Innovative Research Methods: Prevention and Management of Symptoms in Chronic Illness (R21)
Grant Amount: Unspecified.
This funding opportunity seeks to update the randomized control trial (RCT) design using novel research methods that are practical, innovative, and hold promise for producing more effective outcomes. Novel clinical research designs, applied to symptom management trials, may identify those treatment strategies that best alter the course of symptom burden in chronic illness by addressing the issues of varied treatment responses across patients, subject retention, and adherence to treatment regimens. For example, “sequential multiple assignment randomization trials” (SMART) design have been used successfully to develop dynamic treatment regimens for alcohol, depression and HIV infection but are not widely used in symptom management trials. The approach is pragmatic in that it mimics clinical practice by allowing a re-evaluation of treatment options based on an individual’s progress towards treatment goals. The levels or inclusion of intervention components are tailored in response to individual characteristics or progress toward a treatment goal. Subjects may be randomly assigned several times to varying amounts and types of intervention components based on predetermined decision rules. This “sequential decision making” process allows for the initial intervention to be adapted and provides subjects with options for achieving a favorable outcome. A “Multiphase optimization strategy “(MOST) could also prove useful when applied to symptom management trials. This design leads to identification of a likely best intervention that can be evaluated at optimal levels in an RCT, through an iterative process of empirical research and discovery. In addition large scale Electronic Health Records (EHR) enabled research and other data mining efforts to identify likely best interventions that could be further tested in clinical trials is needed. The screening of viable treatment regimens and strategies from observational databases has the potential to find patterns of treatment and perhaps the optimal, naturalistic sequencing strategies used in current practice for managing symptoms. These natural trends in treatment variation may form the basis of explicit dynamic treatment regimens that can be tested in comparative trials. Finally comparative effectiveness research is needed to enhance trials that seek to determine the most potent intervention(s) for symptom prevention and management in chronic illness. Determining these interventions through comparative effectiveness research will inform healthcare decisions by providing evidence on the benefits and harms of different treatment strategies.
US Department of Health and Human Services Public Health Service National Cancer Institute National Institutes of Health Office of Communications National Institute of Nursing Research
City Agencies Colleges/Universities Commercial Organizations Community Based Organizations County Agencies Educational Organizations/Institutions Federal Government Agencies IRS 501 (c)(3) Organizations Nonprofit Organizations Religious Organizations Schools State Agencies Tribal Organizations
Award Amount Notes
The number of awards is contingent upon NIH appropriations and the submission of a sufficient number of meritorious applications. Direct costs are limited to $275,000 over an R21 two-year period, with no more than $200,000 in direct costs allowed in any single year.
Application Due Date
Project Start Date
GrantsInfo , Phone: (301) 435-0714
Susan Marden Program Director Office of Extramural Activities NINR
Phone: (301) 496-9623
Up to 2 years.
Alcohol Abuse Clinical Research Disease Prevention HIV Medical Treatments and Therapies
Applicants must download the SF424 (R&R) application package associated with this funding opportunity using the “Apply for Grant Electronically” button in this FOA or following the directions provided at Grants.gov.
It is critical that applicants follow the instructions in the SF424 (R&R) Application Guide (http://grants.nih.gov/grants/funding/424/SF424_RR_Guide_General_Adobe_VerB.pdf), except where instructed in this funding opportunity announcement to do otherwise. Conformance to the requirements in the Application Guide is required and strictly enforced. Applications that are out of compliance with these instructions may be delayed or not accepted for review.
Companion Funding Opportunity: PA-13-165, R01 Research Project Grant; PA-13-166, R15 Academic Research Enhancement Award (AREA)
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