Barrow Clinical Outcomes Center

The Barrow Clinical Outcomes Database exists on a web-accessible, cloud-based, electronic clinical data capture system, VisionTree Optimal Care (VTOC)^®. This interoperable, patient-centered outcomes and engagement platform is 21CFR11 compliant and delivers accuracy of data collection, validation, and multi-center research and registry reporting.

Clinical data such as imaging, neurological status, length of stay, and adverse events are collected via electronic medical record and supplemented with validated patient reported outcomes to assess health-related quality of life metrics and patient satisfaction. Capturing these outcomes at predefined follow-up time points allows for a longitudinal and comprehensive understanding of the patient experience and effectiveness of clinical care. This robust data repository allows for centralization of clinical, functional, health quality, and economic information that can be utilized to inform best medical practices.

Publications

1. Karsy M, Kshettry V, Gardner P, Chicoine M, Fernandez-Miranda JC, Evans JJ, Barkhoudarian G, Hardesty D, Kim W, Zada G, Crocker T, Torok I, Little A. The RAPID Consortium: A Platform for Clinical and Translational Pituitary Tumor Research. J Neurol Surg B Skull Base. 2022 Dec 30;85(1):1-8. doi: 10.1055/a-1978-9380. PMID: 38274483; PMCID: PMC10807961.
2. Findlay MC, Tenhoeve S, Alt J, Rennert RC, Couldwell WT, Evans J, Collopy S, Kim W, Delery W, Pacione D, Kim A, Silverstein JM, Chicoine MR, Gardner P, Rotman L, Yuen KCJ, Barkhoudarian G, Fernandez-Miranda J, Benjamin C, Kshettry VR, Zada G, Van Gompel J, Catalino MP, Little AS, Karsy M. Predictors of Durable Remission After Successful Surgery for Cushing Disease: Results From the Multicenter RAPID Registry. Neurosurgery. 2024 Oct 1;95(4):761-769. doi: 10.1227/neu.0000000000003042. Epub 2024 Jun 21. PMID: 39293794.
3. Findlay MC, Rennert RC, Lucke-Wold B, Couldwell WT, Evans JJ, Collopy S, Kim W, Delery W, Pacione DR, Kim AH, Silverstein JM, Kanga M, Chicoine MR, Gardner PA, Valappil B, Abdallah H, Sarris CE, Hendricks BK, Torok IE, Low TM, Crocker TA, Yuen KCJ, Vigo V, Fernandez-Miranda JC, Kshettry VR, Little AS, Karsy M. Impact of Frailty on Surgical Outcomes of Patients With Cushing Disease Using the Multicenter Registry of Adenomas of the Pituitary and Related Disorders Registry. Neurosurgery. 2024 Jul 10. doi: 10.1227/neu.0000000000003090. Epub ahead of print. PMID: 38985563.
4. Little AS, Karsy M, Evans JJ, Kim W, Pacione DR, Kim AH, Gardner PA, Hendricks BK, Sarris CE, Torok IE, Low TM, Crocker TA, Valappil B, Kanga M, Abdallah H, Collopy S, Fernandez-Miranda JC, Vigo V, Ljubimov VA, Zada G, Garrett NE 3rd, Delery W, Yuen KCJ, Rennert RC, Couldwell WT, Silverstein JM, Kshettry VR, Chicoine MR; RAPID Consortium. Multicenter Registry of Adenomas of the Pituitary and Related Disorders: Initial Description of Cushing Disease Cohort, Surgical Outcomes, and Surgeon Characteristics. Neurosurgery. 2024 Aug 1;95(2):372-379. doi: 10.1227/neu.0000000000002888. Epub 2024 Mar 5. PMID: 39008545.
5. Pacul MA, Karsy M, Evans JJ, Kim W, Pacione DR, Gardner PA, Fernandez-Miranda JC, Zada G, Rennert RC, Silverstein JM, Kim AH, Kshettry VR, Chicoine MR, Little AS. A Multicenter Study of Unplanned Hospital Readmissions after Transsphenoidal Surgery for Cushing’s Disease. J Neurol Surg B Skull Base. 2024 Aug 20. doi: 10.1055/s-0044-1789193

Awards

• Fred Gentili Clinical Excellence Award, Cushing’s disease readmission after surgery. Mark Pacult, 2024, NASBS, Atlanta
• Mizuho Minimally Invasive Brain Tumor Surgery Award, Danielle Wishart, 2024, CNS, Houston, Comparison of Outcomes Following Surgical Intervention for MRI-positive versus MRI-negative Cushing’s Disease: A Multi-Center Study. Wishert

• Jay D. Turner, MD, PhD
  Director, Principal Investigator
• Ildiko Torok, MD, CCRP
  Program Manager
  Ildiko.Torok@DignityHealth.org
• Trevor Low, MS
  Data Analyst
  Trevor.Low@DignityHealth.org

SCOPe: Spine Clinical Outcomes Prospective

Spine Clinical Outcomes Prospective has been created for comprehensive, high-quality data collection in patients with a wide variety of spine conditions. This includes clinical data, health-related patient assessments, patient satisfaction, and complication rates. These measures are to be analyzed longitudinally at pre- and postoperative time points in an effort to improve treatment, maximize patient quality of life and outcomes, and evaluate comparative effectiveness of various surgical interventions.

