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SCOR projects expand basic knowledge about female urethral, bladder and pelvic floor function; improve understanding of the natural history of incontinence; and provide information for the development of novel treatments for female urinary incontinence. The projects also integrate laboratory and clinical research on lower urinary tract function and incontinence in women. This “bench to bedside” collaborative research paradigm facilitates direct translation of scientific results into improved patient care.

A major strength of the UCSF SCOR is the opportunity it provides for integration and collaboration between epidemiologic investigations and basic research. There has been very little previous cross-disciplinary research between epidemiology and basic science in the area of lower urinary tract function and urinary incontinence in women. Such collaboration can move the field forward by facilitating translation of epidemiologic and laboratory research into clinically important treatment and preventive interventions.

The SCOR encompasses two clinical research projects, one basic research project, and a biostatistical core.

Clinical Research Program

The UCSF SCOR clinical investigators, Drs. Brown, Subak and Thom, have a long history of externally funded, successful research projects with the Kaiser Division of Research SCOR investigator, Dr. Van Den Eeden. Their productive research collaboration on the epidemiology of lower urinary tract dysfunction is focused primarily on urinary incontinence and pelvic organ prolapse (SCOR Clinical Research Program: Related Projects). To answer their proposed questions, they assembled an ethnically diverse, population-representative cohort of over 2100 middle-aged and older women who are members of the Kaiser Permanente Medical Care Plan (Kaiser PMCP). These women have been extensively characterized by abstracting labor and delivery records, surgical records, and medical records from up to 50 years ago, conducting detailed in-person interviews, and maintaining voiding diaries for those with incontinence. Because Kaiser PMCP is a mature, large, prepaid health organization, participants in this cohort are linked to numerous electronic clinical databases that include pharmacy records, laboratory tests, hospital discharge files, and outpatient summary clinical records. This level of detailed information on reproductive and other risk factors for incontinence is unique in the United States. The SCOR clinical research projects related to this cohort have been following patients for 5 years and will continue to be followed, allowing for assessment of risk factors for incident incontinence, collection of biological specimens (blood and urine).

Basic Research Program

Members of the SCOR basic science team, consisting of Drs. Lue, Guiting Lin, and Ching-Shwun Lin, have collaborated extensively on projects related to the structure and function of urinary tract organs. The group has developed a rat model for the study of female stress urinary incontinence that will be invaluable to the research efforts of the SCOR. The group has the expertise to perform comprehensive DNA microarray analysis to compare gene expression in continent and incontinent rats as well as developed sophisticated systems for urodynamic testing of female rats with voiding dysfunction. The SCOR project builds on previous and ongoing work from the team's laboratories.

Biostatistics and Data Management Core

The Biostatistics and Data Management Core supports all SCOR research projects.

PI Eric Vittinghoff, PhD; Co-PI: Steven Van Den Eeden, PhD; Co-Investigator: Leslee L. Subak, MD Statistician / Programmer: Jennifer M. Creasman, MSPH

The objective of the BDMC is to apply state-of-the-art science in biostatistics and data management to support the design, conduct, quality assurance, analysis, and reporting of the projects that comprise the UCSF SCOR. By providing expert methodologic support, the Core will ensure rigorous and timely initiation and completion of the projects. Specifically, the BDMC will provide

  • assistance to SCOR investigators with study design and planning of analyses.
  • review of forms for clarity, internal consistency, and implications for analysis.
  • efficient data management and quality control.
  • study monitoring.
  • state-of-the-art data analysis, including economic analyses.

Centralization of the study design and data management as well as statistical support functions in the BDMC has a number of compelling advantages.

Because two of the proposed SCOR projects will use data from the RRISK2 cohort, centralization of data management and analysis will provide efficiencies of scale, improved quality control, and enhanced communication across the two projects.

Centralization will also help BDMC investigators achieve a better understanding of substantive issues involved in all three SCOR research projects. Use of Kaiser databases requires specialized knowledge that will be efficient to centralize in the BDMC. Because economic studies require a specialized set of analysis tools, these analyses will also be implemented through the BDMC, under the direction of Dr. Subak.

The centralization will foster communication between SCOR investigators by stimulating productive discussion of design, analysis, and interpretive issues, and thus contribute to the interaction of basic research and clinical investigation.

The following forms are available to download

SCOR Analysis Form

SCOR Publications & Presentation Guidelines

Study Forms; a list of publications and abstracts and a SCOR contact list are available. Contact Jennifer Creasman at 353-7161 for access to these forms or email her at: jennifer.creasman@ucsf.edu

 

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