The role of physician experience in outcomes of patients with acute respiratory f

医生经验对急性呼吸道疾病患者预后的影响

基本信息

批准号：
8705000
负责人：
Meeta Prasad Kerlin
金额：
$ 13.38万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-01 至 2018-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8705000
关键词：
Acute Acute respiratory failure Adopted Aptitude Caring Clinical Clinical Research Cohort Studies Complex Critical Care Critical Illness Data Data Set Databases Development Development Plans Education Ensure Evidence based practice Exposure to Foundations Future Goals Health Policy Hospitals Individual Intervention Journals K-Series Research Career Programs Knowledge Learning Link Literature Lung Master of Science Measurable Mechanical ventilation Medicine Mentors Mentorship Modeling Morbidity - disease rate Motivation Operative Surgical Procedures Outcome Outcomes Research Patient Care Patients Pennsylvania Physician&apos s Role Physicians Provider Publications Relative (related person)Research Research Infrastructure Research Personnel Research Project Grants Resources Role Science Solutions Statistical Models Structure Surveys Techniques Testing Training Translating Translations Universities Variant Work base career development clinical epidemiology clinical practice experience high risk improved innovation insight interest knowledge translation mortality novel patient population public health relevance respiratory skills uptake

项目摘要

DESCRIPTION (provided by applicant): Patients with acute respiratory failure requiring mechanical ventilation are at high risk for morbidity and mortality. Although several recent advances have improved management of such patients, these therapies have been incompletely adopted and patient outcomes continue to vary across hospitals. One factor that may be associated with improved translation of evidence into practice is the experience of the physician provider. Previous studies indirectly provide evidence for this relationship; for example, higher annual hospital volume is associated with reduced mortality. However, there is little direct evidence, physician "experience" has not been defined, and the capacity of organizational solutions to modify the relationship is unknown. A better understanding of this complex relationship could reveal novel targets for interventions to improve uptake of evidence-based practices of mechanically ventilated patients and ultimately their outcomes. Therefore the overall goal of this proposal is to understand the relationship between physician experience and outcomes for mechanically ventilated patients. Specifically, we will determine (1) if there is an association of physician experience, defined as years since completing of training, with patient outcomes; (2) the relative contributions of physician experience and hospital volume to patient outcomes; and (3) if effects of physician experience are modified by the presence of organizational factors. For this project we will create an innovative database linking multiple publicly available administrative and clinical datasets of patients hospitalized in the state of Pennsylvania with data obtained from a state-wide hospital survey and will use state-of-the-art statistical modeling techniques to advance our understanding of the role of the physician in patient outcomes. This database and career development award will be a foundation for the candidate's future work as an independent clinical researcher with a focus on developing and implementing organizational interventions to improve care of patients with acute respiratory failure. Dr. Meeta Prasad Kerlin has a clinical background in pulmonary and critical care medicine and a Master of Science in Clinical Epidemiology from the University of Pennsylvania. She has demonstrated her interest and aptitude for clinical research through the successful completion of several research projects in the topics of critical care outcomes and education. She has had multiple publications in high-impact journals such as JAMA and Critical Care Medicine. In this proposal, she has developed a career development plan that includes a complementary approach of didactic learning, structured professional development, intensive mentorship, and direct research experience leading the project described above. She has the full support of her department, outstanding mentors who are already the leaders in critical care outcomes research, and access to the vast resources of the University of Pennsylvania. Together, these will ensure her successful development into a leader in her own right.

描述（由申请人提供）：需要机械通气的急性呼吸衰竭患者的发病率和死亡率很高。尽管最近的几项进展改善了对此类患者的治疗，但这些疗法已被不完全采用，并且患者的结果在整个医院中继续有所不同。可能与改进证据转化为实践有关的一个因素是医师提供者的经验。先前的研究间接提供了这种关系的证据；例如，年度医院量较高与死亡率降低有关。但是，几乎没有直接的证据，医师的“经验”尚未定义，组织解决方案修改关系的能力尚不清楚。对这种复杂关系的更好理解可以揭示干预措施的新目标，以改善对机械通风患者的循证实践的吸收，并最终获得其结果。因此，该提案的总体目标是了解医师经验与机械通风患者的结果之间的关系。具体而言，我们将确定（1）是否存在自培训完成以来的医师经验的关联，并与患者结局相关；（2）医师经验和医院量对患者预后的相对贡献；（3）如果组织因素的存在来改变医师经验的影响。对于该项目，我们将创建一个创新的数据库，该数据库将在宾夕法尼亚州住院的患者的多个公开可用的行政和临床数据集，并通过从州范围内的医院调查中获得的数据链接，并将使用最先进的统计建模技术来促进我们对医生在患者临床中的作用的理解。该数据库和职业发展奖将为候选人作为独立临床研究人员的未来工作的基础，重点是开发和实施组织干预措施，以改善急性呼吸衰竭患者的护理。 Meeta Prasad Kerlin博士具有肺和重症监护医学的临床背景，并且是宾夕法尼亚大学临床流行病学科学硕士学位。她通过成功完成重症监护成果和教育主题的几个研究项目，证明了自己对临床研究的兴趣和能力。她在JAMA和重症监护医学等高影响力期刊上有多个出版物。在这项建议中，她制定了一项职业发展计划，其中包括教学学习，结构化专业发展，密集指导和直接研究经验的补充方法，领导了上述项目。她得到了部门的全力支持，杰出的导师已经是重症监护效果研究的领导者，并获得了宾夕法尼亚大学的庞大资源。这些将共同确保她成功地发展成为领导者。