Improving the equity of RCTs among patients with acute and chronic respiratory failure

提高急慢性呼吸衰竭患者随机对照试验的公平性

• 批准号: 10664527
• 负责人: Scott D Halpern
• 金额: $ 12.73万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10664527
• 关键词: Acute; Acute Lung Injury; Acute Respiratory Distress Syndrome; Address; American Heart Association; Award; Calibration; Cardiovascular system; Caring; Characteristics; Chronic; Clinical Trials; Cohort Studies; Consent; Critical Care; Data; Detection; Discrimination; Disparity population; Early treatment; Effectiveness; Electronic Mail; Elements; Engineering; Enrollment; Equity; Ethnic Origin; Evidence based practice; Faculty; Failure; Family Caregiver; Funding; Future; Goals; Grant; Growth; Individual; Inequity; Infrastructure; Intervention; Intervention Trial; Interview; Investments; Journals; K-Series Research Career Programs; Lead; Leadership; Learning; Lung; Measures; Medical; Medicine; Mentors; Mentorship; Methods; Mid-Career Clinical Scientist Award (K24); Midcareer Investigator Award in Patient-Oriented Research; Modeling; National Heart, Lung, and Blood Institute; Natural Language Processing; Outcome; Patient Recruitments; Patient Representative; Patient-Focused Outcomes; Patients; Performance; Persons; Postdoctoral Fellow; Prevention; Principal Investigator; Prospective Studies; Prospective, cohort study; Publishing; Qualitative Methods; RNA Interference; Race; Reporting; Research; Research Project Grants; Resources; Respiratory Failure; Risk; Risk Adjustment; Scientist; Smoking Cessation Intervention; Structure; System; Talents; Technology; Testing; Text; Time; Training; Training Programs; Training Support; United States National Academy of Sciences; United States National Institutes of Health; Visit; Work; advanced disease; behavior test; behavioral economics; care outcomes; career development; clinical trial enrollment; comorbidity; compliance behavior; design; ethnic diversity; experience; financial incentive; health equity; improved; indexing; innovation; insight; intervention effect; meetings; novel; outcome prediction; palliative; participant enrollment; prediction algorithm; predictive modeling; prevent; professor; programs; provider adherence; racial bias; racial diversity; randomized, clinical trials; recruit; sex; skills; statistics; student mentoring; systematic review; trial enrollment

The goal of this Midcareer Investigator Award in Patient-Oriented Research is to enhance Dr. Scott Halpern’s ability to mentor students, residents, post-doctoral fellows, and junior faculty in developing and testing strategies to improve fairness in the enrollment and analysis of randomized clinical trials (RCTs) among patients with acute and chronic respiratory failure, thereby leading to more equitable care for such patients. During his initial K24, Dr. Halpern completed 3 scientific aims that help augment the efficiency of such RCTs, and 3 career development goals that made him a more effective mentor. Milestones completed during the initial K24 include his primarily mentoring 7 new individuals to receive NIH K awards and 8 mentees to earn 14 R01 or equivalent independent research grants. Motivated by his team’s increased commitments to health equity, this renewal K24 proposes new scientific aims that will improve the equity of enrollment in and analysis of respiratory failure RCTs while helping Dr. Halpern develop new skills in training more junior mentors, building infrastructures that catalyze successful mentorship, and developing and applying equitable prediction models to guide care and predict outcomes for patients with acute and chronic respiratory failure. The new scientific aims of this K24 renewal will leverage the resources and patients enrolling in several new initiatives of Dr. Halpern’s Palliative and Advanced Illness Research (PAIR) Center. Aims 1a and 1b will test the hypotheses that using mobile patient recruitment strategies and behavioral economic approaches to framing consent decisions will improve the diversity and representativeness of respiratory failure RCTs. These aims will leverage parallel insights being developed through his recently established Behavioral Economics to Transform Trial Enrollment Representativeness (BETTER) Center, funded by the American Heart Association to enable more equitable enrollment in cardiovascular RCTs. Dr. Halpern will also lead qualitative interviews among patients with acute and chronic respiratory failure engaged in prospective cohort studies led by several of his mentees. Aims 2a and 2b will use patient-level data from 15 RCTs completed by the PAIR Center or NHLBI’s ARDSNet and PETAL Networks to determine whether the 7 predictive models most commonly used for risk adjustment in respiratory failure RCTs perform equitably across groups defined by race, ethnicity, and sex, and to identify features of these models that are associated with inequitable performance. These latter aims will provide essential insights for Dr. Halpern’s team’s future efforts to develop more equitable models. Renewal of this K24 award would enable Dr. Halpern to quell growth in his administrative responsibilities and thus (1) maintain the time he currently commits to mentoring, (2) attend meetings to learn from more senior mentors and research leaders and to train his junior faculty mentees to develop their own mentoring skills, and (3) grow his national impact on POR mentoring by supporting his training in research leadership and growth of the “Junior Faculty Visiting Professor Program” he established under his original K24.

