Congressionally Directed Medical Research Programs

Abstract The Congressionally Directed Medical Research Programs (CDMRP) originated in 1992 via a Congressional appropriation to foster novel approaches to biomedical research in response to the expressed needs of its stakeholders‐the American public, the military, and Congress. Currently there are 35 CDMRP programs each addressing a specific disease or condition.The Peer Reviewed Alzheimer’s Research Program (PRARP) began in 2011 and has a vision to mitigate the impact of Alzheimer’s and related dementias associated with military and diverse risks. To do this, the PRARP funds person‐centered research to address critical needs and improve quality of life for people living with Alzheimer’s diseases and related dementias.A CDMRP hallmark is the inclusion of people with lived experience at all levels. For the PRARP, this means inclusion as an equal voice and vote in setting the annual investment strategy and priority areas for a program, reviewing research applications, and making funding recommendations. They may be a person with a dementia diagnosis, family member, and/or care partner. This collaborative approach brings an important perspective and insight on the needs of the Alzheimer’s and dementia community and brings a sense of urgency to the entire process. The PRARP goes one step further and requires community collaboration in funded research projects. Any project proposing clinical research is required to have community collaboration throughout the design, execution, and dissemination of the research. This talk from the PRARP program manager and a PRARP lived experience peer‐reviewer will describe how people with lived experience are empowered to share their voice and are integrated throughout the PRARP’s processes and funded projects.

ABSTRACTAs a follow-up to the 2008 state-of-the-art (SOTA) conference on traumatic brain injuries (TBIs), the 2015 event organized by the United States Department of Veterans Affairs (VA) Office of Research and Development (ORD) analysed the knowledge gained over the last 7 years as it relates to basic scientific methods, experimental findings, diagnosis, therapy, and rehabilitation of TBIs and blast-induced neurotraumas (BINTs). The current article summarizes the discussions and recommendations of the scientific panel attending the Preclinical Modeling and Therapeutic Development Workshop of the conference, with special emphasis on factors slowing research progress and recommendations for ways of addressing the most significant pitfalls.

Sleep disorders are common and important comorbid conditions in children with autism spectrum disorder (ASD) and can contribute to cognitive and behavioral problems. Sleep-disordered breathing (SDB) is a diagnosable and treatable cause of behavioral problems in children. We aimed to quantify the relative risk for children with ASD versus controls of being diagnosed with sleep disorders including SDB and undergoing related diagnostic and surgical procedures. This retrospective case-cohort study included 48,762 children with ASD aged 2 to 18 years enrolled in the military health system (MHS) from 2000 to 2013. Children with ASD were matched 1:5 by birthdate, sex, and enrollment time to children without an ASD diagnosis. The MHS database was queried for International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for sleep disorders or ICD-9-CM and Current Procedural Terminology codes for diagnostic and surgical procedures. Relative risks (RR) and 95% confidence intervals (CI) were determined with binary Poisson regression conditional on the match and adjusting for confounders. Children with ASD were at higher risk of receiving any sleep disorder diagnosis (RR: 1.97 [95% CI, 1.91-2.02]) including SDB (RR: 1.96 [95% CI, 1.88-2.05]). Children with ASD also were at increased risk of undergoing polysomnography (RR: 3.74 [95% CI, 3.56-3.93]) and sleep disorder-related surgery (RR: 1.50 [95% CI, 1.46-1.54]). Children with ASD are more likely to be given a sleep disorder diagnosis including SDB and are more likely to undergo related diagnostic and surgical procedures compared with controls without ASD.

The Department of Defense (DOD), Breast Cancer Research Program (BCRP) was established in 1993. Since its inception, Congress has appropriated more than 878 million dollars for the BCRP, a unique public-private partnership between the DOD, consumer advocacy, and scientific communities which has funded approximately 1,800 breast cancer research grants. Through this partnership, the BCRP designed a model program for consumer involvement in scientific peer review. This paper describes the BCRP's approach to the processes of recruitment, selection, and preparation of consumers for this expanded role. Further, factors critical to program implementation, such as effective program management, ongoing process improvement, strong program leadership, and allocation of resources, that led to the BCRP's success in developing the previously undefined role of breast cancer survivors as members of scientific peer review panels are discussed. The BCRP demonstrates the feasibility and unique contributions of consumers in scientific peer review and provides a critical foundation for future efforts to ensure consumer involvement in scientific research programs.