Tag Archives: Health research council

HRC success in Christchurch

The Health Research Council announced Programme and Project grant recipients.  Here’s the list from the Christchurch campus of the University of Otago in which I get a brief mention :).  If others have abstracts of successful grants they’d like posted on this blog, then please let me know.

*****Update: It’s come to my attention that this announcement sent to Uni Otago staff left off the investigator lists investigators who were not current University staff.  I’ve added a few I know about below, but here may be others left out of the list, sorry.  ****

Monday, 9 June 2014.

University of Otago, Christchurch researchers have been awarded more than $8 million of Health Research Council 2014 funding. The results were announced by Minister Steven Joyce at 11.30am today.

The funded projects are:

  • HRC Programme Grant to Professor Mark Richards: Heart Failure: markers and management ($4,980,858).
  • HRC Project Grant to Professor David Murdoch: Legionnaires’ disease in New Zealand: improving diagnostics and treatment ($999,467).
  • HRC Project Grant to Dr Ben Hudson: A randomised controlled trial of nortriptyline in knee osteoarthritis ($1,190,921).
  • HRC Project Grant to Professor Tim Anderson Genetics, brain imaging, and cognitive decline in Parkinson’s disease ($1,178,804).
  • Emerging Researcher First Grant to Dr Tracy Melzer: Imaging markers of imminent cognitive decline in Parkinson’s disease ($149,943).

A summary of each project follows:

HRC Programme Grant to Professor Mark Richards ($4,980,858)

Heart Failure: markers and management

Heart failure (HF) will affect 20% of people now aged 40 years and confers high rates of early readmission and death.  Professor Richards and his team will implement an integrated programme addressing unmet needs in HF including: (1) The IMPERATIVE-HF controlled trial of intensified immediate post-discharge management using special blood tests to individually grade risk and guide intervention with rapid adjustments to treatment to improve outcomes. (2) Testing of candidate kidney damage markers for early warning of this frequent and dangerous complication of HF. (3) Establishing correct sampling times for novel markers for best prediction of early and long term outcomes in HF. (4) Testing our newly discovered markers for early warning of pneumonia complicating HF. (5) Clarification of diagnoses and testing management plans for patients in the Emergency Department with breathlessness or chest pain who do not have clear-cut HF or heart attacks but who nevertheless have elevated blood biomarkers and a poor outlook.

Other investigators are: Prof Vicky Cameron, Prof Richard Troughton, A/Prof Chris Pemberton, A/Prof Miriam Rademaker, A/Prof Chris Frampton, Prof Chris Charles, Dr Leigh Ellmers, Medicine, A/Prof John Pickering, Dr Anna Pilbrow (all University of Otago). Professor Zoltan Endre (University of New South Wales), Dr Martin Than (ED, Christchurch District Health Board), Prof Robert Doughty (University of Auckland), Dr James Pemberton (Cardiology, Auckland District Health Board)

HRC Project Grant to Professor David Murdoch ($999,467)

Legionnaires’ disease in New Zealand: improving diagnostics and treatment

Legionnaires’ disease is a severe type of pneumonia that is under-diagnosed in New Zealand. Special tests are required to make a diagnosis of legionnaires’ disease, but there are no clear guidelines about which patients to test. An enhanced testing system for legionnaires’ disease was developed in Canterbury and has been used there since 2010. The system involves targeted use of the current best test for legionnaires’ disease: PCR(polymerase chain reaction), which detects bacterial DNA. This approach has uncovered many cases of legionnaires’ disease that would have otherwise gone undetected. This study will roll out this same testing strategy across New Zealand for one year in order to measure the national burden of legionnaires’ disease, toimprove patient treatment, to identify cost-effective ways to test for legionnaires’ disease in the future, and to create better guidelines for the treatment of pneumonia.

Other investigators: A/Prof Patricia Priest, Prof Stephen Chambers, Dr Ian Sheerin.

HRC Project Grant to Dr Ben Hudson ($1,190,921)

A randomised controlled trial of nortriptyline in knee osteoarthritis

Osteoarthritis (OA) is a very common and painful condition.  Medicines currently available for treating OA pain are not ideal: they are either inadequately effective or cause unpleasant or dangerous side effects. Recent research has shown how the brain processes pain in OA and this has opened up the possibility of using different types of medicines for OA pain.  Nortriptyline (an antidepressant) has been used to treat persistent pain in other conditions, and other antidepressants may reduce pain in knee OA.  It is not known whether nortriptyline is useful in this condition.  We plan to test this effect by randomly allocating participants to treatment with nortriptyline or placebo and to measure changes in their pain before and after a period on the medication.  We hope that this will tell us whether nortriptyline will be helpful.  If it is, then we believe that many people may benefit from taking this medicine.

