VA Office of Research and Development, Health Services Research and Development Service 1

2007 Translating 

Research

into Practice

Vol. 5, No. 1 January 2007

In This Issue

New Director of HSR&D 

Named Page 1

HSR&D Research Featured in 

JAMA’s “Author in the Room” 

Series Page 2

New REAP Sites Page 2

Newly Funded Page 3

VA HSR&D Research Briefs is a semiannual publication of the Office of 

Research and Development’s Health 

Services Research and Development 

Service. For more information please 

contact:

Geraldine McGlynn, Editor

Email: geraldine.mcglynn@va.gov

Phone: (857) 364-6073

VA HSR&D Research Briefs is available at www.hsrd.research.va.gov and 

at vaww.hsrd.research.va.gov

New Director of HSR&D 

Named

Seth A. Eisen, MD, MSc, has been 

named Director of HSR&D effective late 

December 2006. Dr. Eisen received his 

Medical Degree 

from Washington 

University in St. 

Louis, MO and his 

Masters of Science in 

Epidemiology from 

the Harvard School 

of Public Health. 

After completing 

his training in Seth A. Eisen, MD, MSc

rheumatology, Dr. HSR&D Director

Eisen devoted several years to lab bench 

science. In the late 1970’s, he realized he 

missed contact with patients and accepted 

the opportunity to become Director of 

Ambulatory Care at the newly constructed 

St. Louis VA Ambulatory Care facility. 

Thus, a long history with the VA and VA 

research began.

In a recent interview, Dr. Eisen spoke 

enthusiastically about his research. His 

first VA funded project was an evaluation 

of the relationship between medication 

adherence and blood pressure control. 

The medication compliance monitoring 

device that he and colleagues invented for 

this work was later patented by VA. In the 

early 1980’s, he became very interested 

in the health effects of the Vietnam War. 

Over 8 million Americans were in service 

during the Vietnam War, and Dr. Eisen and 

colleagues had the idea to create a national 

registry of Vietnam era veteran twins. 

After an initial demonstration project that 

confirmed the proposed study’s feasibility, 

they developed the Vietnam Era Twin (VET) 

Registry, a cohort of 7400 monozygotic 

and dizygotic twin pairs in which twin 

siblings both served in the military during 

the Vietnam War. Twin pairs were then 

evaluated by phone and mail to assess the 

physical and psychological effects of war 

on health. Subsequently, collaborating 

with colleagues at Washington, St. 

Louis, and Boston Universities, and the 

University of California San Diego, the 

research team received funding from the 

National Institutes of Health to study many 

disorders including post-traumatic stress 

disorder (PTSD), major depression, tobacco 

dependence, drug abuse and dependence, 

and pathological gambling. Work with 

the twin registry is ongoing. Additionally, 

Dr. Eisen is engaged in work on a national 

study of Gulf War veterans and their 

families. 

Dr. Eisen brings this research commitment and enthusiasm to his new position 

as HSR&D Director. He knows all too well 

the great disappointment of funding failures, as well as the satisfaction of success. 

“I have personally experienced many of the 

issues researchers in the field are dealing 

with. In this new position, I will be on the 

side of the researchers.” 

For example, information technology 

and access to VA databases for research is 

very much on Dr. Eisen’s radar. “I am an 

epidemiologist by training and, as such, 

I love data and databases. VA’s national 

databases are important to the Office of 

Research and Development in general, 

and to HSR&D specifically. A major goal 

is to ensure that the current level of access 

remains and, further, to improve access to 

VA databases for researchers,” said Eisen. 

He went on to say that in IT planning 

meetings that he has attended thus far, 

there is a clear recognition on the part of 

all parties of the importance of data for 

research.

In addition, Dr. Eisen sees wonderful 

opportunities for collaborations across 

health services, clinical science, and 

rehabilitation research. “The expertise for 

evaluating and implementing the results of 

clinical science and rehabilitation resides 

in HSR&D and VA’s Quality Enhancement 

Research Program. I have a strong interest 

in developing these collaborations.” 

Dr. Eisen also is interested in developing 

Continued on page 2

HSR&D 

NATIONAL MEETING

February 21-23, 2007

Hyatt Regency Crystal City, 

Arlington, VA

Agenda and details on the web at 

www.hsrd.research.va.gov/

meetings/2007

We look forward to seeing you there!
2 VA Office of Research and Development, Health Services Research and Development Service

January

New Director of HSR&D Named 

Continued from page 1

the next generation of health services 

researchers as evidenced by his work as 

Chair of the Career Development Review 

Committee for the past four years.

At the same time that warm welcomes 

are extended to Dr. Eisen, a heartfelt 

THANK YOU is given to Shirley Meehan. 

