General pathways and personalized risk of morbidity after sepsis

脓毒症后发病的一般途径和个性化风险

基本信息

批准号：
8950589
负责人：
Hallie Christine Prescott
金额：
$ 19.43万
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：
2015
资助国家：
美国
起止时间：
2015-08-15 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8950589
关键词：
Accounting Acute Acute Kidney Failure Adult American Award Big Data Biometry Caring Cataloging Catalogs Cessation of life Charge Chronic Chronic Disease Chronic Obstructive Airway Disease Clinical Data Clinical Management Clinical Research Cohort Studies Critical Care Critical Illness Data Development Diagnosis Disease Doctor of Philosophy Ensure Environment Epidemic Epidemiology Face Failure Foundations Goals Health Healthcare Heart failure Heating Hospitalization Hospitals Impaired cognition Incidence Individual Infection Inflammation Inpatients Intervention Laboratories Lead Left Literature Logistic Regressions Lung Maps Medicare Mental Depression Mentors Methodology Michigan Modeling Morbidity - disease rate Outcome Outpatients Pathway interactions Patient Care Patient risk Patients Phase Physicians Physiological Population Procedures Process Productivity Public Health Pulmonary Inflammation Quality of life Recovery Recurrence Rehabilitation therapy Relative (related person)Research Research Design Research Personnel Risk Sampling Science Scientist Sepsis Site Statistical Methods Statistical Models Sterility Survivors System Techniques Testing Time Training Universities Veterans Work adverse outcome beneficiary career career development clinical epidemiology clinically relevant experience forest health administration implementation science improved innovation model building mortality personalized medicine predictive modeling prevent skills tool usability

项目摘要

DESCRIPTION (provided by applicant): This K08 proposal will complete Hallie Prescott, MD; MSc's training towards her long-term career goal of improving the long-term survival and quality of life of critical illness survivors. Dr. Prescott is a pulmonary & critical care physician and scientist at the University of Michigan, with Master's training in clinical study design and biostatistics. This proposal builds on Dr. Prescott's prior experience, leveraging advanced statistical methods, granular clinical data, and the rich training environment at University of Michigan to improve our understanding and management of post-sepsis morbidity. The research will be completed under the guidance of primary mentor Theodore J. Iwashyna, MD, PhD, co-mentor Kenneth Langa, MD, PhD, and co-mentor Richard Gonzalez, PhD, with a planned mentor-the-mentor strategy and additional input from an advisory board of physician-scientists. This 5-year plan includes formal coursework, professional development, and mentored research, with defined milestones to ensure productivity and a successful transition to independence. This mentored research has 2 specific Scientific Aims: AIM 1: Test the relative importance 3 competing hypotheses for the general pathway of post- sepsis morbidity. * AIM 2: Develop a diagnosis-specific readmission risk profile tool to personalize treatment for severe sepsis survivors in the immediate (90-day) post-hospital setting. Inherent to completing these high-level Aims, Dr. Prescott will also (1) characterize the epidemiology of multi- morbidity and hospitalization in severe sepsis survivors, (2) identify the health conditions most increased after severe sepsis, (3) define the incremental benefits of specific clinical data in improving risk prediction, (4) compare the accuracy and usability of complementary cutting edge personalized prediction methodologies. This work will build to at least two R01 proposals: (1) to examine the mechanism by which a specific chronic health condition is increased after severe sepsis (as identified in Aim 1) or to examine how post-sepsis morbidity differs from that of less-severe infections and sterile inflammation, and (2) to implement and evaluate the diagnosis-specific risk profile tool developed in Aim 2. Beyond establishing the foundation for a programmatic line of research to improve the care of severe sepsis survivors, this proposal will provide Dr. Prescott with research skills that are readily applicable to additional domains of critical illness research In short, this K08 award will support and accelerate the career development activities of Dr. Prescott and allow her to successfully launch into the next phase of her career as an independent investigator.

描述（由申请人提供）：本 K08 提案将完成医学博士哈莉·普雷斯科特 (Hallie Prescott) 的培训，以实现她改善危重疾病幸存者的长期生存和生活质量的长期职业目标。密歇根大学的护理医师和科学家，接受过临床研究设计和生物统计学的硕士学位培训。该提案建立在 Prescott 博士先前的经验基础上，利用先进的统计方法、精细的临床数据和密歇根大学丰富的培训环境可提高我们对脓毒症后发病率的理解和管理该研究将在主要导师 Theodore J. Iwashyna（医学博士、博士）和联合导师 Kenneth Langa（医学博士、博士）的指导下完成。和联合导师理查德·冈萨雷斯博士，制定了导师对导师策略，并得到了医生科学家顾问委员会的额外投入。这个五年计划包括正式课程、专业发展和指导研究，确定了确保生产力和成功过渡到独立的里程碑。这项指导性研究有 2 个具体的科学目标：目标 1：测试脓毒症后发病一般途径的 3 个相互竞争的假设的相对重要性 * 目标 2：制定特定的诊断。 Prescott 博士还将 (1) 描述再入院风险概况工具，用于在出院后立即（90 天）对严重败血症幸存者进行个性化治疗。严重脓毒症幸存者的多重发病率和住院治疗的流行病学，(2) 确定治疗后增加最多的健康状况严重脓毒症，(3) 定义特定临床数据在改善风险预测方面的增量效益，(4) 比较互补的尖端个性化预测方法的准确性和可用性这项工作将构建至少两个 R01 提案：(1)检查严重脓毒症后特定慢性健康状况恶化的机制（如目标 1 中确定的）或检查脓毒症后发病率与不太严重的感染和无菌性炎症的发病率有何不同，以及 (2) 实施和评估目标 2 中开发的诊断特定风险概况工具。除了为改善严重脓毒症幸存者护理的计划性研究奠定基础之外，该提案还将为 Prescott 博士提供可轻松应用于其他关键领域的研究技能简而言之，这个 K08 奖项将支持和加速 Prescott 博士的职业发展活动，并使她能够作为一名独立研究者成功进入职业生涯的下一阶段。