We are proud to show off the work Dr. Paul Lantos, a member of general internal medicine and a researcher in pediatric infectious diseases. This post describes his newest project as the principal investigator studying the treatment of cytomegalovirus (CMV) and the related health disparities. Dr. Lantos has unique skills for the use of geographic information systems (GIS) and geostatistical analyses, both applied in this research.
Background:
From Dr. Lantos, we recognize that congenital infection with CMV is one of the leading causes of deafness and neurologic abnormalities in newborns. It is important to diagnose symptomatic congenital CMV infection early, because antiviral treatments can improve hearing outcomes. We do not, however, have agreement on how best to identify infected newborns. Prior research by Lantos et al has shown that chronic CMV infection among pregnant women as well as in the general population is heavily concentrated in socioeconomically disadvantaged neighborhoods, particularly among racial and ethnic minorities. This raises the hypothesis that high risk neighborhoods would benefit from universal newborn CMV screening, an approach that is not the current standard of care.
Here is the project summary:
This study will be a secondary analysis of data from CHIMES. CHIMES is a large study coordinated at the University of Alabama, Birmingham, which has evaluated more than 100,000 newborns at 7 centers for both hearing loss and CMV infection.
Aims:
- The researchers will perform geospatial analyses of infants from the 7 participating centers in CHIMES. Our analyses will identify whether congenital CMV infection is concentrated in socioeconomically disadvantaged neighborhoods and among minorities. From this analysis they will categorize geographic strata of congenital CMV risk – these strata will be used to populate decision models in Aim 2.
- The team will perform decision analyses to evaluate the costs and benefits of three strategies: standard of care (no systematic CMV testing), targeted testing (CMV testing is restricted to infants with a failed hearing test), and universal testing. The populations used to populate these decision models will be derived from our spatial analysis in Aim 1.
Name of Study: Geostatistically-guided decision modeling to reduce health disparities from congenital cytomegalovirus
Principal Investigator: Paul M. Lantos, MD, MS GIS
Coinvestigators:
Sallie Permar, MD, PhD (Duke University)
Truls Ostbye, MD, MPH (Duke University)
Mark Janko, PhD (Duke University)
Kate Hoffman, PhD (Duke University)
Karen Fowler, DrPH (UAB)
Soren Gantt MD, MPH, PhD (University of British Columbia)
Francois Dionne, PhD (Vancouver Coastal Health Institute)
Funding Agency: National CMV Foundation
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