Other investigators: Prof Les Toop, Prof Lisa Stamp, Dr Jonathan Williman, Prof Gary Hooper, A/Prof Dee Mangin, Ms Bronwyn Thompson

HRC Project Grant to Professor Tim Anderson ($1,178,804)

Genetics, brain imaging, and cognitive decline in Parkinson’s disease

Many people with Parkinson’s are at risk of dementia but scientists and clinicians have been unable to predict when that will occur. Professor Tim Anderson and his team will do advanced brain scans (MRI and PET) gene testing and clinical evaluations in 85 Parkinson’s patients who have mild cognitive impairments, who are known to be at higher risk, and then determine whether they progress to dementia over the subsequent three years. By identifying characteristics present in the scans and genetic tests of those who develop dementia, compared to those who do not, Professor Anderson and his team can advance understanding of this important issue and establish a useful and reliable tool for researchers and clinicians. It is critical to do this so that preventative treatments to protect against dementia can be targeted at the most appropriate patients when that treatment becomes available and also to select the right ‘at risk’ Parkinson’s patients for trials of new treatments.

Other investigators are: Prof Martin Kennedy, Dr Tracy Melzer, Dr John Pearson.  Prof. John Dalrymple-Alford (University of Canterbury), Dr Ross Keenan (CDHB, Christchurch Radiology Group), Prof. David Miller (University College London)

HRC Emerging Researcher First Grant to Dr Tracy Melzer ($149,943)

Imaging markers of imminent cognitive decline in Parkinson’s disease.

Most Parkinson’s disease (PD) patients eventually develop dementia, which is the most burdensome aspect of this progressively worsening condition.  Mild cognitive impairments often indicate imminent dementia, but the two to 20 year time course poses a major problem for medical interventions, as brain changes associated with dementia in PD are still poorly understood.  Recent evidence suggests that neurodegenerative diseases such as PD progress along discrete brain networks.  One important network, known as the ‘default mode network’ appears particularly susceptible to neurodegeneration. Dr Melzer and his team will examine this network to determine if its disruption can specify which PD patients are vulnerable to progression to dementia within the next two years. A sophisticated but readily available brain imaging technique, called resting state functional imaging, will be used. These measures will assist in the selection of the most suitable patients for new treatments that may delay or prevent subsequent dementia in this vulnerable population.

The other investigator is: Prof Tim Anderson. Prof. John Dalrymple-Alford (University of Canterbury), Dr Ross Keenan (CDHB, Christchurch Radiology Group), Dr Daniel Myell (NZ Brain Research Institute)

 

What the HRC should have done

The system is broke.  It is no better than a lottery.  The Health Research Council tacitly acknowledged this last year when they introduced a lottery to their grant funding round.  The lottery was for three grants of $150,000 each.  These “Explorer Grants” are available again this year.  The process went thus: HRC announced the grant and requested proposals;  proposals were required to meet simple requirements of transformative, innovative, exploratory or unconventional, and have potential for major impact;  proposals were examined by committees of senior scientists;  all that met the criteria were put in a hat and three winners were drawn out.

116 grants were received, 3 were awarded (2.6%!!!). There were several committees of 4-5 senior scientists. Each committee assessed up to 30 grants.  I’m told it was a couple of days work for each scientist. I’m also told that, not surprisingly given we’ve a damned good science workforce, most proposals met the criteria. WHAT A COLOSSAL WASTE OF TIME AND RESOURCES.

Here is what should have happened:  All proposals should have gone immediately into the hat.  Three should have been drawn out.  Each of these three should have been assessed by a couple of scientists to make sure they meet the criteria.  If not, another should be drawn and assessed.  This would take about a 10th of the time and would enable results to be announced months earlier.

Given that the HRC Project grants have only about a 7% success rate and that the experience of reviewers is that the vast majority of applications are worthy of funding  I think a similar process of randomly drawing and then reviewing would be much more efficient and no less fair.  Indeed, here is the basis of a randomised controlled trial which I may well put as a project proposal to the HRC.

Null Hypothesis:  Projects assessed after random selection perform no differently to those assessed using the current methodology.

Method:  Randomly divide all incoming project applications into two groups. Group 1: Current assessment methodology.  Group 2: Random assessment methodology.  Group 1: assess as per normal aiming to assign half the allocated budget.  Group 2: Randomly draw 7% of the Group 2 applicants;  assess;  draw more to cover any which fail to meet fundability (only) criteria;  fund all which meet this criteria in order they were drawn until half the allocated budget is used.

