Key Dates

Related Announcements

PA-20-185 - NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)

Issued by

National Heart, Lung, and Blood Institute (NHLBI)

National Institute of Neurological Disorders and Stroke (NINDS)

Purpose

This Notice of Special Interest (NOSI) highlights interest in receiving grant applications focused on mechanistic, genetic, and other studies to evaluate causes and consequences of and risk factors for sudden death in the young. Studies are required to use data and DNA samples, and associated sequence data from the NIH/CDC Sudden Death in the Young (SDY) Case Registry as foundations for their research. Results of such studies are expected to be disseminated widely and to provide an evidence base to advance discussions about screening and prevention of SDY.

The sudden, unexpected loss of a child is a tragic event with significant impact on families and communities. The Sudden Death in the Young (SDY) Case Registry (sdyregistry.org) is a unique collaboration between the National Institutes of Health (NHLBI and NINDS) and the Centers for Disease Control and Prevention (CDC). It was designed to address critical knowledge gaps in the epidemiology and causes of SDY and to develop a resource for research that will enhance the evidence base to inform prevention efforts.

Fundamental gaps in knowledge about incidence, mechanisms, and risk factors for SDY limit the identification of effective prevention efforts. In the majority of SDY cases, after autopsy and investigation, a cause cannot be identified. In deaths where a cause can be identified, sudden, unexpected, non-injury-related infant and child deaths are often due to cardiac causes (myocarditis, cardiomyopathy, coronary artery anomalies, and ion channelopathies), respiratory causes (asthma, pneumonia), sudden unexpected death in epilepsy (SUDEP), and various other infections, neurological, hematologic, and gastrointestinal catastrophes. Because of the high number of unexplained deaths and the lack of evidence regarding their cause(s), there is disagreement about the best approach to prevent SDY. The SDY Case Registry and the associated research efforts should help close these knowledge gaps and provide a foundation of data that can be used to inform targeted prevention efforts.

The SDY Case Registry was first funded in 2013 to address critical knowledge gaps on the epidemiology and etiologies of SDY. The CDC is leading population-based surveillance efforts to identify 100% of cases of SDY in funded states/jurisdictions of the SDY Case Registry. To do this, they provide technical assistance to states/jurisdictions to increase case ascertainment and ensure consistent categorization of cases. Support by NHLBI and NINDS is focused on developing a resource for research on SDY by ensuring collection of a comprehensive battery of phenotypic data elements and collection of DNA samples to enable genomic analysis. Detailed phenotyping is performed for cases of sudden cardiac death in the young (SCDY), unexplained infant and child death, and sudden unexpected death in epilepsy (SUDEP), with limited data gathered on other explained SDY cases.

The SDY Case Registry is one of the largest population-based cohorts of children who have died suddenly in the US, including over 3000 SDY cases to date. The SDY Case Registry’s 13 states/jurisdictions include approximately 20% of SDYs in the US. The population of infants and children in the states/jurisdictions funded for the SDY Case Registry is 23% black. Ethnicity data is not available for all jurisdictions, but the funded states include 14% Hispanic/Latino infants and children. Data can be used to explore the causes of SCDY as well as SUDEP, sudden unexpected infant death (SUID), and other causes of pediatric sudden death.

Inclusion criteria are infants and children up to age 20 who die suddenly and unexpectedly. Homicide, suicide, intentional overdose and obvious injury-related deaths are excluded. Data is gathered about symptoms, activity/exercise, previous diagnoses, medications, treatments, seizures, family history, and resuscitation. Cases are categorized by cause by state/local experts in cardiology, neurology and pathology, and, after informed consent from surviving family members, blood/tissue are collected for DNA extraction and stored in the biorepository at the University of Michigan to enable research. This consent allows for use of the child’s DNA sample for research, access to the autopsy report, and re-contact for return of results or discussions of future research opportunities. In addition, families are given the option to consent to re-contact by investigators for the purposes of obtaining additional information or returning clinically actionable results. Consent has been obtained for research on approximately 250 cases to date, and whole genome sequencing has been performed on 200 cases thus far. Sequence data will be made available to investigators through NIH data repositories (dbGAP). Controls are not included in the Registry and must be sought elsewhere.

State public health agencies (or their bona fide agents) participating in the SDY Case Registry have proprietary rights over the data they enter in the Registry; however, under a specific agreement, data from individual states is combined into a single de-identified dataset. The SDY Case Registry’s Data Coordinating Center at the Michigan Public Health Institute will facilitate the initiation of data use agreements between investigators and state public health agencies to access the dataset.

The SDY Case Registry’s Data Coordinating Center (DCC) at the Michigan Public Health Institute is funded separately via a contract and an Interagency Agreement between the NIH and CDC. The DCC provides administrative support to the SDY Case Registry, creates case report forms for phenotypic data, develops consent forms for participation in the Registry, maintains the SDY database, and subcontracts to a biorepository at the University of Michigan for DNA extraction and storage of samples. The DCC works closely with research teams to establish data use agreements with the SDY Case Registry data collection sites (state public health agencies or their bona fide agents) for access to phenotypic data and DNA samples for study. The DCC does not provide statistical support or conduct data analysis for each funded research project. Rather, they facilitate access to the data and act as liaisons between investigators and the jurisdictions that collect the data.

Selected Research Examples

Research questions of interest include, but are not limited to the following:

• What is the prevalence of ion channel mutations or other candidate genes known to be associated with arrhythmias in cases compared to controls?
• What is the prevalence of ion channel mutations or other candidate genes known to be associated with the epilepsies in cases compared to controls, and compared to cases of sudden cardiac death in the young?
• How do ion channel mutations differ between SUID cases and cases of sudden death in older children?
• Is competitive athletics a risk factor for sudden cardiac death in the young?
• Are there diurnal variations in sudden cardiac death in the young, as is the case for some cardiovascular conditions in adults?
• Are there risk factors for SUDEP that are associated with the sleep setting and/or time of death?
• Are there significant environmental or contextual differences between cases and controls, such as socioeconomic status, history of drug exposure, serum toxicology screens, family history, and other factors?
• What is the yield of molecular autopsy (defined as postmortem molecular, typically genetic diagnosis) in autopsy-negative cases of SDY?
• Can machine learning or complex genetic models be used to identified novel SDY risk genes?

Applications that seek to determine the incidence of SDY are outside the scope of this NOSI, will be considered non-responsive, and will not be considered under this NOSI. The CDC, NHLBI, NINDS and SDY Case Registry Steering Committee will be responsible for evaluating incidence.

Application and Submission Information

This notice applies to due dates on or after October 5, 2020 and subsequent receipt dates through January 8, 2023.

Submit applications for this initiative using the following funding opportunity announcement (FOA) or any reissues of this announcement through the expiration date of this notice

• PA-20-185 NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)

All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:

For funding consideration, applicants must include “NOT-HL-20-787” (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.

Inquiries

Scientific/Research Contact(s)

Kristin M. Burns, MD
National Heart, Lung, and Blood Institute
Telephone: 301-594-6859
Email: kristin.burns@nih.gov

Vicky Whittemore, PhD
National Institute of Neurological Disorders and Stroke
Telephone: 301-594-8909
Email: vicky.whittemore@nih.gov

Peer Review Contact(s)

Examine your eRA Commons account for review assignment and contact information (information appears two weeks after the submission due date).

Financial/Grants Management Contact(s)

Judy Sint
National Heart, Lung, and Blood Institute
Telephone: 301-480-1307
Email: sintj@mail.nih.gov