Dr. Meehan has done a tremendous job 

as Acting Director of HSR&D for the past 

two and a half years, and all of us in 

HSR&D are grateful for her dedication, 

leadership, and guidance. Dr. Meehan will 

now resume her role as Deputy Director of 

HSR&D.

HSR&D Research Featured in 

JAMA’s “Author in the Room” 

Series

Two studies will be discussed by 

HSR&D investigators in the “Author in 

the Room” series – a joint initiative from 

The Journal of the American Medical 

Association (JAMA) and the Institute for 

Healthcare Improvement (IHI). In this 

Publication Notification

HSR&D requires notification of all 

articles by HSR&D investigators 

when the article is ACCEPTED for 

publication. When an article is 

accepted please send an email to 

vhacohsrd@va.gov and to research.

publications@va.gov and include the 

journal name, expected publication 

date, funding source, and a copy of 

the accepted article.

series, an author of a study published in 

JAMA, with the potential to change clinic

practice, will talk to clinicians during 

a conference call that is facilitated by 

clinical experts in implementing changes 

in practice. 

An HSR&D Advanced Career 

Development Awardee, Dr. Louise Walter 

discussed her study on Wednesday, 

December 20, 2006. Walter and 

colleagues conducted a study to determin

prostate-specific antigen (PSA) screening 

rates among elderly veterans, including 

those with limited life expectancy. Most 

screening guidelines do not recommend 

PSA screening in elderly men with limited

life expectancies. However, this study 

showed that PSA screening rates are high 

among elderly veterans aged >70 years, 

with more than half receiving a PSA 

test in 2003 (68% done within VA, 32% 

within Medicare). The study also showed 

that age was the strongest predictor 

of PSA screening. The percentage of 

veterans having a PSA test decreased with 

advancing age, for example, from 64% for

veterans ages 70-74 to 35% for veterans 

age 85 or older.1

Dr. David Ganz, HSR&D investigator 

at the VA Greater Los Angeles Health 

Care System, will discuss his study on 

Wednesday, February 21, 2007 from 2:00-

3:00 pm (EST). Ganz and colleagues 

sought to identify risk factors for falls that 

would be included in a screening test that

could be incorporated into routine clinica

examinations. In 2001, approximately 

2.7 million elderly Americans were 

treated for non-fatal injuries in emergency

departments, 62% as the result of falls. A 

typical intervention begins with a fall-risk 

assessment that a clinician would perform

as part of the patient’s history and physical

examination. This type of intervention 

is usually reserved for high-risk patients, 

thus clinicians must be able to recognize 

patients at high risk of falls. This study 

shows that patients who have fallen withi

the previous year or the past month, or 

who have a gait or balance problem have 

50% chance of falling within the next yea

It also suggests that fall-risk interventions 

for those who screen positive for being 

at high risk could reduce the rate of falls 

among the elderly by 30-40%. 2

For more information about the 

al 

e 

l 

n 

a 

r. 

“Author in the Room” series and to sign 

up for sessions, go to www.ihi.org/

authorintheroom.

1. Walter L, Bertenthal D, Lindquist K, and 

Konety B. PSA screening among elderly 

men with limited life expectancy. JAMA

November 15, 2006;296(19):2336-2342.

2. Ganz D, Bao Y, Shekelle P, and Rubenstein L. 

Will my patient fall? JAMA January 2007, in 

press. 

New REAP Sites

The goal of the Research Enhancement 

Award Program (REAP) is to increase 

HSR&D capacity by assisting VA sites that 

already show promise, as demonstrated by 

a history of HSR&D peer-reviewed research 

and career development funding. Groups 

of investigators who are eligible for funding 

are those located at VA medical centers 

that do not contain and are not affiliated 

with an HSR&D Center of Excellence. 

Following is a description of the newest 

sites to receive HSR&D REAP funding. For 

more information on this program, visit the 

HSR&D web site at www.hsrd.research.

va.gov/about/centers/reap.cfm. 

Colorado REAP to Improve Care 

Coordination for Veterans

Evelyn Hutt, MD, Denver VAMC

Research at this site focuses on quality 

of life and care for the rapidly expanding 

segment of the veteran population with 

complicated chronic disease management 

issues and those who reside in long-term 

care. Projects are designed to improve 

the quality of care for serious acute and 

chronic medical illnesses common in older 

veterans, such as pneumonia, congestive 

heart failure, and depression, and on 

projects designed to enhance quality of 

life for veterans receiving care in multiple 

sites by addressing issues such as care 

coordination, pain management and falls. 

In addition, investigators will pursue a 

research agenda to assist in planning for 

the long-term care needs of the aging 

veteran population by describing the health 

and socio-demographic characteristics of 

veterans who use long-term care across a 

variety of settings. This site is affiliated with 

the University of Colorado Health Sciences 

Center.

