To learn what works best in HIV/AIDS therapy, researchers must study a universe of variables, including unprecedented drug combinations and vastly differing ways in which patients respond to treatment. Now, for the first time, this critical outcomes research will be collected and analyzed through a national electronic clinical data network centered at the University of Alabama at Birmingham (UAB) Center for AIDS Research (CFAR). The National Institute of Allergy and Infectious Diseases (NIAID), in conjunction with the National Heart, Lung, and Blood Institute (NHLBI) — both part of the National Institutes of Health (NIH) — has given the UAB Center for AIDS Research a $2.45 million grant to build and manage an information-sharing network that will support outcomes research through the merger of electronic clinical data from seven centers for AIDS research across the country. "This is a new paradigm for clinical investigation — in essence, a way to study every patient outcome as compared to studying only selected patients, as is done in clinical trials," said project principal investigator Michael Saag, MD, UAB professor of medicine (infectious diseases) and director of the UAB CFAR. "Long-term outcomes research is necessary to provide clinicians with up-to-date information on the best strategies to treat patients. By merging electronic data from clinics nationwide, we create a body of information that is discreet, analyzable and reliable. It's the first formal way to track HIV/AIDS treatments and outcomes on a broad, comprehensive scale, and in real time." The six CFARs partnering with UAB on this project are at Case Western Reserve University, Cleveland; Harvard University, Boston; Johns Hopkins University, Baltimore; University of California, San Diego; University of California, San Francisco; and the University of Washington, Seattle. All seven centers already had databases that tracked the clinical outcomes of their individual patients, Saag said, but were lacking a collaborative, interactive information-sharing network on a national level. The new network not only allows the seven CFARs to combine all of their data to track clinical outcomes, but also gathers information on other factors that affect treatment outcomes, such as lifestyle, quality of life and substance use. The network provides a unique resource for HIV clinical, translational and basic research through new infrastructure and ready access to data addressing rapidly evolving issues in HIV care and research. One of the most interesting aspects, Saag said, is the ultimate ability of networks like this to take the information collected in the clinic and input it into "decision assist" software that uses computer calculations to suggest what treatments have the best chances of working, based upon what has helped patients from across the country with similar clinical presentations. November 2006