Improving Risk-Stratification in Patients with Prolonged ICU Stays

改善长期入住 ICU 患者的风险分层

基本信息

批准号：
10184329
负责人：
Elizabeth Marie Viglianti
金额：
$ 19.66万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-01 至 2026-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10184329
关键词：
Accounting Achievement Admission activity American Austria Automobile Driving Award Bed Occupancy Beds Bioethics COVID-19 pandemic Caregivers Caring Chest Clinical Clinical stratification Cognitive Consult Critical Care Critical Illness Data Data Analyses Data Set Decision Making Development Development Plans Distress Ethics Event Evidence based practice Family Funding Goals Grant Healthcare Systems Hospital Mortality Hospitals Hour Institutes Intensive Care Units Interview K-Series Research Career Programs Knowledge Learned Helplessness Longitudinal Surveys Longitudinal cohort Lung Manuscripts Medical Medical center Medicine Mental Depression Mentors Methodology Michigan Minority Morbidity - disease rate National Heart, Lung, and Blood Institute North Carolina Organ failure Outcome Palliative Care Paper Patient Admission Patient Care Patients Peer Review Physicians Population Prevalence Prevention Probability Process Prognosis Prospective cohort Provider Publications Publishing Research Resources Risk SECTM1 gene Scientist Scotland Shock Societies Source Structure Survey Methodology Surveys Symptoms System Universities Validation Variant Veterans Health Administration Work Writing acute hypoxemic respiratory failure biomarker identification career career development cohort cost design evidence base experience heuristics high risk improved lecturer palliative patient stratification patient subsets prediction algorithm prevent professor prognostic prospective psychologic response risk prediction risk prediction model risk stratification social systematic review tool

项目摘要

Project Summary Candidate’s Long-Term Career Goal: To become an independently funded physician-scientist with a clinical expertise in persistent critical illness and bioethics with a methodological expertise in longitudinal surveys. Clinical Problem: Patients with prolonged ICU stays are costly, increasing in prevalence, and resulting in long-term morbidity. Unfortunately, we have not been able to identify this cohort of patients early and subsequently have not been able to institute evidence-based processes to prevent its development. Candidate Background and Achievements: Dr. Viglianti is a Lecturer in Pulmonary and Critical Care Medicine at the University of Michigan (UM). She received her MD from Duke University, MPH from the University of North Carolina Chapel Hill, and MSc from UM. To date she has published 23 papers, including 14 original peer-reviewed manuscripts; 7 of which she is first author. She won a minority grant award from the American Thoracic Society, an F32 and loan repayment award from NHLBI, and an institutional K12. Regardless of the outcome of this proposal, her department anticipates she will be appointed to an assistant professor on or before July 1, 2021, with a start-up package including $250,000 of discretionary research fund. Career Development Plan: Dr. Viglianti proposes to develop new expertise in longitudinal survey methodology and analysis, and bioethics through formal coursework and mentored research. Her primary mentor is Dr. Theodore J. Iwashyna at UM, who has mentored 7 clinician-scientists on K awards, including 4 to R-level funding. She will be co-mentored by Dr. Mick Couper a research professor at the Institute of Social Research at UM who is an expert in design and implementation of longitudinal surveys. Aims: Using both prospective and retrospective surveys and secondary data, she will 1) Determine the accuracy of physicians to prognosticate new late-onset shock and acute hypoxic respiratory failure; 2) Develop hypotheses about sources of prognostication accuracy and inaccuracy by exploring heuristics, cognitive biases and bioethical principles and values; 3) Determine the extent to which variation in hospital rates of persistent critical illness are explained by new late-onset organ failures and palliative care utilization. Deliverables from Aims: The proposed aims will lead to at least 4 publications and prepare Dr. Viglianti to write 2 R01 proposals: 1) Develop and validate a new risk-prediction tool; 2) Identification of evidence-based practices utilized by high performing hospitals in the prevention and management of late-onset organ failures.

项目摘要候选人的长期职业目标：成为临床的独立资助的身体科学家在纵向调查方面具有方法论专业知识的持续重症疾病和生物伦理学方面的专业知识。临床问题：长时间ICU住宿的患者昂贵，患病率增加，并导致长期发病率。不幸的是，我们无法尽早确定这一患者和随后，无法建立基于证据的过程以防止其发展。候选背景和成就：Viglianti博士是肺和重症监护的讲师密歇根大学（UM）的医学。她从杜克大学获得了医学博士学位，从北卡罗来纳大学教堂山和UM的MSC。迄今为止，她发表了23篇论文，其中包括14篇原始的同行评审手稿；她是第一位作家。她赢得了少数民族赠款奖。美国胸部学会，NHLBI的F32和贷款还款奖，以及机构K12。无论该提议的结果如何，她的部门都预计她将被任命为助理 2021年7月1日或之前的教授，其中包括25万美元的可酌情研究基金。职业发展计划：Viglianti博士提出的纵向调查中的新专业知识方法和分析，以及通过正式课程和指导研究的生物伦理学。她的小学导师是UM的Theodore J. Iwashyna博士，他在K奖中指导了7个临床科学家，其中包括4次。 R级资金。她将由社会研究所的研究教授米克·库珀（Mick Couper）博士共同征收 UM的研究是纵向调查设计和实施专家。目的：使用前瞻性和回顾性调查和辅助数据，她将1）确定医生证明新的晚期休克和急性低氧呼吸衰竭的准确性； 2）发展关于通过探索启发式，认知偏见来提示准确性和不准确性来源的假设和生物伦理原则和价值观； 3）确定医院持续率的变化程度新的晚期器官失败和姑息治疗利用来解释重症疾病。 AIMS的可交付成果：拟议的目标将导致至少4个出版物，并为Viglianti博士做好准备编写2个R01建议：1）开发和验证一种新的风险预测工具； 2）鉴定循证高表现医院在预防和管理后期器官故障中使用的实践。