Seth A. Eisen, Director, and Shirley Meehan, 

Deputy Director of HSR&D.
VA Office of Research and Development, Health Services Research and Development Service 3

2007

Columbia Center for the Study of 

Chronic, Comorbid Mental and 

Physical Disorders

Linda Ganzini, MD, MPH, Portland VAMC

The Columbia Center’s mission is to 

conduct interdisciplinary research to 

improve care for veterans afflicted with 

both physical and mental disorders. 

Of particular interest is the interaction 

between mental illnesses and delivery 

of primary medical care, screening for 

medical illnesses, cancer care, and 

treatment for hepatitis C. The Center will 

investigate patient, clinician, and systemsbased barriers to delivering medical care 

to patients with mental disorders and 

test novel methods of health delivery to 

patients with both mental and physical 

disorders. In addition, the Center will 

develop new conceptual models of how 

patients with chronic, comorbid mental 

and physical disorders and their providers 

understand the patients’ illnesses and 

health care needs. Academic collaborators 

include Oregon Health & Science 

University and the Kaiser Permanente 

Center for Health Research.

Newly Funded

Career Awardees

Diana Burgess, PhD Minneapolis VAMC Understanding and Ameliorating Racial/Ethnic Disparities in Healthcare

Michael Ho, MD Denver VAMC Improving Hypertension Outcomes among IHD Patients

Cari Levy, MD Denver VAMC Site of Death among Veterans in Nursing Home Care Units

Douglas Robertson, MD White River Junction VAMC Developing Sensible Cancer Screening Strategies Following Colonoscopy

Christianne Roumie, MD Nashville VAMC Targeted Evidence-Based Improvements to Overcome Clinical Inertia

Paul Varosy, MD San Francisco VAMC Optimizing Utilization of ICD Therapy in Veterans

Research Projects

(Only awards/projects with funding start dates that have been confirmed since the last issue of Research Briefs are listed here.)

Investigator-Initiated Research

Neena Abraham, MD, MSc Houston VAMC Economic and Clinical Outcomes of Recommended NSAID Prescription 

Strategies 

Cathy Alessi, MD VA Greater Los Angeles Health Care System Non-Pharmacological Interventions on Sleep in Post-Acute Rehabilitation

Barbara Bokhour, PhD VA New England Health Care System Culture and Communication in Hypertension Management

Kenneth Boockvar, MD, MS Bronx VAMC Reducing Transition Drug Risks after Patient Transfer

Katharine Bradley, MD, MPH VA Puget Sound Health Care System Alcohol Misuse and the Risk of Post-Surgical Complications and Mortality

Laurel Copeland, PhD VA South Texas Health Care System Patterns of Late-Life Healthcare among VA Patients with Schizophrenia

Timothy Dillingham, MD Milwaukee VAMC Electrodiagnostic Services: Guidelines, Compliance, and Outcome

Jack Edinger, PhD Durham VAMC Sleep Specialty Consultation: Improving Management of Sleep Disorders

Leonard Egede, MD Charleston VAMC Telepsychology-Service Delivery for Depressed Elderly Veterans

Michael Gould, MD, MS VA Palo Alto Health Care System Quality of Practices for Lung Cancer Diagnosis and Staging

Erik Groessl, PhD VA San Diego Health Care System A Self-Management Intervention for Veterans with Hepatitis C

Hildi Hagedorn, PhD Minneapolis VAMC Effectiveness of Contingency Management in VA Addictions Treatment

Said Ibrahim, MD, MPH VA Pittsburgh Health Care System Knee Replacement Disparity: A Randomized, Controlled Intervention

Mark Kunik, MD Houston VAMC Partners in Dementia Care

Steven Lash, PhD Salem VAMC Reinforcement of Abstinence and Attendance in Substance Abuse Treatment

Todd Lee, PharmD, PhD Hines VAMC NSAID Related Adverse Events: Evaluating Risk Using Clinical Information

Bruce Ling, MD, MPH VA Pittsburgh Health Care System Improving Patient-Provider Communication for Colorectal Cancer 

Screening

David Litaker, MD, PhD Cleveland VAMC Summary Measures of Quality for Diabetes Care

Matthew Maciejewski, PhD Durham VAMC Long-Term Outcomes of Bariatric Surgery in the Veterans Health 

Administration

Clare Mahan, PhD Washington, DC VAMC Profile of Gulf War Veterans Receiving Undiagnosed Illness Compensation 

Megan-Crowley Matoka, PhD VA Pittsburgh Health Care System Sociocultural Dimensions of Provider Decision-Making in Pain 

Management

John McKellar, PhD VA Palo Alto Health Care System Improving Long-Term SUD Outcomes with Telephone Case Monitoring

Terri Monk, MD Durham VAMC Intra-Operative Predictors of Adverse Outcomes

Maureen Murdoch, MD, MPH Minneapolis VAMC Sexual Assault Prevalence among Male, PTSD-Disabled Gulf War Veterans 

Jonathan Nebeker, MD, MS VA Salt Lake City Health Care System Implementation of Real-Time ADE Surveillance and Decision Support

Eli Perencevich, MD VA Maryland Health Care System Predicting Antibiotic Resistant Bacteria Carriage at Hospital Admission

Steven Pizer, PhD VA Boston Health Care System How Do Medicare Health Plan Options Affect VA Utilization and 

Outcomes?

