Year 4. November 10. Honoring Our Veterans
Tomorrow is Veterans Day, a federal holiday that recognizes the contributions of all who have served in the U.S. military. The U.S. Department of Veterans Affairs (VA) is the largest federal agency by employee count and the Veterans Health Administration is an important provider of health care for millions of Americans. The collaboration between the VA and schools of medicine has played an important role not only in the delivery of care, but in the training of large numbers of practicing physicians and in major scientific innovations. There is variability nationally in the relationship between the VA and academic medical centers. The relationship between our VA and the UCLA Department of Medicine (DoM) is robust and strong, representing a critical component that supports all of our missions and a pivotal part of our department’s strategic plan. This week, as we honor those who have served in the military, I use this space to highlight some of the unique contributions of the integral partnership between our VA health system and the DoM.
Zhaoping Li, MD, PhD Reflects on the Contributions of the GLA VA to our Community and the Importance of this Strategic Partnership
The UCLA DoM is a proud affiliate of the Greater Los Angeles Veterans Affairs Healthcare System (GLA VA). This symbiotic partnership in education, research, patient care and community engagement has tremendous benefits for both UCLA and the VA, as our shared resources give Veterans access to world-class heath care and amplify our progress across all of our missions.
To honor and recognize Veterans Day, I asked VA Chair of Medicine and DoM Executive Vice Chair of VA Health Care Zhaoping Li, MD, PhD, who is also a professor of medicine and serves as division chief of clinical nutrition, to reflect on the current activities of the GLA VA, particularly as they relate to our partnership.
“The VA’s mission is to ‘fulfill President Lincoln’s promise to care for those who have served in our nation’s military and for their families, caregivers, and survivors.’ UCLA and the Greater Los Angeles (GLA) VA share a common mission encompassing clinical care, research and education. Together, the GLA VA and UCLA recruit the best clinicians and provide the most advanced medical care possible for Veterans. This partnership also attracts leading scientists to UCLA and the GLA VA, fostering collaboration across disciplines to build synergistic programs that advance medical science.
The VA offers stable intramural funding and GLA VA houses nationally recognized centers, including the Air Force Health Study — with 178,000 biospecimens from over 2,700 veterans, many followed for more than 20 years; the Women’s Health/Center for the Study of Healthcare Innovation, Implementation & Policy; the Pain Management, Opioid Safety, and Prescription Drug Monitoring Program; the Precision Oncology/Cancer Center serving Southern California, Arizona, and New Mexico; and the Artificial Intelligence Center of Research and Education. We have over 150 faculty jointly appointed at UCLA/VA. Recently, all four of our Career Development Award applicants received funding, a strong endorsement of our critical role in training the next generation of biomedical research innovators.
The strong partnership between the VA and UCLA provides a rich academic environment that trains the next generation of healthcare providers. Our medical students, residents, fellows are inspired to join our mission of caring for our nation’s Veterans.”
Other exciting developments highlighted by Dr. Li include the forthcoming National Center for Warrior Independence (NCWI), a planned VA facility in West L.A. that will provide housing and support for unhoused Veterans. The NCWI was established through a presidential executive order in May 2025 and will offer services like housing, health care and career assistance, with the goal of housing up to 6,000 Veterans by 2028.
Thank you, Dr. Li and our GLA VA LEADERS, for all that you do to improve Veterans’ lives!
Lucinda Leung, MD, PhD, MPH Launches Research Funded by Major DoD and VA Grants
I am pleased to announce the commencement of a pair of grants awarded to Lucinda B. Leung, MD, PhD, MPH, associate professor of medicine and psychiatry and a health services researcher at VA Greater Los Angeles Healthcare System (VA-GLA). Earlier this year, Dr. Leung was awarded a Department of Defense (DoD) Congressionally Directed Medical Research Program (CDMRP) grant valued at $2,923,778 in total costs and a VA Quality Enhancement Research Initiative (QUERI) grant valued at a total of $13,827,531 in direct costs. The DoD CDMRP grant began Sept. 1 and is active through August 30, 2029; the VA QUERI grant began Oct. 1 and runs through August 31, 2030.
Dr. Leung felt a sense of “excitement and gratitude” upon learning of the two awards, which will be used to dramatically expand existing programs on mental health care for Veterans that she first launched through the VA-GLA.
