Breaking Barriers in Urologic Research: Tackling Health Disparities and Collaborative Solutions - Cheryl T. Lee

May 23, 2023

Sam Washington and Cheryl Lee discuss the Challenges of Urologic Research Symposium, focusing on overcoming health disparities in urologic research. The conversation highlights the need to address health disparities through research and collaboration. They discuss various aspects, including the history of race in research, clinical and translational research, increasing representation in clinical trials, social determinants of health, community outreach and engagement, and the importance of patient representation. They emphasize the need for collaboration, investment, and resource utilization to reduce health disparities. Dr. Lee suggests engaging specialty societies and geographic regions to prioritize the highest disparities and increase representation in research. The conversation concludes with the idea of including patient representatives and the patient's voice in future discussions, along with health services research and community engagement efforts.


Cheryl T. Lee, MD, Urologist, The Ohio State University, Comprehensive Cancer Center, Columbus, OH

Samuel L Washington III, MD, MAS, Assistant Professor of Urology, Goldberg-Benioff Endowed Professorship in Cancer Biology, University of California San Francisco, San Francisco, Ca

Read the Full Video Transcript

Samuel Washington: Hello, everyone. I'm Dr. Sam Washington with UroToday. Today, I have Dr. Cheryl Lee, Chair of the Department of Urology for Ohio State's Wexner Medical Center, among many different other roles. You serve within our society. You're also chairing our session in Challenges of Urologic Research Symposium, overcoming Health Disparities in Urologic Research. Thank you for taking the time to come today to speak to us.

Cheryl Lee: Well, thank you for the invitation to even think more broadly about these issues of health disparity and also how we can use research as a tool to begin to set the stage for preclinical models, to set the stage for statistical methods and to examine our data and tissue banks so that we can actually formulate strategies, study them, and apply them to our constituency, to our patients.

Samuel Washington: It's an exciting session happening today. For those who are in attendance, what do you hope that they gain from attending this and seeing all of the different speakers?

Cheryl Lee: Well, this is an inaugural session, so we are going to be flying the plane as we're making it a bit, but I really hope that this is just going to be the start of a conversation. Again, it's a commitment and investment by the AUA to think of gathering its members to say how do we share and collaborate our tools so that we can, again, put together the fundamentals that we need to study health disparities in a way that's actionable, in a way so that, in 20 years, we're not looking back asking the same questions that we are now, that we, unfortunately, were asking about 20 years ago.

Samuel Washington: That's exciting because disparities, we've described them in many different ways, many different modalities over the last few decades, but that transition to action has been intermittent, spotty here and there, depending on which group is focused on which specific domain. When you thought of these topics, was there an overarching strategy that you had?

Cheryl Lee: Yeah. Part of this issue about the stagnancy in our progress relates to the fact that we don't have the models. We don't have the tools. We're not able to look in a more innovative way at the resources that we have. This symposium is sinking through those issues in the key research domains in urology. We're first taking a look at the history of race in research, and I think that will allow us to reflect on why we are experiencing some of the challenges that we are.

We'll then think about clinical and translational research. Again, what are the tools that we have in terms of cellular models and structures, and how should we be thinking about the social determinants of health and the actual physiologic implications of those social determinants? We'll be thinking about race and ancestry and what does that mean for our work that we're doing?
We'll then move into clinical trials. I think we all agree that, ultimately, to have practice changing work, we need level one evidence. We'll be thinking how do we increase representation in clinical trials? That may mean relaxing or revisiting eligibility criteria. It may mean thinking about the systems within which we work and how do we make those systems more inviting for patients who are historically underrepresented in trials? How are we thinking about financial toxicity? What does that mean for our patients who want to participate but struggle to do so because of the implications on their daily lives?

I think it's also important to consider our community outreach and engagement and how we're actually presenting research to the larger community that we serve. How do we engage them in the questions? How do we use our resources to really address those issues in the populations that we serve?

Another piece of the conference will be devoted to the AUA's actions and what they hope to do. I think they'll be taking all of this discussion into consideration. We'll be thinking about some of the work that's already ongoing in the Office of Research, but my hope is that people attending the symposium will think, "How can we collaborate to join forces in our tissue and data banks? How can we come up with more novel statistical methods to be able to assess and analyze those specimen and data?" My hope is that we'll be using all of our resources more efficiently and in a more collaborative fashion. Again, just the beginning of a conversation.

Samuel Washington: But it's an exciting conversation where all those pieces that have existed separately are coming together. It'll be interesting to see how things go for the symposium and then afterwards. What do you hope, perfect world, would happen in the next 12 months, before the next symposium, as the effect of this one lingers and persists over it?

Cheryl Lee: My hope is that, one, we'll have a good group of attendees that are engaged across the specialties in urology. My hope is that the AUA will continue with this investment to engage the specialty societies, to think about how, as groups, we're going to really focus on the highest priority health disparities that exist in our field across the specialties and say, "We are going to work to identify the best preclinical models we can, the best tissue and data repositories we can, and we're all going to work to contribute to those with the specific aim to try to reduce the highest priority disparities across the specialties."

Again, that requires investment from the AUA to keep the dialogue going, not only at the annual meeting, but considering it at the specialty society meetings that are occurring throughout the year. I would say to engage the sections of the AUA to contribute as well. We do know that there are geographically some regions and some institutions that will be very important to be engaged in these kind of conversations because of the constituents that they serve. We want to increase the representation in our research materials and methods.

Samuel Washington: Very exciting. I like how it's going to permeate through, so it won't just live at our annual meeting and just in wherever our annual meeting happens to be that year, but continue on throughout. Were there any last thoughts or things that you would like to impart upon people watching this about the symposium and the efforts moving forward?

Cheryl Lee: Actually, yes. We didn't do it in this particular inaugural session but, ideally moving forward, we would have patient representatives in our discussions like this, again, so we're hearing the voice of the patient. An important section of this symposium also is around health services research and how to engage the patient and the patient's voice within research. Extending our efforts to the community, even at a meeting like this or at a subspecialty meeting, I think will be critical.

Samuel Washington: Thank you again for taking the time. I know you're incredibly busy. It's great to take a few moments just to talk to you about this exciting symposium that's happening now and where it will take us as a field moving forward.

Cheryl Lee: Fantastic. Thank you so much.

Samuel Washington: Thank you.