Integrated physiomarker, biomarker and clinical predictive analytics for early warning of sepsis and necrotizing enterocolitis in very low birth weight infants.

综合生理标志物、生物标志物和临床预测分析，用于早期预警极低出生体重婴儿的败血症和坏死性小肠结肠炎。

• 批准号: 10773555
• 负责人: Brynne Archer Sullivan
• 金额: $ 7.06万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10773555
• 关键词: Algorithms; Award; Biological Markers; Brain; Child; Clinical; Clinical Markers; Clinical Research; Clinical Trials; Clinical assessments; Data; Data Set; Development Plans; Diagnosis; Disease; Disease Progression; Doctor of Philosophy; Early Diagnosis; Early treatment; Enrollment; Environment; Faculty; Goals; Hand; Heart Rate; Immunologic Markers; Immunology; Infant; Inflammatory; Injury; Institution; Laboratories; Life; Medical; Mentors; Mentorship; Methodology; Mission; Monitor; Morbidity - disease rate; Multicenter Trials; National Institute of Child Health and Human Development; Necrotizing Enterocolitis; Neonatal Intensive Care Units; Organ; Outcome; Oxygen; Parents; Patients; Pattern; Performance; Predictive Analytics; Premature Infant; Productivity; Pulse Oximetry; Records; Recovery; Research; Research Personnel; Resources; Risk; Risk Factors; Risk Marker; Sepsis; Source; Survivors; System; Testing; Time Series Analysis; Training; Training Activity; United States National Institutes of Health; Universities; Very Low Birth Weight Infant; Virginia; career; career development; clinical application; clinical predictors; clinical risk; data integration; disability; experience; feasibility testing; immune activation; improved; improved outcome; late onset sepsis; mortality; multidisciplinary; predictive modeling; professor; randomized trial; tool

PROJECT SUMMARY/ABSTRACT – Unchanged from Parent Award Candidate: Dr. Brynne Sullivan is an Assistant Professor at the University of Virginia (UVA) with experience in research involving clinical applications of predictive analytics in NICU patients. She is currently supported by an internal mentored career develop award and enrolled in courses to earn a MSc degree in clinical research. Career development plan and goals: The proposed training plan will establish Dr. Sullivan as a clinician- investigator with expertise in predictive analytics to improve diagnosis and outcomes of life-threatening inflammatory illness in very low birth weight infants (VLBW). Training activities during the award period include graduate-level coursework and tutorial in time series analysis, clinical trial methodology and immunology. Research Plan: Late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) occur in 20% of VLBW infants and cause significant morbidity and mortality. Early diagnosis and treatment can start the course to recovery before serious injury occurs; therefore, tools to detect the first signs of illness could save lives and improve outcomes for survivors. Physiomarkers, biomarkers and clinical risk markers of LOS and NEC exist, currently as separate sources of data. The critical need for making a substantial difference in morbidity and mortality from LOS and NEC is to integrate data to develop tools for earlier diagnosis and treatment. The objective is to develop predictive analytics using clinical, physiomarker and biomarker data and test the hypothesis that integrating these data improves algorithm performance. SPECIFIC AIMS: 1) Develop and validate a Pulse Oximetry Warning Score for early detection of LOS and NEC using patterns in heart rate (HR) and oxygen saturation (SpO2) from a large, multi-center data set and compare performance to predictive models using clinical risk factors; 2) Determine whether biomarkers of immune activation inform risk of imminent LOS and NEC in the context of physiomarker and clinical monitoring; 3) Test feasibility of integrated physiomarker, biomarker and clinical monitoring in a pilot randomized trial to inform next steps of a multi-center trial that will be the focus of an R01 proposal. The proposed research is consistent with the NICHD mission to ensure that all children have the chance to fulfill their potential to live healthy and productive lives free from disease or disability. Mentors: The primary mentor, Randall Moorman, MD, and secondary mentors, Karen Fairchild, MD and William Petri, MD, PhD, have broad and diverse expertise and strong track records in successful completion of NIH-supported studies and in mentoring trainees and junior faculty to become independent investigators. Environment: The UVA Center for Advanced Medical Analytics and Dr. Petri’s laboratory will provide the intellectual environment and resources necessary to accomplish the goals of this proposal. The exceptional resources and institutional support at UVA and outstanding multi-disciplinary mentorship team will allow the candidate to achieve her long-term goal of becoming an independent investigator and nationally recognized expert in predictive analytics for life-threatening inflammatory illnesses in premature infants.

