Research and Mentorship in Medical Decision Making for Chronic Diseases of Older Adults

老年人慢性病医疗决策的研究和指导

基本信息

批准号：
10652524
负责人：
ELBERT S. HUANG
金额：
$ 11.65万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10652524
关键词：
Address Advanced Development Affect Aging Architecture Award Benefits and Risks California Cardiovascular system Caregivers Caring Characteristics Chicago Chronic Chronic Disease Clinical Clinical Research Cohort Studies Complex Complications of Diabetes Mellitus Computerized Medical Record Consolidated Framework for Implementation Research Cost Analysis Cost Effectiveness Analysis Data Data Collection Decision Aid Decision Making Dementia Development Diabetes Mellitus Disease Management Documentation Elderly End stage renal failure Environment Epidemiology Evaluation Event Foundations Future Genetic Glucose Glycosylated hemoglobin A Goals Guidelines Health Health and Retirement Study Heterogeneity Hypoglycemia Individual International Intervention Kidney Learning Life Longitudinal cohort Mathematical Model Simulation Medical Medicare claim Medicare/Medicaid Medicine Mentorship Methodology Mid-Career Clinical Scientist Award (K24)Modeling Nurses Observational Study Outcome Patient Selection Patients Pharmaceutical Preparations Pharmacoepidemiology Population Population Heterogeneity Prediabetes syndrome Process Quality of life Randomized Recording of previous events Reduce health disparities Registries Research Research Personnel Resources Risk Risk Factors Selection for Treatments Series Shapes Social Functioning Social Sciences Testing Time Training Treatment Protocols United Kingdom Universities Update Variant clinical implementation clinical practice cohort cost effectiveness data repository design diabetes management diabetic field study human centered design improved individual patient insight interdisciplinary collaboration interest models and simulation mortality multi-ethnic next generation non-diabetic novel drug class novel therapeutics older patient outcome prediction patient engagement patient population personalized approach personalized care personalized intervention practice-based research network predictive modeling preference primary endpoint professor programs prospective prototype response secondary endpoint social social relationships support tools therapy development tool treatment response

项目摘要

PROJECT ABSTRACT: Medical decisions for many chronic diseases such as diabetes are becoming more complex as the number of available therapies expand and as we learn how risk factor targets and treatments may need to be individualized based on a patient's clinical characteristics, genetic profiles, treatment preferences, and social circumstances. To strengthen training and research in medical decision making in the study of chronic diseases of older adults, Dr. Elbert Huang, Professor of Medicine at the University of Chicago, is submitting this K24 renewal proposal. The University of Chicago is an ideal environment for this program because of its well-established clinical research programs, history of interdisciplinary collaboration, and significant strengths in the social sciences. The overall goal of the program is to support young investigators who are studying medical decision making in older adults living with individual or multiple chronic diseases. Trainees of the program will have access to cohort studies of older adults (Kaiser Permanente Northern California Diabetes Registry, the National Social Life Health and Aging Project, national Medicaid and Medicare Claims), support for the construction and evaluation of simulation models of chronic diseases, guidance for developing decision support interventions, and facilitated access to the UChicago Practice-Based Research Network. In his own research in geriatric diabetes, Dr. Huang will pursue the following aims: 1) advance the study of variation in diabetes onset, complications and treatment response in observational studies; 2) advance the development of simulation models of diabetes complications; and 3) advance the development of diabetes decision support for personalizing care for older adults. In two ongoing observational studies (R01 AG060756, R01 AG063391), Dr. Huang will explore population-level variation in the onset of diabetes and its complications as well as variation in response to achieved glucose targets and treatments. As part of Aim 2, Dr. Huang is part of an investigative team led by his mentee, Dr. Neda Laiteerapong (R01 MD013420) developing a new simulation model of diabetes complications using multi-ethnic data from the Kaiser Registry. This model will be comprised of a series of individual outcome prediction models (cardiovascular events, hypoglycemia, dementia, mortality) that interwoven together. Under Aim 3, Dr. Huang will first complete evaluation of a trial of a decision support tool (My Diabetes GOAL) created during his initial K24. The tool, embedded within the electronic medical record, is designed to engage patients in personalized goal setting and disease management with the support of a nurse. He will also develop an updated stakeholder-informed diabetes decision support intervention for personalized care for older adults, addressing both goal setting and treatment selection. This K24 award will allow Dr. Huang to strengthen his mentorship program in medical decision making in chronic diseases and expand his research portfolio in new directions that will guide individualization of care for diverse populations of patients living with diabetes.

