April 5, 2019

If the FIT Test Fits: Research coordinator plays important role in major study

It’s safe to say Rachel Gruber did not foresee adenomatous polyps in her career path when she earned an advanced degree in industrial organizational psychology. But for the past two years, she has been immersed in the scientific literature surrounding fecal immunochemical tests, known as FIT.

As a research coordinator with the Regenstrief Institute, Gruber juggles a bit of everything from study recruitment to data management to serving as a project consultant for practicing physicians on research fellowships. But her special focus on manuscript development is how she became involved in a meta-analysis review led by Tom Imperiale, M.D., a Regenstrief research scientist and a professor in gastroenterology and hepatology at Indiana University School of Medicine.

The Regenstrief Institute is a global leader dedicated to improving health and healthcare through innovations and research in biomedical informatics, health services, and aging.
“Honestly, it was a fun side project that turned into more,” said Gruber, who earned a position as second author on the paper as she took on more and more responsibility with the project.
The team began with an algorithm of keywords created by Tom Emmet, M.D., of the Ruth Lilly Medical Library at IU School of Medicine. A query of all existing medical literature yielded about 4,000 studies. They narrowed papers down by title and abstract, ending up with around 500 to be read in full.
All told, Gruber read around 2 million words — four times the length of War and Peace — for this project alone. She also had to be extremely organized and produced copious notes as documentation.

“Yes, it’s a lot of time, but it’s also just one of those things I’ve always wanted to be a part of,” she said. “Meta analyses are what you hand students to help them learn. So, you’re at the forefront of knowledge in that area, and the people who write them have to grab all that knowledge and synthesize it in 3,000 words or fewer.”

Dr. Imperiale said, “Rachel was the linchpin for this very complicated project. Completing it would not have been possible without her.”

The resulting paper “Test Characteristics of Fecal Immunochemical Tests for Colorectal Cancer and Advanced Adenomatous Polyps: A Systematic Review and Meta-analysis” was published by the Annals of Internal Medicine in February 2019. It concluded that yearly FIT stool tests are effective for cancer screening and highlights opportunities for change to gastrointestinal healthcare in the U.S.

“So many people refuse to have a colonoscopy,” Gruber said. “Until you make it important for them, they’re not going to do it.”

Making the right FIT

Gruber says her degrees prepared her well for this type of work, using social psychology principles at both a micro-level — understanding the motivation and work styles of colleagues — and a macro-level — helping organizations make better decisions to improve productivity.

Her unique combination of training and ability pairs well with the ethos of the institute, established in 1969 by mid-century Indiana business mogul Sam Regenstrief, who earned his fortune through expertise in industrial efficiency and was known to care about workers at a personal level. He believed healthcare should benefit from the same data-driven interventions as manufacturing.

“Rachel has what it takes to succeed in our scientific environment: a positive attitude, a collaborative spirit and work ethic, reliability, integrity, attention to detail, a natural sense of curiosity, and a good sense of humor!” said Michael Weiner, director of Regenstrief’s Center for Health Services Research and the VA Center for Health Information and Communication at the Richard L. Roudebush Veterans Affairs Medical Center.

In the last four years Gruber has seen 35 research papers through to publication. She holds an associate’s degree from North Central Michigan College, a bachelor of science from Northern Michigan University, and a master’s of science degree from Northern Kentucky University.

Gruber works in the Regenstrief Institute’s William M. Tierney Center for Health Services Research. The institute is located in Indianapolis.

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