项目摘要/摘要 - 与父母奖没有变化 候选人：Brynne Sullivan博士是弗吉尼亚大学（UVA）的助理教授 NICU患者中涉及预测分析的临床应用的研究。她目前得到了 内部修改的职业发展奖，并参加了课程，以获得临床研究的硕士学位学位。 职业发展计划和目标：拟议的培训计划将建立Sullivan博士为临床 - 研究人员具有预测分析方面的专业知识，以改善威胁生命的诊断和结果 非常低的出生体重婴儿（VLBW）的炎症疾病。颁奖期间的培训活动包括 时间序列分析，临床试验方法和免疫学的研究生级课程和教程。 研究计划：晚期败血症（LOS）和坏死性小肠结肠炎（NEC）发生在20％的VLBW婴儿和 引起明显的发病率和死亡率。早期诊断和治疗可以开始康复课程 严重受伤；因此，检测疾病迹象的工具可以挽救生命并改善结果 生存。 LOS和NEC的物理标志物，生物标志物和临床风险标记存在，目前是独立的 数据源。从LOS和 NEC将集成数据以开发用于早期诊断和治疗的工具。目的是发展 使用临床，生理标志物和生物标志物数据进行预测分析，并测试整合的假设 这些数据改善了算法性能。具体目的：1）开发和验证脉搏血氧饱和度 使用心率（HR）和氧气满意度的模式对LOS和NEC进行早期检测的警告评分 （SPO2）从大型多中心数据集中，并将性能与使用临床风险的预测模型进行比较 因素； 2）确定免疫激活的生物标志物是否为迫在眉睫的LOS和NEC的风险提供 物理标志物和临床监测的背景； 3）测试综合物理标志物，生物标志物和 在一项试验随机试验中，临床监测为多中心试验的下一步提供信息，这将成为 R01提案。拟议的研究与NICHD的任务一致，以确保所有儿童都有 发挥其健康和产品潜力的机会，没有疾病或残疾。 导师：主要导师，医学博士兰德尔·摩尔曼（Randall Moorman）和次要导师，医学博士Karen Fairchild和 医学博士威廉·彼得里（William Petri）在成功完成时拥有广泛而富裕的专业知识和强大的往绩记录 由NIH支持的研究以及在心理学员和初级教师中成为独立研究人员。 环境：UVA高级医学分析中心和Petri博士的实验室将提供 实现该提案目标所需的知识环境和资源。异常 UVA的资源和机构支持以及杰出的跨学科Mentalship团队将允许 候选人实现她成为独立调查员并获得全国认可的长期目标 预测性分析的专家在早产婴儿中威胁生命的炎症性疾病。

项目成果

Artificial and human intelligence for early identification of neonatal sepsis.

人工智能和人类智能用于新生儿败血症的早期识别。

• DOI: 10.1038/s41390-022-02274-7
• 发表时间: 2023
• 期刊: Pediatric research
• 影响因子: 3.6
• 作者: Sullivan,BrynneA;Kausch,SherryL;Fairchild,KarenD
• 通讯作者: Fairchild,KarenD

Antibiotic spectrum index: A new tool comparing antibiotic use in three NICUs.

• DOI: 10.1017/ice.2021.467
• 发表时间: 2022-11
• 期刊: INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY
• 影响因子: 4.5
• 作者: Sullivan, Brynne A.;Panda, Aneesha;Wallman-Stokes, Aaron;Sahni, Rakesh;Fairchild, Karen D.;Newland, Jason G.;McPherson, Christopher C.;Vesoulis, Zachary A.
• 通讯作者: Vesoulis, Zachary A.