Meet our Leadership Circle 2019 Grant Finalists

These six Grant Finalists will be competing for Leadership Circle 2019 funds when they present their projects at the annual luncheon held on April, 18, 2019, at the Paradise Valley Country Club.  Make sure you have the opportunity to cast your vote for the project you want to be funded by renewing your membership or joining now!

Arash Sabati, MD
Division: Heart Center
Proposal Title: Exercise prescription for children with congenital heart disease
Amount Requested:  $26,008

I am requesting support to develop a home exercise prescription program for children with congenital heart disease. The ultimate goal of this program will be to provide exercise therapy in multiple settings: home, outpatient and inpatient. This program can work within multiple other disciplines and clinics to eventually provide a patient centered approach to exercise therapy for other children with chronic illnesses. This request is for equipment, testing and staff time. There are multiple barriers to exercise in children and adults with Congenital Heart Defect (CHD). Obesity and sedentary lifestyle have become common in this country and equally impact our CHD patients. There is fear and anxiety regarding physical activity from both parents and patients, normal feelings of breathlessness and fatigue can be misinterpreted. Patients with residual lesions may not be able to do the same amount of activity as their peers, they may start by over-exerting and over-training and stop exercising.

The goal of this project will be to help establish and show the effectiveness of a home exercise prescription in motivated CHD patients who are low risk but have potential for high benefit. The goal will be to have several months of closely monitored home exercise to “jump start” the patient into an active lifestyle. This is a patient centered endeavor that tailors therapy and prescription to the individual needs of the child and family. This will provide an opportunity for growth in the exercise stress lab as well as open the door for both outpatient and inpatient exercise therapy as new service lines. As a pilot program this will test the feasibility and resources to provide evidence based exercise recommendations for our chronically ill patients beginning with congenital heart disease.

Carrie Schaefer, MD
Division: Radiology
Proposal Title: Vascular Map: The future of efficiently getting difficult IVs and central lines
Amount Requested:  $128,000

Radiology, Cardiology and IT will collaborate to help babies and children get through PCH with less trauma of unneccesary IV sticks by mapping the blood vessels. Data exists within our sophisticated EMR about vessel abnormalities. We plan to mine this data and get IVs and central lines into kids more efficiently by creating a map of patient blood vessels. This is a new program that will revolutionize how clinicians approach poking a child with a needle. A map will be available before painful pokes with needles. Our team will reduce the fear of needle pokes and minimize pain by creating personalized maps of our Phoenix Children’s patients vessels for our highly skilled teams to use before attempting complex IVs.

This project will be measured in improving quality of those most in need of subspecialized personalized care. Patients with cancer, heart disease and kidney failure will benefit the most. Emergency Department and intensive care doctors as well as surgeons and interventionists will rely on this vessel map to efficiently care for their sickest patients. But even those who are getting an IV for the first time can be reassured that the vessel map will stay with them for a time that they may need another IV or line. Their history will be preserved and unnecessary needle pokes can be avoided when their knowledgeable doctors see the vessel map before entering a potentially closed vessel.

Dianne Bardo, MD
Division: Radiology
Proposal Title: Fetal Cardiac Magnetic Resonance (CMR); An Ultrasound Based ECG Synchronization Device Enables Imaging and Inspires Research Applications
Amount Requested:  $56,000

The Fetal Imaging Program at Phoenix Children’s provides accurate, timely and compassionate prenatal diagnosis using state-of-the art diagnostic imaging. Our fetal imaging team provides family-centered care that focuses on the needs of the child first, and values the family. The program is on track to become a ‘destination’ program for fetal care on a local, regional, and even national level at Phoenix Children’s. The current state-of-the-art in fetal imaging does not include fetal Cardiac Magnetic Resonance (CMR). The fetal imaging team at Phoenix Children’s has been making headway into this challenging field with promising though inconsistent results.

If we can advance our technical capabilities to include use of the SMaRT device this represents an exciting opportunity to move beyond our current fetal CMR and ultrasound capabilities to provide more comprehensive prenatal care, plan postnatal care and to counsel families about their future in caring for a child with congenital heart disease. We request Grant support to purchase a prototype Doppler ultrasound based ECG-gating device (SMaRT, North Medical GmbH, Hamberg, DE) and to support implementation costs and expenses.

This research effort will expand our ability to provide advanced evaluation of the fetal heart, will further support the fetal cardiac echocardiography program at Phoenix Children’s and the Arizona Fetal Care Network, and strengthen our position as a leader in the development and clinical translation of advanced fetal imaging technologies in tandem with the ongoing development of the Maternal-Fetal Medicine program at Phoenix Children’s, including construction projects in Gilbert and at the main Thomas campus.

Steven Zangwill, MD and Jonathan Plasencia, PhD
Division: Heart Center
Proposal Title: Development of a Virtual Reality Experience for Treatment Planning and for Patient and Family Education
Amount Requested:  $144,793

The development of a virtual reality (VR) platform will provide users with a multimodal, digital experience for visualizing and interacting with patient anatomy. The multimodal process, i.e., multiple media/data process, is comprised of 3D anatomical computer models that could be fused, i.e., overlaid, with CT, MR, and/or echo medical images to enhance the experience of anatomic visualization and data interpretation. Objective targets for this VR project grant will be to provide Phoenix Children’s with a tool that would (1) broaden clinicians’ interactive capabilities with complex anatomy during surgical and interventional planning, (2) improve patient/parent health literacy and satisfaction, (3) aid in trainee/medical personnel education, (4) overcome current 3D printing limitations, and (5) allow clinical personnel to customize a computer environment fitting of their work habits.

