AAD work groups aim to facilitate research within the specialty

Schaumburg, Ill. - The American Academy of Dermatology (AAD) Council on Science and Research’s Research Agenda work group has identified three keys areas - pruritus, cutaneous oncology and performance measurement and outcomes - to target in the future for continuing research in the dermatology specialty.

The group surveyed and met with key leaders in dermatology research, including physician stakeholders, patient advocacy groups, and industry representatives to determine several priority research areas and then set out to develop a plan for promoting and facilitating research in those areas.

The group narrowed down eight identified gaps in research to these three key areas that the AAD can facilitate movement on, according to Henry W. Lim, M.D., chairman and C.S. Livingood chair, department of dermatology, Henry Ford Hospital, Detroit.

The initiative’s objective is to develop a collaborative research agenda in dermatology, which will help dermatologists prepare for significant changes facing the healthcare system.

“We started discussing that we need to evaluate as a specialty what we considered to be the gaps in the research arena from the vantage point of what the academy can promote, facilitate and advocate for the research agenda,” says Dr. Lim, who notes the initiative will translate, integrate and disseminate findings to all stakeholders.

Over the past year and a half, the research work group has created a process for developing the first specialty-wide collaborative research agenda for dermatology, which will serve as the foundation for the AAD’s efforts around clinical guidelines, maintenance of certification (MOC), continuing medical education (CME), performance measurement, outcomes and delivery of evidence-based care.

The group broadly defined research and then established a steering committee to plan out the initiative.

Research agenda

In June 2012, the research agenda committee met with the key opinion leaders and they agreed upon the final three areas of research. An article regarding the consensus conference will be published in an upcoming issue of Journal American Academy Dermatology.

“The group selected pruritus because this is the area that we as dermatologist all deal with it. However, treatment of pruritus is less than satisfactory, and in terms of how do we grade the degree of the pruritus, there is no consensus,” Dr. Lim says.

Clearly creating guidelines for an agreed upon scale will aid in the diagnosis of the condition and also help when the Food and Drug Administration is regulating new drugs in the category.

The broad area of cutaneous oncology is one that all dermatologists handle, Dr. Lim says. “It is an area that has a lot of morbidity and mortality of patients, and it is an area where significant prevention, patient education, and research can be conducted,” he says.

The final area is performance measurement and outcomes, which Dr. Lim says is very important to the future of healthcare.

“The time has come that dermatology can have a significant input on how we can measure our own performance, how we measure outcomes, and the quality of care,” Dr. Lim says. It is imperative to determine how it is best to measure the medications that come up in terms of affecting the clinical results. Data collection has to be done to get to that level, he says, noting that the performance measurement and outcomes category will also serve as a foundation for the pruritus and cutaneous oncology agendas.

Moving forward

Dr. Lim points out that the group has made significant progress since last June’s meeting. A work group was established for each category. The pruritus work group has proposed an annual multidisciplinary session at the annual AAD meeting to increase the awareness among dermatologists about the latest developments in research, etiology, and treatment of the condition.

The first proposed session will be at the 2014 annual AAD meeting in Denver in March. The session will host pruritus experts in the fields of dermatology, and have outside speakers from other specialties, such as neurologists or behavior biologists.

“This will encourage interactions within various specialties and will exposed academy members to them,” he says.

The cutaneous oncology work group will examine the mortality rates from squamous cell carcinoma (SCC) in transplant patients and coordinate a skin cancer registry.

“We know that patients who have received organ transplant are immunosuppressed and because of this there is a higher risk of developing skin cancers and SCC,” he explains. The group will work to coordinate eight or 10 transplant academic centers in the country, and develop a database to evaluate the mortality caused by SCC among these patients.

“This is ongoing. The work group is coming up with a more detailed proposal and also, most importantly, determining what resources they will need from the academy for coordination of data collection,” Dr. Lim says.

Finally, performance measurement and outcomes is a key element of future research. Multiple areas within the academy are performing work on data collection for various data points, mortality, patient registries and outcomes.

“The data collection work group will help coordinate the entire effort with in the different structures within the academy,” he says, adding that the group met in Miami during the 2013 annual meeting.

“It is very helpful for the academy to be able to do this. So we can step back, think of what are steps we can do as an academy to help facilitate the research. There are a lot of practical consequences related to this,” he says.

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