Outcome measures:  I need to do a power calculation and think about the most appropriate measure, but this could be either a blinded assessment of final reports or a metric like difference in numbers of publications.

Let’s hope that lessons are learnt when it comes to the processes used to allocate National Science Challenges funds.

Happy WKD

I love living in NZ, it enables me to be the first in the world to wish everyone a happy World Kidney Day.  May your kidneys never lack oxygen, be always filtering, and ever distant from the nephrologists biopsy needle!

Let me remind you:

 If it weren’t for your kidneys where would you be

You’d be in the hospital or mortuary

If you didn’t have functioning kidneys

(with apologies to John Clarke)

Better, take a look at this video too (from www.worldkidneyday.org):

This year’s theme for World Kidney Day is “Kidneys for Life: Stop Kidney Attack.”  If you’ve not caught up with my myriad of other posts, Kidney Attack (aka Acute Kidney Injury) is the rapid loss of kidney function and/or structural damage brought about by toxic damage to the kidneys or temporary loss of blood to the kidneys.

This week I published a blank post entitled “A list of effective treatments for Kidney Attack.”  There is no known treatment – merely acute dialysis, a support for the kidneys, not a treatment. There is no treatment because detection is delayed and difficult and because not enough research has been done.

The good news is that I and many others around the world are engaged in finding new ways of detecting this disease.  Before I list some of the good news I want you all to repeat after me “30,000 kidney attacks a year in New Zealand, 1300 deaths.”  If you live out of New Zealand you may say “Two million die of Kidney Attack each year.”  Now tell someone else … anyone … the next person you see (not your boss if you read this at work).  Well done, thank you.

So, for some good news:

Hooray – we have for the first time means of measuring structural damage to the kidneys.  For us, this is the X-ray moment.  Imagine life before the X-ray – all that could be said is that you could no longer bowl a bouncer (throw a curve ball), play the piano, or dance a jig (whatever that is).  In other words, all that could be said was function was lost.  With the X-ray actual injury to the bone could be observed.  Importantly, it could be observed before function was lost permanently.  The measurement of various molecules we make in the urine are to us like the X-ray – they are measures of injury to the kidney (we call them biomarkers).

We are busy investigating how best to use these biomarkers and have been discovering:

  • which are best after Cardiac surgery, Contrast procedures or in the ICU (all risk factors for Kidney Attack),
  • what the optimal timing is for measurement of each biomarker,
  • how to use the biomarkers in Randomised Controlled Trials aimed at testing new treatments,
  • which biomarkers are best for detecting Kidney Attack when someone has additional co-morbidities like sepsis, and
  • which biomarkers add the most value to what we already know and enable the best assessment of risk of poor outcomes.

In the meantime, some of my work has shown how we can better utilise the information we already have with urine output and the mainstay of nephrology, the plasma creatinine measure:

  • the discovery that even when creatinine does not change after Cardiac Arrest there is likely to be Kidney Attack (it had been thought that it was only when creatinine was elevated there was a problem),
  • a combined measurement of plasma & urine creatinine and urine flow rate (called creatinine clearance) over a short period of time in the ICU helps identify Kidney Attack patients otherwise missed,
  • how best to estimate someone’s “normal renal function” so that a judgment can be made if it has recently changed, and
  • how best to utilise creatinine in Randomised Controlled Trials to tell if an intervention is improving kidney function.

All these add up to progress.  My own and my group’s work over the last 6 years has received funding from a number of funders (see logos attached) some of which originate with your tax dollar – hence my commitment to keep the tax payers informed. I am indebted to my boss, Professor Zoltan Endre, not only did her hire me (I think he mistook Physicist to mean Physician!), he has taught me heaps and consequently we have formed a strong collaboration. Our work has also depended on the good staff of Dunedin and Christchurch Hospital ICU’s, Christchurch Emergency Department, and the Canterbury Health Laboratories.  Without the commitment to research these people make, progress would not have been made.  Most important are the patients or their families who have consented for us to take extra samples or enroll them in a trial. The decision to participate is often made at a difficult time – families wrestling with issues of possible death or long term health issues of their loved ones.  I salute them.  I thank them.  New hope, new medicines, new tests, and new procedures are built on the courage and generosity of the patients and families who participate in research.

Sponsors who have provided grants (top row), or run assays (middle row), or provided free accommodation (me!) for the Christchurch Kidney Research Group, University of Otago.

Sponsors who have provided grants (top row), or run assays (middle row), or provided free accommodation (me!) for the Christchurch Kidney Research Group, University of Otago.

Congratulations awardees – shame on the system

At 1am this morning (has someone something to hide?) the recipients of Marsden grants were announced.

