October 17, 2024

Screening for Stage 1 and Stage 2 Diabetes
Meeting minutes, Oct 17, 2024

Slides from meeting

Attendees: Osagie Ebekozien, Trevon Wright, Nicole Rioles, Lauren Culbreth, Laura Levin, Shideh
Majidi, Alex Tuttle, Jamie Felton, Ori Odugbesan

•  Review of project aims and timelines
• Request for N/A if A1c not available. Use 0 for now.
• Qualtrics: screened, positive (to know who is being monitored). Smartsheet is
  everyone, including people who screen negative. Need all confirmatory tests.
• Send email out: patients for Qualtrics; patients for Smartsheet so that there is less
  ambiguity. Will send out week of 10/21
• Interventions happening now
  •  Texas Children’s
    • Webinar for education. Shared with others- PCPs have been sending
      referrals
    • Created a referral type and added into scheduling
    • Education to PCPs and info on referrals
    • Patient/family focus: education, flyer on screening- posted in exam
      room.
    • Will send MyChart blast message on the SIT Down T1D
    • 30 patients in group: they have gotten referrals from flyers; PCPs: 5-6
      referrals; Dept faculty
  • Children’s National
    • 1 person with TZield infusion. Someone scheduled in Dec. Three
      infused so far.
    • Plan: increase awareness through handouts. In draft format. Just done
      word of mouth now.
  •  Lurie
    • Target: family education. Families want to screen. Providers need to
      get more comfortable talking to families about it.
      • Flowsheet in Epic will ask/prompt providers to discuss with
        families
      • Clinic lab may be easier- would be first choice (challenge is
        cost- clinic lab is expensive. Out of pocket costs are very high)
      • Enable kits- second choice
      • Creating a dot phrase for documenting screening
      • Working on a family handout
      • Talking about TZield
      • Thinks that screening will pick up
    • Increasing provider education
      • Talk with GI colleagues
      • Encourage endo clinics to use flowsheet
      • Presentation planned Dec/Jan to division about screening
      • Building order set for the 5 antibodies
      • Want to start tracking- across all providers
      • Prediction: providers will start screening and thinking more and
        numbers will increase
  •  Indiana
    • Have given 5 patients TZield. Rash is the most common reaction,
      starting day 5. No severe cytokine release reactions. One patient with
      a venous clot due to PICC line, identified after removal
    • PDSA cycles: change idea: discussing and documenting screening.
      Cerner challenges with documentation. Have to rely on auto-text in
      clinic notes to say screening was discussed. Interest, education, etc.
      44% documentation rate
      • All offered screening through TrialNet pathway
      • For next step- will look to expand to another provider to
        document
    •  Appropriate patients for confirmatory screening and staging, done by
      fellows
      • 6 referrals.
      • Will develop a decision tree to decide referral processes
      • Want to get POC kits in center (from Enable). There might be
        some delays in getting kits.
• Osagie- can we get case surveillance of TZield, with no identifiers, to describe what
  we are seeing. PIs are willing to contribute. They have been keeping a log of adverse
  events already. I want to know how effective TZield is outside of the research setting.
  And monitoring to stage 3. Trevon will share documents from the T1DX-QI COVID
  Surveillance study, as a template. Lauren, Alex, Laura, and Shideh can model
  questionnaire draft to that. We need help writing up the protocol. We can submit to
  WCG. If we can get responses from most/many of the Collaborative centers, this
  could be a significant dataset for TZield.
• Reminder on next call: we will share results from the survey
• Next Meeting: Friday November 15, 2024, 11:00AM-12:00PM EST