Sharing skills in the AIDS fight

In unique, NIH effort at global training, five researchers from China absorb SCHARP's expertise in statistical analysis, data collection/management
Chinese researchers workers at computer
Chinese researchers (from left) Jiang Tao, Ma Linmao, Xu Tao and "Kevin" Wang Jiansheng get training in database management from Phil Kirsch, systems administrator for SCHARP, the Statistical Center for HIV/AIDS Research and Prevention in the Public Health Sciences Division. Photo by Todd McNaught.

The Public Health Sciences Division staff at SCHARP have spent more than seven years honing their expertise in statistical analysis, protocol operations, data collection and data management to advance knowledge about the treatment and prevention of HIV/AIDS around the world.

Now, five Chinese researchers are striving to absorb as much of that expertise as possible in just two months.

Backed by a far-reaching NIH program called CIPRA (the Comprehensive International Program of Research on AIDS), SCHARP (the Statistical Center for HIV/AIDS Research and Prevention) is training the Chinese researchers to support HIV/AIDS studies in the most populous country on the globe.

Thula Weisel, a SCHARP project manager, said the collaboration is "what public health is all about. This is a wonderful opportunity for us. We're helping to make a difference."

And the Chinese team is feeling that difference.

"We are here to try to learn many technical skills about data management," said Jiang Tao. "Compared with the systems we have in China, the systems here are more sophisticated."

Jiang and the rest of the Chinese team - Xu Tao, Ma Linmao, "Kevin" Wang Jiansheng, and Shan Guang Liang - are spending eight hours a day in classes at Met East. "After that, we take our laptops home to practice," Wang said. "The classes are very intense and go very fast."

SCHARP collects, manages and analyzes data from clinical trials and behavioral studies around the world. It supports both the HIV Vaccine Trials Network (HVTN) and the HIV Prevention Trials Network (HPTN). SCHARP interacts with 37 sites, receiving an average of 15,000 data-collection report forms each week, which are processed in Seattle using the DataFax data-management system.

Lingual patience

Jiang praised SCHARP staff as knowledgeable, friendly and "very patient because we have a little bit of a problem with our English" - to which Phil Kirsch replied, "And we have a little problem with our Chinese."

Kirsch is helping train the Chinese team. "They learn very quickly," he said. "It's been a tremendous amount of information to condense into a few lessons."

Training includes not only data management, but also clinical-trial operations. As a result, the Chinese team has visited local vaccine and prevention clinical-trial sites, as well as the Seattle/King County health department's AIDS research center.

Several SCHARP staff have served as trainers, including Scott Horton, Lori Filipcic, Claire Chapdu, Tom Fraser, Lisa Ondrejcek, Al Williams and Leslie Cottle. SCHARP also is fortunate to have several Chinese-speaking staff, including Lei Wang and Fang Gai, who have assisted with translation.

SCHARP receives local support from Uwajimaya Apartments, which provides living quarters at a discount for CIPRA staff, and Court Furniture, which provided apartment furnishings.

CIPRA targets infrastructure development and training of scientists and staff who will conduct HIV/AIDS clinical research on their own. As a result, CIPRA grants go directly to foreign governments. China is the first to receive funding.

"It's the first large-scale attempt to transfer knowledge from U.S. organizations to other places in the world," said Tom Darden, deputy director of SCHARP HVTN. "That's what makes it significant. The Chinese government was allowed to choose its collaborators, and they chose us for data management. We may not have all the answers, but we have many years of experience. They're getting an opportunity to see a mature system."

The SCHARP training is part of China's five-year plan to combat HIV/AIDS. "In China, the risk of HIV is very dangerous," Jiang said. "China has a very big problem: one million HIV patients. We came here to learn how to control it."

Chinese team members are affiliated with the Chinese Centers for Disease Control in Beijing. When they return, they will use their new skills to create the infrastructure needed to support a half-dozen HIV/AIDS studies to begin later this year. The studies ranges from prevention techniques to a vaccine trial to a treatment trial.

Three areas

In its stay with SCHARP, the Chinese team has divided its members among three areas: computer networks and set-up; data collection and management; and clinical trial design and operation. What they are learning ranges from the design of case-report forms to compliance with U.S. regulations to retention of study participants.

"I have learned more information about clinical trials, especially how to develop a protocol and how to do trial design and how to choose patients," said Shan Guang Liang.

Even so, most of the team's energy is devoted to mastering tools to manage databases, so the team can replicate SCHARP's approach in China.

"We are the first (to be trained)," Wang said. "We will build the system."

Besides working hard, the Chinese team has found time for fun. SCHARP staff have taken their guests to a Sonics game, the ballet and a Chinese New Year's party and on a tour of Seattle. They will visit Bainbridge Island later this month.

Wang said he was surprised at the friendliness they encounter. "China is a very crowded place," he said. "Strangers are not so polite."

The completion of training in mid-March is not the end of the collaboration. This spring, SCHARP staff will reunite with team members in China to help them install and setup new hardware and software and apply what they've learned.

Darden considers SCHARP'S collaboration with the Chinese a two-way street.

"Anytime you teach somebody to do your job, you learn to do your job better," he said. "We're also learning how to teach other scientists in other parts of the world to do this. And now we have collaborators in China. The collaborations begun here can go on for years."

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