Research Structure
While delivering optimal patient care is the foremost goal of all multidisciplinary clinics, VA-MDCs also offer an ideal framework to create and apply new knowledge that improves patient outcomes. A VA-MDC provides a structure to conduct clinical trials, quality improvement projects, and conduct longer-term observational studies. The structure of the VA-MDC can allow for research participant identification, collection of biologic samples, molecular testing to explore prognostic factors, and application of molecular targeted therapies.23,24 A VA-MDC is perfectly positioned to bridge the research laboratory knowledge with clinical and translational research. Research capabilities should be incorporated at the inception of the program. It is important to assess the research landscape of your institution and form partnerships in order to utilize the existing resources and research infrastructure. For example, the VA-MDC may be able to utilize an existing pediatric cancer center solid tumor biorepository for banking pathologic specimens. Such a biorepository can help facilitate identification of new genetic abnormalities in vascular anomalies, probe the molecular mechanisms involved in vascular morphogenesis/growth/development, and allow genotype-phenotype correlation studies and other translational studies. Having tissue available for research will allow for future research involvement that has the potential to revolutionize the field vascular anomalies. In addition, setting up a database to collect clinical information on patients seen in the VA-MDC will assist in future retrospective and prospective research projects. Platforms such as REDcap® can by utilized to collect information regarding diagnosis, imaging and lab results, medication management, procedures and surgeries performed. Other options to expand the research footprint of a VA-MDC is to consider becoming an affiliate member of a cooperative group, if available, as this enables a program to partner with a member institution and participate in all trials offered through the institution’s cooperative group affiliation.23,24 Because of the rare nature of these disorders, a collaboration with clinical and basic scientists at other institutions may provide an additional opportunity to advance research in vascular anomalies. Careful attention should be paid to issues of authorship and grant support at the beginning of any research collaboration, taking into account the academic and financial constraints of each contributing party.