CTSA News

The NC TraCS K12 scholar helps run some potentially game-changing clinical trials on diabetes—and she wants to get more people involved.

When you grow up in a family with two parents who are both researchers and clinicians, the idea of helping people through science can be a regular topic of conversation around the dinner table.

"It was really fun as a kid to see my parents talk about problems," says Klara Klein, an endocrinologist at the University of North Carolina School of Medicine. Klein's mother, an endocrinologist and osteoporosis specialist, studied mechanical forces and bone remodeling in the laboratory, and her father, a cardiologist, built computer programs to help with cardiac imaging, alongside his clinical work.

"I saw the challenges of being a physician, but I also saw how rewarding it was—the joy that they got out of both the science of medicine and being able to help people."

Klein, one of the current K12 scholars at the North Carolina Translational and Clinical Sciences (NC TraCS) Institute, traces her own medical and research career back to this influence.

"Their jobs were not just jobs, right? This was their calling, that's how it always felt to me, and I always admired that and wanted to emulate that," she says.

Specifically, Klein says she always wanted to help bring science to the clinic, create a bridge between the data-driven world of research and the patient-focused world of healthcare. And for her K project, she's developing a tool that will be able to plug into UNC Health's system of electronic health records to help connect patients with clinical trials that they may want to join—expanding the impact of the medical science being done at UNC to patients in every corner of North Carolina.

Klein began connecting academic research and patient care as an undergraduate, when she worked in labs at Stanford University and the drug company Roche Pharmaceuticals. Soon after, she came to Chapel Hill for a joint MD-PhD program and stayed for her residency and fellowship before joining the faculty in 2022.

"UNC embodies what makes me tick...It's not about trying to make one person famous; it's about doing the best and bringing the best to the community."

Klein

"I do think UNC embodies what makes me tick, which is trying to do science for the community together," Klein says. "It's not about trying to make one person famous; it's about doing the best and bringing the best to the community."

Currently, she leads the endocrinology clinical trials team at UNC, which studies potentially groundbreaking new treatment options for diabetes and other endocrine conditions, including medications such as semaglutide (commonly sold as Wegovy or Ozempic). The challenge is that these trials can be difficult to access for everyone who might benefit. Recruitment for clinical trials often happens when clinicians who are involved in a study talk to patients during routine appointments—but when most of the research is based in Chapel Hill, participants are more likely to be drawn from those who live nearby and receive care at UNC's main campus.

"This is a hospital for the state. We are here to serve the people of North Carolina, and I have these incredible things I can offer the people of North Carolina," Klein says. "But it's offered to a very small proportion of people that are in our area."

Her K project aims to help rectify this. Klein is reaching out to diabetes and kidney disease patients and providers across the UNC Health network (meaning in all corners of the state) to gather their perspectives on clinical trials. Specifically, she'll be trying to understand what might prevent doctors from informing their patients about clinical trials, and what might prevent patients from signing up for those trials. In addition, Klein is seeking to learn more about why providers may or may not prescribe new medications and therapies, and why patients may or may not want to try new medications and therapies.

"I always go into these interviews saying, 'The goal is to learn from you'," Klein says. "There's no wrong answers, I'm here to listen to your perspective."

Klein will use this feedback and information to develop a tool that can be installed into UNC Health's electronic health record system to help identify patients who are eligible to join clinical trials or might benefit from newer, state-of-the-art therapies.

This tool alone won't singlehandedly make these connections feasible. "Just because we can identify someone in rural North Carolina doesn't mean they're going to be able to come to the main campus," she says. "We have to be able to identify people and then figure out how to deliver it."

But this tool can be the first step toward getting more people into clinical trials. And while Klein is focusing her project on diabetes and kidney disease, she's quick to note that ideally, this kind of project, and the electronic health record tool she's building, could be implemented for any other group of diseases.

"...it should be something that increases access to all clinical trials that are done at UNC—...and sharing the idea or the methods with other academic research centers so it's not just North Carolina, it's the whole country."

Klein

"I want to create this for diabetes and chronic kidney disease because that's what I'm passionate about, but it should be something that increases access to all clinical trials that are done at UNC—and if it works, you could imagine sharing the idea or the methods with other academic research centers so it's not just North Carolina, it's the whole country," Klein says.

Klein says she's receiving support from multiple mentors at UNC, including John Buse, a diabetes expert and former co-director of NC TraCS, Jenny Flythe, a clinical trialist and nephrologist, and Emily Pfaff, an informatics researcher and co-director of the Informatics and Data Science (IDSci) team at NC TraCS. Klein is also working with the North Carolina Network Consortium, which helps strengthen connections between researchers and clinics and bring research out into communities across the state.

Projects like this can be a win-win-win for researchers, clinicians, and patients. For researchers, enrolling study participants from a wider pool of patients can help speed up the pace of their work and produce more robust data. This approach can also help researchers learn what kinds of support or healthcare innovations are needed across different clinical settings. For example, small clinics in rural areas of the state may have different day-to-day needs and capacities than large academic research hospitals.

Klein hopes that if more clinicians see their patients responding well to new therapies during clinical trials, they might be more likely to prescribe those new therapies once they're available. And of course, connecting patients across the state with clinical trials will give more people a chance to receive cutting-edge medical care.

"I think of the UNC mission in and of itself," Klein says. "There's lots of different types of healthcare facilities that are now part of the UNC Health system. And that's a real opportunity to expand the wonderful work we do at the main campus to all the people within that system."