Congratulations to them all.

$54.6 million was distributed over 86 research projects.  Marsden funds “blue skies” research across a number of disciplines – humanities, science, technology etc. The list of topics reflect the diversity.  I think that they are worth celebrating so I have listed below the projects and awardees mentioned in the media pack (only 30 something, so there must be others).

The awards fall into two categories:  Standard grants of up to $330K per annum for three years (open to anyone) and Fast-start grants of $115K per annum for three years which go to early career researchers (within 7 years of getting PhD:  It used to be 7 years of post PhD research experience which enabled me to get such a grant 3 years ago despite having had a 15 yr hiatus between postdoc and next science position – they changed the rules the following year!).

Shame on the system

While 86 projects were funded, 1113 proposals were made.  This is a success rate of 7.7%.  I have posted before on just what such an appalling low success rate looks like when the Health Research Council funded just 7% of proposals.  This is a crisis.  Successive governments are responsible.  Fellow sciblog bloggers Grant Jacobs and Eric Campton pointed out to me Canadian research which showed the total cost to prepare grant proposals was greater than the amount awarded.  Eric blogged about this in 2009.  When is/was the cross-over point for HRC or Marsden funding?  Was it when the success rate fell below 20% (crisis point according to HRC chief executive Robin Olds).  Is it still viable at 7%.  Minister Steven Joyce needs to put some people onto answering that question straight away.

Colleagues of mine have talked about Marsden and HRC becoming a lottery.  They are not taking away from the tremendous work and great insights grant recipients have shown, only that many others have also shown those attributes without getting funding.  The problem is having to rank a large bunch or excellent applications.  This is not “taking the cream off the top”, rather it is attempting to pick out the tastiest tiny fraction of the cream – an impossible and meaningless task.  Perhaps this is why in announcing the new Explorer grants the Health Research Council have said that any proposals that meet the criteria will go into a pot and the grantees will be decided by lottery.  Quite possibly this may be just as fair as a ranking system.  Quite probably the HRC have been driven to this position because of the unwillingness of researchers to sit on committees and spend many hours shuffling paper making impossible ranking decisions knowing that such a small proportion of applicants will be funded.

(ps – please forget I mentioned the Explorer grants…I may apply for one myself, and I don’t want too many people knowing about it as this will reduce my chances).

The Projects

Ozone’s role in Southern Hemisphere climate change
Dr Olaf Morgenstern
NIWA
 
Searching for the tell-tale signs of galaxy cluster formation.
Dr Melanie Johnston-Hollitt
Victoria University of Wellington
 
Earthquake hydrology gets a shake up
Dr Simon Cox
GNS Science
 
Clarity vs efficiency in speech
Dr Donald Derrick
University of Canterbury
 
Gesture, speech, and the lopsided brain. 
Professor Michael Corballis
University of Auckland
 
Dem bones, dem bones, dem … heavy bones. 
Professor Stephen Robertson
University of Otago
 
Young cancer researchers get funding boost 
Dr Anita Dunbier and Dr Zimei Wu
Dunbier: University of Otago, Wu: University of Auckland
 
Kauri and climate change. 
Dr Catriona MacInnis-Ng
University of Auckland
 
How do birds “tell the time” when migrating?
Dr Phil Battley
Massey University
 
Unravelling male reproductive responses to social cues. 
Dr Patrice Rosengrave
University of Otago
 
Pollen key to plant development  
Dr Lynette Brownfield
University of Otago
 
How does the heart grow?
 Professor Peter Hunter
The University of Auckland
 
Getting to the heart of heart failure
 Professor Martyn Nash
The University of Auckland
 
Could tidal power realistically help meet future energy needs?
Dr Ross Vennell
University of Otago
 
Making a controlled splash. 
Dr Geoff Willmott
Industrial Research Limited
 
Getting to the heart of dark matter 
Dr Brendon Brewer
The University of Auckland
 
Criminal minds – the science behind the science
Dr Heather Wolffram
University of Canterbury
 
Toi Te Mana: A history of indigenous art 
Dr Deidre Brown
The University of Auckland
 
Cloaked in invisible bending light
Dr Robert Thompson
University of Otago
 
Laughing gas not so funny on high
Dr Joseph Lane
The University of Waikato
 
New Zealand Agribusiness investing in rural China
Dr Jason Young
Victoria University of Wellington
 
Converting microwave photons to optical photons
Dr Jevon Longdell
University of Otago
 
Identity and wellbeing in Aotearoa New Zealand.
Associate Professor Helen Moewaka-Barnes
Massey University
 
Corporate community development: harnessing business power in the Pacific. 
Professor Regina Scheyvens
Massey University