项目摘要：糖尿病等许多慢性疾病的医疗决策变得越来越重要随着可用疗法数量的增加以及我们了解风险因素的目标和治疗方法，情况变得更加复杂可能需要根据患者的临床特征、遗传特征、治疗进行个体化偏好和社会环境。加强医疗决策培训和研究芝加哥大学医学教授 Elbert Huang 博士对老年人慢性病的研究，正在提交此 K24 续订提案。芝加哥大学是该项目的理想环境由于其完善的临床研究项目、跨学科合作的历史，以及社会科学领域的显着优势。该计划的总体目标是支持年轻的研究人员他们正在研究患有某种或多种慢性疾病的老年人的医疗决策。该计划的学员将有机会参加老年人的队列研究（Kaiser Permanente Northern 加州糖尿病登记处、国家社会生活健康和老龄化项目、国家医疗补助和医疗保险索赔），支持慢性病模拟模型的构建和评估，制定决策支持干预措施的指导，并促进获得芝加哥大学实践基础研究网．在他自己的老年糖尿病研究中，黄博士将追求以下目标：1）推进观察性糖尿病发病、并发症和治疗反应变化的研究研究； 2）推进糖尿病并发症模拟模型的开发； 3) 推进开发糖尿病决策支持，为老年人提供个性化护理。在两项正在进行的观察中研究（R01 AG060756、R01 AG063391）中，黄博士将探讨疾病发病的人群水平差异糖尿病及其并发症以及对达到的血糖目标和治疗的反应变化。作为作为目标 2 的一部分，黄博士是其徒弟 Neda Laiteerapong 博士 (R01 MD013420）使用来自不同种族的数据开发了一种新的糖尿病并发症模拟模型凯撒登记处。该模型将由一系列单独的结果预测模型组成（心血管事件、低血糖、痴呆、死亡）交织在一起。目标 3 下，黄博士将首先完成对决策支持工具（我的糖尿病目标）试验的评估，该工具是在他最初创建的 K24。该工具嵌入电子病历中，旨在让患者参与个性化治疗在护士的支持下设定目标和疾病管理。他还将开发一个更新的利益相关者知情的糖尿病决策支持干预措施，为老年人提供个性化护理，解决目标设定和治疗选择。这个K24奖项将使黄博士能够加强他的指导慢性病医疗决策计划，并将他的研究组合扩展到新的方向这将指导不同人群的糖尿病患者的个体化护理。

项目成果

期刊论文数量（71）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The Cost and Safety of Insulin in Older Adults.

DOI：
10.1001/jamainternmed.2020.9185
发表时间：
2021-05-01
期刊：
JAMA internal medicine
影响因子：
39
作者：
Huang ES;Lipska KJ
通讯作者：
Lipska KJ

Building and experimenting with an agent-based model to study the population-level impact of CommunityRx, a clinic-based community resource referral intervention.

DOI：
10.1371/journal.pcbi.1009471
发表时间：
2021-10
期刊：
PLoS computational biology
影响因子：
4.3
作者：
Lindau ST;Makelarski JA;Kaligotla C;Abramsohn EM;Beiser DG;Chou C;Collier N;Huang ES;Macal CM;Ozik J;Tung EL
通讯作者：
Tung EL

Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes.

DOI：
10.1016/j.jdiacomp.2016.11.020
发表时间：
2017-03
期刊：
Journal of diabetes and its complications
影响因子：
3
作者：
Brennan MB;Hess TM;Bartle B;Cooper JM;Kang J;Huang ES;Smith M;Sohn MW;Crnich C
通讯作者：
Crnich C

The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (The Diabetes & Aging Study).

DOI：
10.2337/dc17-1144
发表时间：
2019-03
期刊：
Diabetes care
影响因子：
16.2
作者：
Laiteerapong N;Ham SA;Gao Y;Moffet HH;Liu JY;Huang ES;Karter AJ
通讯作者：
Karter AJ

Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use.

DOI：
10.1001/jamainternmed.2017.3844
发表时间：
2017-10-01
期刊：
JAMA internal medicine
影响因子：
39
作者：
Karter AJ;Warton EM;Lipska KJ;Ralston JD;Moffet HH;Jackson GG;Huang ES;Miller DR
通讯作者：
Miller DR