This grant will allow Phoenix Children’s clinicians to be involved in the development of an intuitive VR platform that will give them control in a more natural and seamless interface to review anatomy amongst themselves and with patient families. They will be able to easily (readily) view anatomical structures important to diagnosis without relying on directing an engineer how to render a reconstructed image. Further, VR (as opposed to 3D printed models), customized with real time interaction, will allow viewing angles and cutaway depth to be altered on the fly without the additional expense of printing and re-printing. Expected long-term changes will be a reduction in the number of requested 3D prints, improved experience in clinician anatomical visualization/interaction, improved educational experiences, and a platform that will diversify the 3D Print Lab’s portfolio to new, promising areas of research. We anticipate that the final product will be demonstrated by allowing users, e.g., clinicians, patients, parents, or donors, to experience the developed VR platform.

Shauna Schroeder, MD
Division: Gastroenterology
Proposal Title: Transnasal Esophagoscopy for Monitoring therapy in pediatric eosinophilic esophagitis
Amount Requested:  $135,273

Eosinophilic esophagitis (EoE) is an increasingly common pediatric chronic inflammatory disease.  Because of its potential to progress to esophageal stricture and the fact that clinical symptoms do not always correlate with the degree of eosinophilia, many patients have to undergo repeated assessment of the esophageal mucosa to ensure mucosal healing after implementation of treatment. There are significant risks, costs, and time commitment associated with traditional sedated esophagogastroduodenoscopy (EGD).  To address these concerns alternative methods for surveillance of the esophageal mucosa are needed.  However, esophagoscopy with biopsies continues to be the gold standard and other devices including cytosponge, throat swab, and esophageal strings are still not commercially available at this time.  Unsedated transnasal endoscopy (TNE) can be performed safely and provide adequate tissue samples to assess for active esophageal disease.  These monies will provide the initial infrastructure and training needed for a pediatric gastroenterologist to safely perform this procedure.

Since 2014, myself, Dr. Cindy Bauer (Allergy/Immunology), and Dr. Benjamin Wright (Allergy/Immunology) established a multidisciplinary Eosinophilic Gastrointestinal Disease Clinic at Phoenix Children’s to enhance and coordinate the 400 patients with this disorder in Arizona and throughout the southwest region. To date we have treated over 250 patients in the clinic and we need a safer, less costly method of screening our patients’ responses to treatment.  Unsedated transnasal endoscopy takes less time (missed from school, activities and parents work), less risk from sedation including risks of aspiration, drug reactions, and possible effects of anesthesia on the developing pediatric brain, and lastly the reduction of cost is significant $9,391 per standard-anesthesia EGD v $ 3,548 per TNE.  A safer, less costly procedure also provides us with the opportunity to continue to perform collaborative research with Mayo Clinic and novel projects developed by the EGD group.

Kaloe Ede, MD
Division: Gastroenterology
Proposal Title: Rapid Screening and Assessment of Juvenile Idiopathic Arthritis Associated Uveitis with Laser Flare Photometry
Amount Requested:  $67,821

The goal of this project is to reduce blindness and ocular morbidity in children with Juvenile Idiopathic Arthritis (JIA)-associated uveitis through the use of a Rheumatology office-based Laser Flare Photometer at Phoenix Children’s.  The grant funds will be used to purchase a portable Laser Flare Photometer machine and salary for a 0.1 FTE effort from a clinical research coordinator and Biostatistics consultation.  A Leadership Grant will establish the Division of Pediatric Rheumatology at Phoenix Children’s as the first and only pediatric rheumatology division in the United States to utilize office-based laser flare photometry to screen JIA patients for the presence of JIA-associated uveitis.

This technology has the potential to facilitate earlier detection and treatment of JIA-uveitis, better monitoring of active uveitis and responsiveness to treatment, enhanced coordination of care with our colleagues in the Division of Pediatric Ophthalmology, and improved quality of life for JIA patients through the potential for better visual outcomes in children with uveitis well as the possible need for fewer ophthalmology screening appointments in those children without uveitis. The combination of point of care screening with the laser flare photometer in the pediatric rheumatology office, and a partnership with the newly established Division of Pediatric Ophthalmology to expedite referrals of patients with active JIA-associated uveitis, will allow our patients to avoid the severe complications associated with this disease including blindness. This project would provide an innovative technology unavailable at any other pediatric rheumatology clinic in the US resulting in improved outcomes for our patients.  In addition, this research project will lead to improved clinical quality and safety, as well new generalizable evidence to improve the evaluation and management of all patients with uveitis at Phoenix Children’s.

For additional information about Leadership Circle or the grant application process contact Brooke Turley at 602-933-2662 or bturley@PhoenixChildrens.com.