Investigators

• Jay Turner, MD, PhD
• Juan Uribe, MD
• Kumar Kakarla, MD
• Randall Porter, MD
• Laura Snyder, MD
• David Barranco, MD

Cerebrovascular Study: BRAVO

The purpose of the BRAVO (Barrow Registry for Aneurysm and Vascular Outcomes) project is to collect detailed clinical data and outcomes on patients who present to our high-volume institute with a variety of cerebrovascular lesions, including aneurysms, arteriovenous malformations, arteriovenous fistulae, cavernous malformations (CM), cerebrovascular bypass, moyamoya disease, stroke, and other ischemic disorders. The study aims to measure and refine treatments to provide optimal evidence-based therapies for patients with vascular lesions.

Investigators

• Michael Lawton, MD
• Andrew Ducruet, MD
• Felipe Albuquerque, MD

Vestibular Schwannoma Outcomes Research (VSOR)

Vestibular schwannoma (also called acoustic neuroma) is a benign and slow-growing tumor of cranial nerve VIII. There are multiple treatment options available, including surgical resection, radiosurgery and observation. Due to the benign nature of the tumor it is important to consider a modality with significant favorable benefit to risk ratio, which makes the decision making for the management of this disease particularly difficult. The absence of a treatment algorithm makes the choice even more challenging.

With these challenges in mind, the VSOR registry aims to:

• Compare the functional outcomes and radiological and audiological progression among patients managed with different surgical approaches: stereotactic radiosurgery versus surgery versus observation alone
• Identify the prognostic factors affecting the functional and surgical outcomes
• Ultimately, propose a decision-making algorithm that can be used on routine basis for the management of this pathology

Investigators

• Randall Porter, MD
• Shawn Stevens, MD
• Kaith Almefty, MD
• F. David Barranco, MD

ZAP/Radiosurgery

The Zap-X Gyroscopic Radiosurgery system is a newly introduced stereotactic radiosurgical platform providing a unique patient experience, beneficial patient and operator safety features, and economically improved installation and maintenance costs compared to existing radiosurgical systems. Barrow Neurological Institute is the first center to use this device for clinical treatments, providing an opportunity to share our experience using this technology with the radiosurgical academic community.

Investigators

• F. David Barranco, MD
• Joseph DiDomenico, MD
  

Metabolic Therapy for Gliomas

Nutritional ketosis may provide a unique adjunctive therapeutic benefit for patients with gliomas.  However, to this point little data has been compiled to demonstrate the degree of benefit as well as dietary tolerance therapeutic ketosis may have for patients with gliomas.  As a world-renowned center for neuroscience, Barrow Neurological Institute has access to a diverse patient population allowing a unique opportunity to compile and share data among a large community.  This study will initiate further conversation nutritional ketosis may provide as an adjunctive therapy, as well as potentially identifying key genomic information in choosing this therapy as a treatment.

Investigators

• Kris A. Smith, MD
• Alex Bakowski, FNP

RAPID Consortium

The RAPID (Registry for Adenomas of the Pituitary and related Disorders) Consortium is a multicenter surgical outcomes collaboration database founded to improve treatments for patients with pituitary tumors. We are studying Cushing’s disease, acromegaly, prolactinomas, and non-functioning pituitary adenomas. The RAPID consortium tracks elements important to studying pituitary surgery patient outcomes, which include patient medical history, surgery, pathology, follow-up, and remission status.

Mission

To serve the clinician-scientist through accelerating pituitary tumor research by (1) developing a platform for multicenter clinical and translational research, (2) by promoting collegiality and scholarship, and by (3) applying innovative solutions to the challenges of outcomes research.

Investigators

• Andrew Little, MD
• Kevin Yuen, MD

Project Coordinator: Michelle Magana Mendoza, MBS

Program Manager: Ildiko Torok, MD

Data Analyst: Trevor Low, MS

Steering Committee

Chairperson: Andrew Little, MD

Scientific Lead: Varun Kshettry, MD

Secretary: Michael Karsy, MD

Garni Barkhoudarian, MD

Carolina Benjamin, MD

Michael Catalino, MD

Michael Chicoine, MD

James Evans, MD

Juan Fernandez-Miranda, MD

Paul Gardner, MD

Won Kim, MD

Adam Mamelak, MD

Donato Pacione, MD

Robert Rennert, MD

Julie Silverstein, MD

Jamie Van Gompel. MD

Kyle Wu, MD

Gabriel Zada, MD

Nathan Zwagerman. MD

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