using large administrative databases for epidemiological and economics research. A team of 15 program managers, doctorate-level statisticians and system analysts currently support the work of more than 20 investigators at UAB.
The scope of projects has included work in osteoporosis, rheumatoid arthritis, heart disease and cancer, along with work in policy analysis and the development of analytic methods. The PEER Group’s work has received support from the National Institutes of Health, Department of Health and Human Services, industry and non-profit groups.
“We have solid funding for the foreseeable future,” Kilgore says, “but the more the merrier. I’d like to diversify our funding streams and our areas of expertise. We’re in the position where UAB can be one of the top two or three centers doing this sort of work.”
|“You have to be diversified,” says Meredith Kilgore, M.D., co-director of the Pharmaco-Epidemiology and Economics Research (PEER) Group along with Jeff Curtis, M.D. “You never know where the next national priority for research is going to be, and when it reveals itself, you have to be ready to jump in. If you’ve never done it and don’t have a team together, you’re never going to be competitive for that type of money.”|
The PEER Group has access to data that can be made available to other UAB investigators with their own research questions. The group can either make the data available to researchers, or investigators can let PEER conduct the analysis for them — all at a cost that is a fraction of what it would be otherwise.
“Our group is dedicated to rigorous, multidisciplinary data analysis intended to improve public health,” Kilgore says. “We support the research and training missions of UAB, and we’re very capable of turning things around quickly.”
The PEER Group was formed of multiple disciplines, with Kilgore and Curtis leading the way. UAB faculty to utilize the PEER Group in their research include Ken Saag, M.D., professor of medicine in Clinical Immunology & Rheumatology; Julie Locher, Ph.D., associate professor of Gerontology, Geriatrics & Palliative Care; Ali Ahmed, M.D., professor of medicine in Gerontology, Geriatrics & Palliative Care; and Tim Beukelman, M.D., associate professor of Rheumatology.
Saag says PEER is an instrumental part of outcomes research activities at UAB, specifically pointing to the group’s work with the Center for Outcomes Effectiveness Research and Education.
“PEER is a critical resource for our outcomes and effectiveness research,” Saag says. “We have a substantially growing portfolio, and our ability to both do research and train people to do research in that area is critical. We have several new training grants that really are dependent on the expertise and capacity of the PEER Group. And for many of our research training grants from the Agency for Health Care Research and Quality, this is the cornerstone of that activity. It’s also is a fundamental component of the Center for Education and Research on Therapeutics, our funded CERTS grant. These are both areas where we’re very much dependent on the success of the PEER Group.”
|The PEER Group has access to data that can be made available to other UAB investigators with their own research questions. The group can either make the data available to researchers, or investigators can let PEER conduct the analysis for them — all at a cost that is a fraction of what it would be otherwise.|
What makes PEER unique is the rich data sets it has in house. Part of that comes from its partnership with Amgen, a pharmaceutical company that discovers, develops, manufacturers and delivers innovative human therapeutics. That partnership only strengthened recently when PEER was approved by the Food & Drug Administration (FDA) to go forward with a contract with Amgen to do the post-marketing safety surveillance study for a new osteoporosis drug. PEER became the first group to have the FDA approve this approach for that type of post-marketing research.
Data in hand
The Centers for Medicare and Medicaid Services (CMS) also allows data UAB has purchased for projects to be reused after the initiation of a new Data Use Agreement (DUA). Thus, data that are in house can be made available to UAB investigators at greatly reduced cost. The data currently in hand include:
- 5 percent longitudinal sample of all Medicare beneficiaries for the years 1999 through 2010, which includes approximately 2.5 million beneficiaries in each year, 150 million Medicare Parts A and B claims per year and 60 million Medicare Part D claims per year from 2006-2010.
- 100 percent sample of Medicaid beneficiaries from 1999-2002, and a 5 percent sample of all beneficiaries enrolled in both Medicare and Medicaid from 2003-2005.
- 100 percent of Medicare beneficiaries diagnosed with Rheumatoid Arthritis or other rheumatologic conditions treated with biologic agents for the years 2000-2010.
- 100 percent of inpatient and skilled nursing facility claims for 2000-2008.
- Medicare inpatient records linked to the OPTIMIZE-HF heart failure study.
- Medicare enrollment and claims data linked to REGARDS study participants.
- Various years for the Surveillance, Epidemiology and End Results (SEER) tumor registry data for various cancers linked to Medicare claims.
- Miscellaneous public use files containing administrative for survey data.
PEER also has experience in United Health Care, Etna and Kaiser Foundation databases, among others. The group also can use data that UAB Hospital and the Veteran’s Administration Hospital generates on its own patients for quality improvement and other initiatives.
In addition, PEER has taken the historic REGARDS UAB stroke study and linked it to Medicare claims data, enabling the group to do more in the area of disparities research.
“Doing these sort of linkages to cohort studies is something we’re pushing hard right now,” Kilgore says.
While most of PEER’s work has been done with Medicare claims, they are not limited to just that data. When they want to examine working-age people, other data sets are available.
“Hopefully we’re coming along to where we’ll have data that have more clinical information than you can get out of the claims data,” Kilgore says. “The REGARDS study is one of those resources that has helped us.”
Pre- and post-doctoral fellows welcome
Kilgore says the group also is available to work with core and other training programs around the university. Pre- and post-doctoral fellows are welcome to come and learn how to do this research. PEER has internships available and can provide some classroom instruction on how the data is put together or help to find research projects those working on their dissertation. In fact, CMS will waive the fee for reusing that data for those working on their dissertation.
Only Harvard University, the University of Pennsylvania and the University of Minnesota rival UAB’s data sets and the hardware, software and technical expertise to manage them, Kilgore says. The opportunity for UAB to thrive in this area is evident.
“We’re competitive, we’re connected and there are plenty of conduits to support people and find the expertise they need,” Kilgore says. “We put together proposals that are really strong. We want to add to our capabilities and build on what we have. It’s all about doing research that has a practical impact and actually improving the public’s health. What we need from other folks in the university is their interest and focus on specific questions. We’re good analysts, modelers and programmers. Working with the clinical folks keeps us grounded and focused on the important things we need to be looking at. We’re all about collaboration with folks all across campus. We can work with them and help them put something together that’s much less expensive than somewhere else.”