Mid-Career Mentoring Award For Patient-Oriented Research in Frailty and Health Outcomes

职业生涯中期指导奖，表彰以患者为导向的虚弱和健康结果研究

• 批准号: 10651807
• 负责人: Dae Hyun Kim
• 金额: $ 17.25万
• 依托单位: HEBREW REHABILITATION CENTER FOR AGED
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10651807
• 关键词: Academy; Acceleration; Acute; Adopted; Adoption; Affect; Age; Aging; Award; Cardiology; Caring; Clinical; Clinical Management; Complex; Data; Data Scientist; Data Sources; Dedications; Disease; Elderly; Environment; Epidemiologist; Epidemiology; Faculty; Fellowship; Fostering; Funding; Future; Geriatrics; Goals; Grant; Growth; Health; Health Policy; Health Services Research; Health Status; Health system; Healthcare Systems; Heterogeneity; Individual; Institution; K-Series Research Career Programs; Leadership; Learning; Link; Measurement; Medical; Medicare; Medicine; Mentors; Mentorship; Methodology; Mid-Career Clinical Scientist Award (K24); Mission; National Institute on Aging; Operative Surgical Procedures; Outcome; Paper; Patients; Peer Review; Persons; Pharmacoepidemiology; Pharmacotherapy; Physiological; Pilot Projects; Population; Postdoctoral Fellow; Proliferating; Public Health; Publishing; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Research Project Grants; Resources; Students; Surgical Specialties; Training; Training Programs; Translating; Writing; career; career development; clinical decision-making; collaborative environment; feasibility testing; frailty; functional outcomes; human old age (65+); implementation science; improved; indexing; individual patient; inter-individual variation; medical specialties; older patient; patient oriented research; personalized care; personalized medicine; primary care practice; programs; responsible research conduct; skills; standard of care; stressor; treatment effect; treatment response; trend

PROJECT SUMMARY Increasing evidence suggests that frailty—a common problem of old age characterized by reduced physiologic reserve and inability to tolerate acute stressors—may determine inter-individual variability in outcomes after drug therapy and surgical procedures among older adults. While this understanding supports the idea of personalizing treatments based on a patient's frailty level, there is little empirical evidence on how to use frailty information to maximize benefits or avoid harms in older patients. There is a pressing need to understand how frailty affects the outcomes of various medical and surgical treatments. The candidate is a geriatrician and epidemiologist who has established a robust patient-oriented research program on frailty, geriatric pharmacoepidemiology, and prediction of functional outcomes after surgery at Hebrew SeniorLife Marcus Institute for Aging Research. He is also a dedicated mentor of trainees and junior faculty, who have published a number of peer-reviewed papers and have successfully competed for training and career development awards in aging research. The candidate's research program has a long-term objective to improve care of older adults with frailty by generating high-quality evidence, training future clinicians and researchers, and changing health systems and policy. Toward this goal, his current NIA-funded research focuses on use of a frailty index for Medicare data to determine who should be treated with a drug therapy or a surgical procedure and who should not due to lack of benefit or increased likelihood of harm. This K24 Mid-career Investigator Award proposal will allow the candidate to develop a formal mentoring program, expand his research, and become a more effective mentor and leader. The specific aims are to: 1) develop a mentoring program in frailty research for early-stage and new investigators from diverse clinical and research backgrounds; 2) conduct high-quality research to determine heterogeneity of treatment effects by frailty for a broad range of medical and surgical interventions; and 3) acquire new research skills in implementation science and enhance capacity in mentorship and leadership within and outside geriatrics. The outstanding collaborative environment of Hebrew SeniorLife and other Harvard-affiliated institutions will provide resources (e.g., various data sources, including Medicare data, computing environment, and career development training courses) and support (e.g., data scientists and research methodology experts) needed to accomplish the proposed activities. The advancement of the candidate's mentoring and research program, supported by this K24 award, will foster growth of well-trained clinician investigators in aging research and accelerate adoption of personalized medicine for older adults across medical and surgical specialties based on a patient's frailty level.

项目概要 越来越多的证据表明，虚弱是老年人的一个常见问题，其特征是生理机能下降 储备和无法耐受急性应激源——可能决定药物治疗后结果的个体间差异 虽然这种理解支持个性化的想法。 治疗基于患者的虚弱程度，但很少有经验证据表明如何使用虚弱信息来治疗 迫切需要了解衰弱如何影响老年患者。 各种药物和手术治疗的结果。候选人是一位老年病学家和流行病学家。 他建立了一个强大的以患者为中心的研究计划，涉及虚弱、老年药物流行病学和 希伯来高级生命马库斯衰老研究所的手术后功能结果预测。 也是实习生和初级教师的忠实导师，他们发表了许多同行评审的论文 并成功角逐衰老研究方面的培训和职业发展奖项。 研究计划的长期目标是通过产生高质量的成果来改善对虚弱老年人的护理 证据，培训未来的支持者和研究人员，并改变卫生系统和政策以实现这一目标， 他目前由 NIA 资助的研究重点是使用医疗保险数据的虚弱指数来确定谁应该接受治疗 接受药物治疗或外科手术治疗且由于缺乏益处或增加而不应接受的人 K24 职业生涯中期研究员奖提案将允许候选人制定正式的损害可能性。 指导计划，扩大他的研究，并成为一个更有效的导师和领导者的具体目标。 目标是： 1) 为来自不同领域的早期和新研究人员制定衰弱研究指导计划 临床和研究背景；2）进行高质量的研究以确定治疗的异质性 虚弱对广泛的医疗和外科干预措施的影响；3) 获得以下领域的新研究技能： 实施科学并增强老年医学内外的指导和领导能力。 希伯来高级生活中心和其他哈佛附属机构的出色协作环境将提供 资源（例如各种数据源，包括医疗保险数据、计算环境和职业发展 培训课程）和完成所需的支持（例如数据科学家和研究方法专家） 候选人的指导和研究计划的进展，并得到支持。 该 K24 奖项将促进衰老研究领域训练有素的临床研究人员的成长并加速采用 根据患者的虚弱程度，跨医学和外科专业为老年人提供个性化医疗。

项目成果

Assessment of Frailty Index at 66 Years of Age and Association With Age-Related Diseases, Disability, and Death Over 10 Years in Korea.

• DOI: 10.1001/jamanetworkopen.2022.48995
• 发表时间: 2023-03-01
• 期刊: JAMA NETWORK OPEN
• 影响因子: 13.8
• 作者: Jang, Jieun;Jung, Heewon;Shin, Jaeyong;Kim, Dae Hyun
• 通讯作者: Kim, Dae Hyun

Balancing Benefit and Harm of Intensive Blood Pressure Lowering Based on Individual Outcome Profile Analysis.

基于个体结果分析的强化降压的利弊平衡。

• DOI: 10.1016/j.amjmed.2023.09.003
• 发表时间: 2023
• 期刊: The American journal of medicine
• 作者: Shi,SandraM;Gouskova,Natalia;Park,ChanMi;Travison,ThomasG;Wei,Lee-Jen;Kim,DaeHyun
• 通讯作者: Kim,DaeHyun