"Optimizing Combat Casualty Care"
Epidemiology and Biostatistics Team (left to right) Jeana Orman, Sc.D.,
Jeff Howard, Ph.D., Judson Janak, Ph.D., Nicole Jaime, and Tuan Le, MD, Dr.PH.
Not in photo is the newest member of the team Alexis Santos.

Epidemiology and Biostatistics Team (left to right) Jeana Orman, Sc.D., Jeff Howard, Ph.D., Judson Janak, Ph.D., Nicole Jaime, and Tuan Le, MD, Dr.PH. Not in photo is the newest member of the team Alexis Santos.

Epidemiology, Biostatistics: A Change in Culture at USAISR

By Steven Galvan, Public Affairs Officer
U.S. Army Institute of Surgical Research
03 FEBRUARY 2015

To optimize the quality of their research, investigators at the U.S. Army Institute of Surgical Research (USAISR) need scientifically sound study designs, meticulous data collection and expert analysis. A weak research design, hasty data collection, or overly simplistic data analysis can be detrimental to a research study, resulting in publication of incomplete findings or inaccurate conclusions. That’s where epidemiologist Jeana Orman, Sc.D. and her team in the Epidemiology and Biostatistics office can assist the researchers.

“To do good research you must use the proper study design AND perform the appropriate data analysis and interpretation,” said Orman. “We help to make sure that the important things are measured so that the data that are analyzed and reported are meaningful.”

Orman, who studied at Johns Hopkins and was a senior scientist at both the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) before coming to the ISR, created the team of five epidemiologist/biostatisticians. Four of the staff are doctoral-level professionals trained in both Epidemiology, the branch of medicine that studies causes, risk factors, and treatment of disease and injury, and in Biostatistics, the field of statistics specific to biological and medical data—both important resources for clinicians and scientists doing research at the Institute.

“That team is phenomenal,” said Lt. Col. (Dr.) Kevin Chung, the Clinical Trials in Burns and Trauma task area manager. “They can take us to another level.”

“I’m excited to have this team here,” said Vic Convertino, Ph.D., USAISR Combat Casualty Care Research Senior Scientist. “They can identify the best statistical tools for analyzing data which can add significant credibility and reliability to the investigators and the studies at the Institute.”

Convertino pointed out that when analyzing data many researchers rely too heavily on p-values and statistical ‘significance’ while not focusing enough on the strength of the association and whether it is clinically significant. For example, a large study comparing the effectiveness of two blood pressure lowering medications may find that a two point difference in blood pressure is statistically significant; but this difference is not meaningful for patient care.

“As this example shows, the focus on statistical significance doesn’t always work in clinical studies,” said Convertino. “We need to change the culture by taking the views of Orman’s team to use and interpret statistics correctly.”

Judson Janak, Ph.D., an epidemiologist and a member of Orman’s team, stressed that research is a process and the entire team is here to assist researchers from identifying clinically relevant research questions in line with the Institute’s mission, to final analysis and interpretation of results.

“The researcher has to define the research question,” said Janak. “Then we help them develop a conceptual research model that guides the data collection process and the analytical plan.”

“This new focus on appropriate design, analysis and interpretation is critical to keep us on point to meet the Army’s needs,” said Convertino.

Chung added that sound research benefits not only ISR researchers who publish higher quality research, but also practitioners who use the research to guide their use of sound practices, which in turn benefits patients.

“It’s about quality, not quantity,” Chung said.

Chung also believes that the insight provided by the Epidemiology and Biostatistics team will take research at the USAISR to a higher level.

“I like the direction we’re going,” said Chung. “The caliber of our research has the potential to be on par with premier government research agencies like the NIH and the CDC.

Convertino agrees with Chung.

“The Epidemiology and Biostatistics team can change the culture of how we design our studies, apply statistical analysis techniques, and interpret data,” he said. “Cultural change is required.”