“I look forward to the opportunity to scale the intervention we developed in our Los Angeles clinic to multiple sites across the country, potentially benefitting hundreds to thousands of patients,” Dr. Leung said. “Moreover, I look forward to engaging individuals that traditionally have difficultly accessing mental health care, specifically rural veterans and transitioning military service members.”
The DoD CDMRP grant will fund a trial that tests the effectiveness of a new care model to treat depression and several implementation strategies to improve uptake of online computerized cognitive behavioral therapy (cCBT) among patients and clinicians. The trial will involve 400 Veterans and military members who are transitioning out of service; they will randomly be invited to receive cCBT through existing primary care-based collaborative care managers or a new model where fellow Veterans who are certified mental health professionals join clinical teams to help their peers navigate the VA system, find resources and pursue their recovery goals. Dr. Leung’s team will conduct interviews to make sure the treatment is effective for people who are at the highest risk of depression, such as Veterans who are women or who have traumatic brain injury.
“Over the next four years, the study goal is to bring effective digital mental health tools, like cCBT, and Veterans with lived mental health experience to engage primary care patients in depression treatment across multiple clinics in Greater Los Angeles and San Diego,” Dr. Leung said.
The VA QUERI award is part of a national program where researchers are partnered with VA providers, leaders and Veterans to scale up and expand quality practices across the U.S. The funds from the award will be used to bring the online cCBT program that will be tested with the DoD CDMRP grant to Veterans in rural areas, as well as to test implementation strategies for two other interventions that involve telepsychiatry and online therapy for pain management.
Altogether, the grants will fund three cluster randomized controlled trials that will span two dozen states and will affect thousands of patients over the next five years. They will ultimately serve a critical goal to reduce rural health disparities.
“We want to ensure that the intervention we developed will improve health outcomes for all,” Dr. Leung said. “In addition to having robust institutional research infrastructure and a great team/collaborators, I am thankful to have so many willing partners in this work, spanning from the patients who provided input on intervention development to the operational leaders ready to sustain the intervention at trial’s end.”
Congratulations to Dr. Leung and the rest of her team on beginning this vital work! I look forward to seeing the results.
Matthew B. Rettig, MD and Team Awarded Funding for Cancer Research Center at the VA
I am thrilled to share that the GLA-VA will soon host a new clinical cancer research center thanks to the dedication of a team led by Matthew B. Rettig, MD, who was recently awarded a grant for this work from the national VA. The funding will make the GLA-VA a central hub for cancer research that will serve all 7 VA medical centers in our Veterans Integrated Service Network (VISN), which covers the Southwest U.S.
“I was ecstatic to learn that we were selected for funding for a clinical research center,” Dr. Rettig said. “This funding will go a long way to further grow our clinical trials program for not only our VA but all VA medical centers in our network.”
The funding mechanism that Dr. Rettig received is called a Clinical Cancer Research Center (CCRC) grant. It is designed to support precision oncology research within a VISN region through a “hub and spoke” model, where a central VA serves as the “hub” to coordinate all precision oncology activities across the “spokes”, namely other VISN sites in the region. The grant provides funds to create the infrastructure for precision oncology clinical trials and patient care. The CCRC grant awarded to Dr. Rettig is for lung and genitourinary (GU) cancers, two of the most common cancers amongst Veterans that are also the leading causes of cancer mortality in the VA.
“This development is significant because it aims to democratize precision oncology across all VA centers in the Southwest U.S., so that Veterans irrespective of geography can access state-of-the-art precision oncology care and clinical trials,” Dr. Rettig said. "The CRC grant will go a long way to improving the outcomes of our Veterans who suffer from these cancers.”
From an academic standpoint, the grant will give the VA the means to leverage massive amounts of existing data to learn more about the drivers of cancer incidence and outcomes, the results of which are germane to Veterans and non-Veterans alike. Lung and GU cancers are leading causes of death not only in Veterans, but in men more broadly. Dr. Rettig noted that the CRC grant will also provide an ideal environment for career development for junior faculty and trainees who wish to focus on clinical trials and outcomes research.
Most of the clinical trials the grant funds will identify biomarkers for lung and GU cancers. The work involving VA data will include research on a tissue and data biorepository that includes information from 11.2 million Veterans dating back to 1999. It can be linked to numerous other databases, like the one created through the VA Million Veterans Program that houses data on more than 1 million blood specimens and genomic analyses on them.