Diane Cowper Ripley, PhD North Florida/South Georgia Veterans Geographic Access to VHA Rehabilitation Services for OEF/OIF Veterans

Health System 
4 VA Office of Research and Development, Health Services Research and Development Service

January

Center for Information Dissemination and 

Education Resources

VA Boston Healthcare System (152C)

150 So. Huntington Avenue

Boston, MA 02130-4893

Anne Sadler, RN, PhD Iowa City VAMC Physical and Sexual Assault in Deployed Women: Risks, Outcomes and 

Services

Usha Sambamoorthi, PhD VA New Jersey Health Care System Chronic Physical and Mental Illness Care in Women Veterans

Usha Sambamoorthi, PhD VA New Jersey Health Care System Health Care Use, Outcomes, and Costs of Comorbid Diabetes and 

Depression

Matthew Samore, MD VA Salt Lake City Health Care System Surveillance of Medical Device-Related Problems in Intensive Care Units

Yujing Shen, PhD VA New Jersey Health Care System Longitudinal Analysis of Utilization and Cost by VA Patients with Diabetes

Jillian Shipherd, PhD VA Boston Health Care System MST Effects on PTSD and Health Behavior: A Longitudinal Study of Marines

Eric Slade, PhD VA Maryland Health Care System Access Criteria and Cost of Mental Health Intensive Case Management

Theodore Speroff, PhD Nashville VAMC Electronically Identifying Adverse Events in Clinical Narrative

Corrine Voils, PhD Durham VAMC A Patient-Spouse Intervention for Self-Managing High Cholesterol

Donna Washington, MD, MPH VA Greater Los Angeles Health Care System Women Veterans Ambulatory Care Use - Project Phase II

Saul Weiner, MD Hines VAMC Identifying and Predicting Contextual Errors in Medical Decision Making

Alan West, PhD White River Junction VAMC Veterans’ Healthcare Needs in National Surveys of the General Population

Joseph Westermeyer, MD, MPH Minneapolis VAMC Pathological Gambling and Gambling Problems among Veterans Receiving 

VA Health Care

Susan Zickmund, PhD VA Pittsburgh Health Care System Barriers to Initiating Antiviral Therapy for Veterans with Hepatitis C

Implementation – Rapid Response Projects

Sherrie Aspinall, PharmD VA Pittsburgh Health Care System Implementation of Practices to Improve Efficiency of Care for Pneumonia

Paul Barnett, PhD VA Palo Alto Health Care System Economic Impacts of Buprenorphine Adoption in VHA

Ann Borzecki, MD, MPH VA New England Health Care System Potential Barriers to Quality Care: Linking Wait Times to Avoidable 

Hospitalizations

Matthew Chinman, PhD VA Greater Los Angeles Health Care System Evidence-Based Review of Peer Support

Ann Hendricks, PhD VA Boston Health Care System Implementing a Metric for VA Hospice Referrals: Phase I, Develop the 

Triggers

Henry Lew, MD, PhD VA Palo Alto Health Care System Predicting Rehabilitation Costs for VA Patients with Traumatic Brain Injury

Audrey Nelson, PhD, RN Tampa VAMC Gap Analysis for Managing Upper Limb Pain and Function in SCI

Amy Rosen, PhD VA New England Health Care System Quality Improvement Initiatives: A Focus on Specific Patient Safety Indicators

Craig Rosen, PhD VA Palo Alto Health Care System VIP: Staff Distance Learning in Substance Use Intervention for Returnees

Constance Uphold, PhD North Florida/South Georgia Veterans Education Materials for Puerto Rican OIF/OEF Veterans and Families

Health System 

Marcia Valenstein, MD VA Ann Arbor Health Care System Implementing the Pharmacy-Based Adherence Facilitation Program

W. Bruce Vogel, PhD North Florida/South Georgia Veterans VHA Costs of Acute vs. Subacute Rehabilitation Care for Stroke

Health System 

Kenneth Weingardt, PhD VA Palo Alto Health Care System Brief Motivational Interventions for Substance-Using Veterans Pilot

Service-Directed Projects

Ann Borzecki, MD, MPH VA New England Health Care System Translating the AHRQ Quality Indicators to the VA

Sonia Duffy, PhD, MS, RN VA Ann Arbor Health Care System Inpatient Smoking Cessation: Bringing the Program to the Smoker