UrogynCREST Program - Research

The AUGS/DUKE Urogynecology Clinical Research Educational Scientist Training (UrogynCREST) program is open to junior faculty within approximately 7 years of fellowship who have a passion for research. The UrogynCREST Program (NICHD R25-HD094667) offers participants the opportunity to increase their knowledge of health services research, data science, and analytics, and to develop a project that can be the basis of future research grants. This program provides in-depth hands-on instruction for promising young physician-researchers in the field of pelvic floor disorders through a combination of online course work in data sciences and one-on-one instruction to design an innovative research project and publish the results.

The UrogynCREST program has four components:

Year 1: Coursework: Participants use the Sakai online learning platform to access their coursework. Courses are taught by experts in study design (Module 1, with 6 sessions); economic, psychometric, and decision-analytic studies (Module 2, with 3 sessions), and statistical techniques applicable in health services research with a focus on working with R (Module 3, which covers descriptive statistics, bivariate analysis, multivariable inferential statistics, propensity score matching, and instrumental variables. Course content consists of reading material, didactic videos by the faculty, faculty-participants group discussions, and assignments with feedback from faculty. Each session lasts 2 weeks, with 1 week to prepare assignments. There is a 2-week break between modules. Module 4 consists of the Stanford Statistical Learning course, and participants receive a certificate at successful completion.

Here’s what Cohorts 1 and 2 have said about the UrogynCREST faculty and coursework:

The highlight was definitely being able to work with such dedicated mentors. As my project topic redirected, [my mentors] were incredibly supportive, offering guidance without overdirecting. They have been so responsive throughout, and I have learned so much as we worked through project development, statistical analysis, and manuscript edits.

I really enjoyed Dr. Weinfurt’s lectures and online sessions. Creating valid and accurate Patient Reported Outcomes is complex and Dr. Weinfurt did an excellent job describing the process.

Dr. Myers was very accessible and was committed to helping us understand the material.

I really had very little experience with meta-analyses/systematic reviews but after going through a systematic review together over zoom with Dr. Williams, I feel like I really learned an incredible amount during this session.

[Healthcare databases] was a fantastic module - everything from the lectures to discussion to assignment were very relevant for our project. I very much appreciated how the assignment was directly related to our project, and completing this assignment helped move my project in a very productive direction.

I really appreciated learning how to use plot and line functions to visualize data. This lesson deepened my understanding of how to perform multivariable linear regression as well as linear regression more appropriately/accurately/effectively.

Dr. Matsouaka has been an amazing mentor and has gone above and beyond to help us familiarize ourselves with R.

Year 2: Support from Mentors and Biostatisticians: Participants are matched with clinical mentors who have expertise in database research. Mentors work with participants to design and execute a research proposal in pelvic floor disorders. Ongoing interaction ensures that projects adhere to the highest standards of scientific validity and remain on track. Biostatisticians provide expert consultation and analytics support to help participants achieve their research objectives. At the completion of the 2^nd year, participants must have submitted their project-based manuscript to a peer reviewed journal.

Cohort 1 completed projects:

Risk Factors for Progression to Urosepsis and Recurrent Urinary Tract Infections in Female Medicare Beneficiaries Undergoing Evaluation for Urinary Tract Infection
Health Disparities in Hospital Revisits following Urogynecologic Surgery
Reoperation and Mortality in Older Women Undergoing Midurethral Sling versus Bulking for Stress Urinary Incontinence: Are we Selecting Patients Correctly?
Examining the role of frailty on treatment trends and perioperative morbidity among women older than 70 years with urinary incontinence
Vaginal Complications after Cystectomy: Results from a Medicare Sample
Prediction of Postoperative Surgical Site Infection in Urogynecologic Surgery

Cohort 2 proposed projects:

Assessing the role of the pelvic floor as a contributor to voiding dysfunction in adult women with storage LUTS
Postoperative Safety of Same-Day Discharge in Minimally Invasive Pelvic Organ Prolapse Surgery: A Nationwide Study in Elderly Women
Utilization of 3rd line therapies in OAB Medicare Beneficiaries
Is urinary incontinence a predictor of incident dementia in women age 65 and older? A longitudinal study of Medicare beneficiaries
Pelvic organ prolapse management in women over 65: trends and timing in the transition from pessary to surgical management
Postoperative Complications in Patients undergoing Combined Rectal Prolapse and Pelvic Organ Prolapse Surgery versus Rectal Prolapse Surgery Only

Access to Data: Participants access the most common and extensive national healthcare database of standard analytic claims files. The dataset can support a broad range of pelvic floor disorder research questions. It does not contain direct identifiers or prescription information. Data are accessed in Duke’s highly secure data analytics environment (PACE). Access to other publicly available datasets or working with datasets already obtained by participants is also possible. For more information about allowable datasets, please contact Cindy Amundsen (Program Director) or Rebecca Kameny (Program Coordinator).