“We also have the capability to understand the impact of environmental and military exposures on incidence and aggressiveness of GU and lung cancers, and many projects in this area are ongoing,” Dr. Rettig said.
The start date for the funding is expected to be some time this coming spring. While some additional staff will need to be hired, the GLA-VA's already-robust infrastructure and enrollment mechanisms — which so far have supported the enrollment of more than 1,000 Veterans into prospective cancer trials since 2018 at our VA alone — offers an ideal launchpad for the new center.
Dr. Rettig added that he is grateful to have chosen the VA for his career path.
“This is a highly rewarding population of patients to serve,” he said. “Veterans have sacrificed so much for our country, and they deserve the very best care that we can possibly offer.”
Congratulations to Dr. Rettig and his team on this immense accomplishment! Your work will be instrumental to improving Veterans’ — and all patients — quality of life.
Let me close with two stories about research and scientific accomplishments of some of our faculty, that illustrate central tenets of our strategic plan to Lead in Innovation, Transform Care and Advance Health for All.
DoM Fellows and Faculty Have Major Presence at the Annual American Thyroid Association Scientific Meeting
I am proud to share that the DoM UCLA Endocrinology Division had a robust presence at the annual scientific meeting of the American Thyroid Association (ATA) — held Sept. 10 through 14 in Scottsdale, Ariz. — with more than 15 UCLA faculty and fellows in attendance. The meeting is the premiere gathering for investigators and clinicians who study and treat thyroid diseases, drawing over 1,400 attendees from across the United States and many other countries. It is preceded by the Ridgway Trainee Conference, which draws more than 100 trainees who conduct basic science and clinical endocrinology research in thyroid disease.
Our faculty and trainees shined bright both in leadership positions and as featured speakers. DoM endocrinologist and assistant professor Melissa G. Lechner, MD, PhD co-chaired the trainee conference; UCLA Endocrinology Division Clinical Chief, Stephanie Smooke Praw, MD and Senior Executive Academic Vice Chair Gregory Brent, MD took part in a panel about careers in the field. Endocrine fellow Kevin Wei, MD was selected to make a platform research presentation on his study of echocardiographic parameters in patients with myxedema coma.
“I found it rewarding to have been selected to present my research findings at ATA because this enabled me to share my work with clinicians who have the same passion for advancing thyroid care,” Dr. Wei said. “This unique experience allowed for insightful discussions of various research ideas with clinicians from institutions across the country.”
Several other fellows also presented their research at the meeting, including Elyssa Berg, MD; Diana Torres Pinzon, MD, MPH; Kevin Zhang, MD; and Katayoun Khoshbin, MD. Kyleigh Kimbrell, a recent UCLA graduate in microbiology, immunology and molecular biology who is a senior research associate in Dr. Lechner’s laboratory, presented a poster on her work on sex-dimorphic T cell response in Hashimoto’s thyroiditis. These outstanding scholars are mentored by faculty in the endocrinology division as well as faculty in the UCLA Division of Endocrine Surgery.
“I gained valuable insights into thyroid disorders and learned practical approaches for managing complex cases,” Dr. Khoshbin said. “It was also a great experience participating in the Ridgeway program designed specifically for fellows.”
Faculty presented exciting findings from their research as well. Anna Milanesi, MD shared her work on thyroid hormone signaling in skeletal muscle, in a session on tissue regeneration. Dr. Lechner presented on novel strategies to prevent and reverse endocrine autoimmune side-effects during cancer immunotherapy in a session on thyroid consequences of cancer immune therapy. Dr. Brent gave the Clark T. Sawin Award Lecture, which focused on the history of thyroidology; he also presented his work on thyroid receptor mediated chromatin modification in the brain and liver, and moderated a panel on the impact of cloning the thyroid hormone receptor on research and the development of novel therapies for thyroid and cardiometabolic disorders. Endocrinology Division Clinical Chief Stephanie Smooke Praw, MD, who also serves as director of the UCLA Thyroid Center, gave a presentation on thyroid cancer survivors who are lost to follow-up.
One particularly special highlight of the conference was an award given to Angela M. Leung, MD, MSc, associate professor of medicine, who received the Woman of the Year Award from the Women in Thyroidology group within the ATA. The award recognizes Dr. Leung’s outstanding contributions to research, clinical thyroid disease and service.
