Administration and Data Analytic Core

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HARP ADA PROJECT SUMMARY Built on two decades of experience with large coordinated NIAAA-funded research projects on HIV and alcohol, The Veterans Aging Cohort Study (VACS) and our extended family of large, well characterized, national Veterans Healthcare Administration (VA) Cohorts (VACo Family) offer an unprecedented resource for the study of alcohol among people aging with and without HIV infection. Derived from Electronic Health Record (EHR), and subjected to rigorous data cleaning and phenotype validation, the VACo Family shares common data elements, including 20 years of longitudinal data on alcohol and health outcomes; it also includes behaviorally similar uninfected individuals, allowing us to characterize the role of HIV infection in determining alcohol associated outcomes; and supports targeted translational and intervention studies. To support excellence in the questions addressed, study design and analyses, we have cultivated an international collaborative network of experts. This well-established infrastructure has resulted in exceptional productivity. Our investigators have used data from the VACo Family to produce >500 peer reviewed publications, cited >26,000 times (h-index 79). We have successfully coordinated observational and intervention studies focused on the role of alcohol in determining modifiable outcomes among people aging with and without HIV infection. We are also proud of the education, training, career development, and leadership experience we offer young investigators, many of whom have transitioned to independent NIH and VA funding. Our ongoing mission is to build and disseminate the evidence needed to optimize care for people aging with HIV (PAH) experiencing medical harm from alcohol through well-coordinated and fully integrated observational and intervention studies. With access to national EHR data including medication fill/refill data, we are uniquely positioned to study harms associated with concurrent use of alcohol and multiple medications (polypharmacy). In service to our larger mission, our Program Project application supports the creation of the HIV and Alcohol Research center focused on Polypharmacy (HARP) to address risks associated with harmful alcohol use and polypharmacy (AP risk). The ADA Core, organized into administrative and data analytic sections, is composed of seasoned study coordinators and an expanded group of experts in data management, high performance computing, biostatistics, and artificial intelligence. The Core will address the challenges of cleaning and analyzing large scale, longitudinal EHR data combined with other data sources (e.g., surveys, biomarkers, and genetics) to support observational and pilot intervention studies. By facilitating and informing data access, analytic approach, and maintaining excellent lines of communication with our larger network, the ADA Core will enhance the significance and impact of HARP, providing experience and resources not available were projects funded separately. With our experience, resources, and momentum, the ADA Core is uniquely positioned to address AP risk among PAH.