这项中级护理研究员奖的目标是增强斯科特博士 Halpern具有精神学生，居民，博士后研究员和初级教师的能力 测试策略，以提高在随机临床试验（RCT）的入学和分析中的公平性 患有急性和慢性呼吸衰竭的患者，从而为此类患者提供更多的公平护理。 在最初的K24期间，Halpern博士完成了3个科学目标，有助于提高此类RCT的效率， 和3个职业发展目标，使他更加有效。里程碑在 最初的K24包括他的主要指导，将获得7个新人，以获得NIH K奖和8个Mentores赚取14 R01或同等的独立研究补助金。由于他的团队对健康的承诺增加了 公平，这种更新的K24提议新的科学目的将提高入学和分析的公平性 呼吸衰竭RCT的同时，帮助Halpern博士发展了培训更多初级导师的新技能， 建立基础架构，促进成功的心态，并发展和应用公平的预测 指导急性和慢性呼吸衰竭患者的护理和预测结果的模型。 此K24更新的新科学目的将利用几个资源和患者的资源和患者 Halpern博士的姑息和晚期疾病研究（PAIR）中心的新计划。目标1A和1B将 测试使用移动患者招聘策略和行为经济方法的假设 框架同意的决定将提高呼吸衰竭RCT的多样性和代表性。这些 目标将利用他最近建立的行为经济学开发的并行见解 由美国心脏协会资助的转型试验注册代表性（更好）中心 为了使心血管RCT的更公平入学。 Halpern博士还将领导定性访谈 在急性和慢性呼吸衰竭的患者中，参与了前瞻性队列研究。 他的麦内斯。 AIMS 2A和2B将使用对配对中心完成的15个RCT的患者级数据或 NHLBI的ARDSNET和花瓣网络确定是否最常用的7种预测模型 对于呼吸衰竭的风险调节，RCT在种族，种族和种族和种族定义的群体之间同样执行 性别，并确定与性能不平等相关的这些模型的特征。这些以后 AIMS将为Halpern博士团队未来开发更公平模型的未来努力提供基本见解。 续签该K24奖将使Halpern博士能够平息其行政 责任，因此（1）保持他目前致力于心理的时间，（2）参加会议学习 来自更多的高级导师和研究领袖，并培训他的初级教职员工以发展自己的教师 指导技能，以及（3）通过支持他的研究培训来增强他对POR心理的影响 他在原始K24下建立的“初级教师访问教授计划”的领导和成长。

项目成果

Stakeholder Perspectives on Minimum Clinically Important Difference and Noninferiority Margin for Hospital-Free Days to Assess Interventions.

利益相关者对评估干预措施的非住院日的最小临床重要差异和非劣效裕度的看法。

• DOI: 10.1001/jamainternmed.2023.0918
• 发表时间: 2023
• 期刊: JAMA internal medicine
• 影响因子: 39
• 作者: Auriemma,CatherineL;Butt,MaayraI;Silvestri,JasmineA;Halpern,ScottD;Courtright,KatherineR
• 通讯作者: Courtright,KatherineR

Cost-Effectiveness of Four Financial Incentive Programs for Smoking Cessation.

四种戒烟财政激励计划的成本效益。

• DOI: 10.1513/annalsats.202012-1473oc
• 发表时间: 2021
• 期刊: Annals of the American Thoracic Society
• 影响因子: 8.3
• 作者: Russell,LouiseB;Volpp,KevinG;Kwong,PuiL;Cosgriff,BenjaminS;Harhay,MichaelO;Zhu,Jingsan;Halpern,ScottD
• 通讯作者: Halpern,ScottD