“I am deeply honored to receive the American Thyroid Association Woman of the Year award,” Dr. Leung said. “The support and resources of the UCLA DoM have been invaluable to me as a clinician-investigator, and I am grateful for the collaborations with colleagues and mentors in the department that have made this recognition possible.”
Please join me in congratulating Dr. Leung on this immense accomplishment and all the participating faculty and fellows in our endocrinology division for their success at the ATA conference!
Joann G. Elmore, MD, MPH and Team Awarded Grant to Study AI in Breast Cancer Screening
Our LEADERS in the DoM continue to lead nationally in innovative, high-impact research. General Internal Medicine Professor Joann G. Elmore, MD, MPH, a primary care physician and internationally recognized expert on breast cancer screening, in September was awarded a $16 million grant from the Patient-Centered Outcomes Research Institute (PCORI) to lead the Pragmatic Randomized Trial of Artificial Intelligence for Screening Mammography (PRISM). PRISM is the first large-scale randomized trial of artificial intelligence in breast cancer screening in the United States — one that, from Dr. Elmore’s perspective, is already overdue.
“AI tools in health care are here - but they are often being implemented without adequate rigor or scrutiny. It can be far too easy to flip a switch and suddenly have an AI tool affecting the 40 million women who undergo screening mammography each year,” Dr. Elmore said. “We are applying the same level of rigor and scrutiny that is used for medications and other areas of health to our assessment of new AI tools.”
While the technology is advanced, the study itself is in many ways a continuation of Dr. Elmore’s earlier research. She vividly remembers the conversation in early 2000’s that led her to investigate the accuracy of computer aided detection tools in mammogram — a precursor to artificial intelligence: A patient who worked two jobs came to Dr. Elmore wondering why she needed to be charged $40 for a computerized reading of her screening mammogram.
“It was a great question. First, we shouldn’t be charging for screening mammograms and second, there wasn’t sufficient scientific evidence at the time to justify the use of these computer programs,” she said. The FDA will often base its clearance of new technologies based on laboratory studies of only a few hundred mammograms, yet those tools may then be used on millions of patients.
Stimulated by her patient’s question, Dr. Elmore analyzed data on thousands of mammograms, some interpreted with support of the computer tool and others without. Her team demonstrated that when radiologists used computerized screenings, they were less accurate — resulting in them either calling back more women for unnecessary testing and likely being falsely reassured if the technology didn’t identify suspicious lesions and missing the cancers.
She does not want the same thing to happen with new AI-accompanied breast cancer screening.
“AI tools in health care hold great promise. It’s an exciting time — they have the potential to enhance accuracy, reproducibility, efficiency and population health,” Dr. Elmore said. “I have some healthy skepticism because there is less scientific research on how we physicians are going to interact with AI tools.”
The study is being co-led by scientists at the University of California-Davis; Dr. Elmore’s co-leader at UCLA is Hannah S. Milch, MD, an Associate Professor in the department of diagnostic radiology. By the end of its three-year course, it will include the interpretation of hundreds of thousands of mammograms taken at medical centers and imaging facilities in California, Florida, Wisconsin, Massachusetts and Washington. The team elected to use an AI tool called Transpara, from ScreenPoint Medical, with clinical workflow integration from the Aidoc aiOS platform, based on the experience of Dr. Milch and her team.
Dr. Elmore hopes that the study will help radiologists avoid some of the pitfalls of working with earlier computerized screening technologies and optimize the use of AI in breast cancer prevention. Above all else, she hopes it will improve the accuracy of breast cancer screening, and bring peace of mind to her patients, who are at the heart of all of her work.
“My interest in breast cancer screening research comes directly from my patients. As a primary care doctor, I’ve received many anxious calls from women who were told they needed additional testing after a screening mammogram,” Dr. Elmore said. “Listening to patients has always guided my best research ideas.”
Congratulations to Dr. Elmore and her team on their groundbreaking new grant!
Dale
P.S.
A few weeks ago, Albert Haro, our department’s chief financial officer, and Tisha Wang,our senior clinical vice chair, turned 19 and 21 respectively! Their colleagues in the office surprised them with two healthy snacks. (Hint: the cakes contained fruit.)
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