Profile of the Center for Health Research in the Columbian Newspaper

Kaiser Center for Health Research ‘An impact on millions’ Vancouver resident heads program that plays role in developing policy

Tom Vogt Columbian staff writer
Publication Date: October 21, 2010
Page: A1 Section: Clark County

Mary Durham’s early interest in numerical analysis wasn’t exactly focused on health research. It was about music.

As a teen, Durham had a scoring system for songs, and that’s how she determined her favorite radio station.

“I like evidence,” she said.

Now the Vancouver woman is heading up an institution that analyzes evidence on critical health issues. Durham is director of the Kaiser Permanente Center for Health Research in north Portland, where scientists also are exploring new fields such as genomics and personalized medicine.

The job provides the intellectual stimulation of understanding diseases, said Durham, who also is a professor of public health at Oregon Health & Science University. But the work can have global implications.

“Physicians see patients one at a time,” said Durham. “Health research has an impact on millions of people.”

The research includes data that represents thousands of Vancouver-area patients, since about 20 percent of the 465,000 members of Kaiser Permanente Northwest live in Clark County. Local Kaiser members also participate in trials, which is what brought Rochelle Johnson into the lab recently. Johnson volunteered for the center’s Long-Term Oxygen Treatment Trial.

Researchers are looking at the threshold for prescribing oxygen to people with lung problems.

Johnson has chronic obstructive pulmonary disease, which makes it hard to breathe. Her lung problems started when she was a child, Johnson said.

In the Kaiser lab, Johnson underwent a test to measure lung capacity. Spirometry measures how much air you breathe and how fast you blow it out, and the oxygen level.

Researchers randomly split the participants into two groups: half with oxygen at home, half without. The goal of the study — which is now closed — is to see if earlier intervention leads to a better quality of life.

Johnson was not chosen to participate, but she is happy to see research on the problem.

“This is something to help people in the future,” Johnson, 87, said. “It seems like more and more people have trouble breathing. Anything I could do to help would be worth it.”

The oxygen trial is one of more than 250 studies the Kaiser Permanente Northwest center is doing this year. The Portland center did about $32 million worth of research in 2009, with most of the funding coming from grants.

“We had $12 million for research when I got here in 1995,” Durham said.

Durham started out with a lot less than that in her first leadership role. A year after earning a doctorate in medical sociology, her professor urged Durham to apply for a job developing a Veterans Affairs research project near Tacoma. Maybe “urge” wasn’t quite the right word. What the professor told Durham was, “You won’t get it, but the experience will be good,” she said.

“I got the job,” Durham said. “I got the key and unlocked an empty office.”

After establishing the American Lake research center, Durham worked for a couple of other health care organizations in the Puget Sound area. Durham and her husband moved to Vancouver after she took the job at the Center for Health Research.

Since then, Kaiser has set up regional research sites in Hawaii and Atlanta. Those sites give the Kaiser research system a much bigger and a more diverse population, which is important in scoring grant funding.

The Portland center also is part of the Oregon Evidence-based Practice Center, along with Oregon Health & Science University and the Portland Veterans Affairs Medical Center.

Lots and lots of data

The Kaiser staff also works with federal programs. Dr. Evelyn Whitlock, associate director of the Oregon Evidence-based Practice Center, and her staff conduct large evidence reviews that evaluate published and unpublished studies for federal programs such as the U.S. Preventive Services Task Force.

“After looking at many, many studies for a topic like cervical cancer screening, we pull it all together to a bottom line of what we know and don’t know.

“People use these reports when making evidence-based decisions for health policy and practice,” Whitlock said.

Dr. Steve Fortmann’s project is more personal. He’s looking at preventing heart disease through more effective stop-smoking strategies, including higher doses of medication to reduce the urge to smoke.

“Eighty percent relapse within a year,” Fortmann said.

In fighting heart disease, “exercise is critically important,” Fortmann said. “Unfortunately, we’ve engineered it out of our lives. Grafting exercise into a sedentary lifestyle is a challenge.”

Overlapping issues

Some of the research is exploring the overlap between physical and behavioral issues, including Greg Clarke’s study of teen depression and insomnia.

“You can take typically healthy college students, deprive them of two hours of sleep for three nights in a row, and their stress hormones and appetite are off the scale,” Clarke said. “We’ll be the first place anywhere to study teen insomnia in a randomized trial.”

The depth and breadth of Kaiser’s health records is helping Lynn DeBar study alternative approaches such as acupuncture in managing chronic pain.

Even though it’s a new study, “We can look back 10 years to see people who have coordinated (alternative care) with our health plan,” DeBar said.

Next steps will include “how they used alternative care and their outcomes and the cost,” she said.

She is looking forward to eventually following test groups.

“Pain conditions are so debilitating and they’re so hard to treat. We try to view surgery as the last resort, so we’re open to other measures,” DeBar said.

Did you know?

* Kaiser Permanente researchers found in 2009 that a few extra pounds can help people live longer. Investigators found that mortality risk is lowest for overweight people; risk is second-lowest for people who are obese and of normal weight. Being underweight is associated with the highest risk of death.
SOURCE: Kaiser Permanente Center for Health Research

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