Dissemination and Networking: Participants present their research to peers, at the biannual Advisory Committee meetings, as well as at scientific conferences such as AUGS. By the end of the program, they are expected to have at least one accepted or submitted manuscript of UrogynCREST-related research. Annual reports are submitted to the NIH detailing participants’ progress. Networking among participants is encouraged throughout the program, and participants build connections that facilitate multi-center studies and collaboration on further manuscripts, research projects, and grant applications. Cohorts 1 and 2 have successfully collaborated on presentations and manuscripts.

Timeline for 2022-2024 Participants

	Apr-Jun 2022	Jul-Sep 2022	Oct-Dec 2022	Jan-Mar 2023	Apr-Jun 2023	Jul-Sep 2023	Oct-Dec 2023	Jan-Mar 2024
Coursework for Skills Development
Concept Proposal for Protocol Design
Data Preparation
Data Analysis
Manuscript/Study Prep and Submission

Participant Publications

Bretschneider CE, Scales CD Jr, Osazuwa-Peters O, Sheyn D, Sung V. Adverse outcomes after minimally invasive surgery for pelvic organ prolapse in women 65 years and older in the United States. Int Urogynecol J. 2022 Jun 4. doi: 10.1007/s00192-022-05238-x. Epub ahead of print. PMID: 35662357.

Bradley MS, Stanger M, Ford C, Lowder J, Handa VL. Characteristics Associated With Repeated Evaluations for Urinary Tract Infections in Older Women: A Case-Control Study. Female Pelvic Med Reconstr Surg. 2022 Apr 1;28(4):e133-e136. doi: 10.1097/SPV.0000000000001129. PubMed PMID: 35234180; PubMed Central PMCID: PMC9035018.

Richter LA, Osazuwa-Peters OL, Routh JC, Handa VL. Vaginal Complications after Cystectomy: Results from a Medicare Sample. J Urol. 2022 Apr;207(4):789-796. doi: 10.1097/JU.0000000000002336. Epub 2021 Dec 2. PubMed PMID: 34854750; PubMed Central PMCID: PMC8916976.

Featured in Practice Update – Urology with expert commentary

Richter LA, Egan J, Alagha EC, Handa VL. Vaginal Complications after Radical Cystectomy for Bladder Cancer: A Systematic Review. Urology. 2021 Oct;156:e20-e29. doi: 10.1016/j.urology.2021.07.001. Epub 2021 Jul 17. PubMed PMID: 34284007; PubMed Central PMCID: PMC8914981.

Cadish LA, Ford CB, Wu JM, Anger JT. Mortality and Reoperation Following Midurethral Sling Versus Urethral Bulking in Older Women. Urology. 2022 Apr 20:S0090-4295(22)00299-0. doi: 10.1016/j.urology.2022.03.033. Epub ahead of print. PMID: 35460678.

Sheyn, D, Jelovsek, E, Gregory, WT. Development and Validation of a Model for Predicting Surgical Site Infection After Pelvic Organ Prolapse Surgery. Female pelvic medicine & reconstructive surgery. (In press)

2022-2024 Participants

The UrogynCREST Advisory Committee has selected six enthusiastic and capable individuals from various institutions for the 2022 program year. The Committee had a very challenging task reviewing a very strong group of Junior Faculty applicants interested in pursuing additional education and training to conduct Health Services Research.

Linda Burkett, MD

VCU Health System

Teni Brown, MD

Northwestern University

Olivia Chang, MD, MPH

University of Washington

Nany Ringel, MD, MS

Yale University

Priyanka Kadam Halani, MD

Montefiore Medical Center/Albert Einstein College of Medicine

Sara E Jeney, MD

University of New Mexico

2020-2022 Participants

The UrogynCREST Advisory Committee has selected six enthusiastic and capable individuals from various institutions for the 2020 program year. The Committee had a very challenging task reviewing a very strong group of Junior Faculty applicants interested in pursuing additional education and training to conduct Health Services Research.