Explaining Racial and Ethnic Disparities in Idiopathic Pulmonary Fibrosis

解释特发性肺纤维化的种族和民族差异

• 批准号: 7791303
• 负责人: David J. Lederer
• 金额: $ 13.51万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7791303
• 关键词: Accident and Emergency department; Accounting; Address; Age; Asbestos; Attitude; Belief; Cardiovascular system; Caring; Characteristics; Clinic; Clinical; Clinical Investigator; Clinical Trials; Clinical Trials Design; Clinical and Translational Science Awards; Cohort Studies; Collagen; Critical Care; Data; Diagnosis; Diffuse; Disease; Environmental Exposure; Epidemiologist; Epidemiology; Ethnic Origin; Etiology; Evaluation; Exercise; Fibrosis; Funding; Future; Gender; Hamman-Rich syndrome; Health; Health Insurance; Health Services Accessibility; Healthcare; Healthcare Systems; Hispanics; Histologic; Hospitals; Hypersensitivity; Impairment; Institute of Medicine (U.S.); Insurance Carriers; Insurance Coverage; Interstitial Lung Diseases; Intervention; Intervention Studies; Investigation; Language; Lead; Left lung; Lung; Lung Transplantation; Lung diseases; Medical; Medicine; Mentors; Minority; National Heart, Lung, and Blood Institute; New York; Not Hispanic or Latino; Outcome; Oxygen; Patient Preferences; Patients; Pattern; Physicians; Presbyterian Church; Process; Provider; Public Health Schools; Pulmonary Fibrosis; Race; Randomized Controlled Trials; Recruitment Activity; Rehabilitation therapy; Reporting; Research; Research Personnel; Respiratory physiology; Risk Factors; Secondary to; Services; Severities; Smoke; Socioeconomic Status; Source; Strategic Planning; Structure of parenchyma of lung; Study Subject; Surgeon; Symptoms; Time; Training; Translational Research; Transplantation; United States; United States National Institutes of Health; Universities; Urban Health; Variant; Vascular Diseases; Walking; base; career; college; community intervention; cost; design; effective therapy; experience; health disparity; improved; male; mortality; patient oriented; physical conditioning; professor; programs; prospective; public health priorities; racial and ethnic disparities; randomized trial; respiratory

The Candidate is an Assistant Professor who plans a career as a patient-oriented independent clinical investigator and epidemiologist focused on health disparities and advanced lung diseases such as pulmonary fibrosis. His training plan includes mentored didactic and practical experience in (1) health disparities research, (2) clinical trials, and (3) advanced epidemiology and biostatistical training within the Division of Pulmonary, Allergy, and Critical Care Medicine of Columbia University, the NCMHD-funded Columbia Center for the Health of Urban Minorities, and Columbia University's Mailman School of Public Health. The proposed research plan will be carried out in Columbia's Clinical and Translational Science Award (CTSA)-funded Irving Center for Clinical and Translational Research. Study subjects will be recruited from the New York Presbyterian Hospital Lung Transplant Program and the Columbia Center for Interstitial Lung Disease, both located at Columbia University's College of Physicians and Surgeons. The Candidate proposes to conduct a prospective cohort study of patients with idiopathic pulmonary fibrosis (IPF), a devastating disease with a median survival of only 3 years. His preliminary data suggest that non-Hispanic black and Hispanic patients with IPF have worse lung function, lower exercise capacity, and a higher mortality rate than non-Hispanic white patients both at Columbia and in a nationwide study at 94 transplant centers. The proposed study will examine whether delayed referral for subspecialist care and more severely impaired exercise capacity among minorities contribute to survival disparities. Health care access factors at multiple levels will be explored as potential contributors to these disparities. The proposal will prepare the Candidate to design and perform randomized trials of specific interventions aimed at ameliorating racial and ethnic disparities in IPF and other advanced lung diseases. Relevance: The NIH Roadmap and the Institute of Medicine have made research that investigates the underlying causes of health disparities a national public health priority. We propose to identify factors that explain survival disparities in a fatal lung disease called idiopathic pulmonary fibrosis. Results of this study will be used to design clinical trials aimed at reducing these disparities.

候选人是一名助理教授，计划成为一名以患者为导向的独立临床医生 研究者和流行病学家专注于健康差异和晚期肺部疾病，例如 肺纤维化。他的培训计划包括 (1) 健康方面的指导教学和实践经验 差异研究，（2）临床试验，以及（3）高级流行病学和生物统计学培训 NCMHD 资助的哥伦比亚大学肺、过敏和重症医学科 哥伦比亚城市少数民族健康中心和哥伦比亚大学梅尔曼公立学院 健康。拟议的研究计划将在哥伦比亚大学临床和转化科学学院进行 奖 (CTSA) 资助的欧文临床和转化研究中心。将招募研究对象 来自纽约长老会医院肺移植项目和哥伦比亚间质中心 肺部疾病，均位于哥伦比亚大学内外科医学院。候选人 提议对特发性肺纤维化（IPF）患者进行前瞻性队列研究， 中位生存期只有3年的毁灭性疾病。他的初步数据表明非西班牙裔 黑人和西班牙裔 IPF 患者肺功能较差，运动能力较低，且血压较高 哥伦比亚大学和全国 94 例移植研究中的死亡率均高于非西班牙裔白人患者 中心。拟议的研究将检查是否延迟转诊至亚专科护理以及更严重的情况 少数群体运动能力受损导致生存差距。医疗保健获取因素 将探讨多个层面作为造成这些差异的潜在因素。该提案将准备 候选人设计并进行旨在改善种族和种族问题的特定干预措施的随机试验 IPF 和其他晚期肺部疾病的种族差异。 相关性：美国国立卫生研究院路线图和医学研究所进行了研究，调查了 健康差异的根本原因是国家公共卫生优先事项。我们建议确定以下因素： 解释一种称为特发性肺纤维化的致命肺部疾病的生存差异。本研究结果 将用于设计旨在减少这些差异的临床试验。