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

• 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
• 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; 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

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：许多糖尿病等许多慢性疾病的医疗决策正在变得越来越多 随着可用疗法数量的扩展，随着我们了解风险因素的目标和治疗方法的复杂 可能需要根据患者的临床特征，遗传特征和治疗来个性化 偏好和社会环境。加强对医疗决策的培训和研究 芝加哥大学医学教授Elbert Huang博士研究老年人的慢性病研究， 正在提交这项K24续订建议。芝加哥大学是该计划的理想环境 由于其公认的临床研究计划，跨学科合作的历史以及 社会科学的重要优势。该计划的总体目标是支持年轻的调查员 他们正在研究患有个人或多种慢性疾病的老年人的医疗决策。 该计划的学员将可以访问老年人的队列研究（Kaiser Permanente Northern 加利福尼亚糖尿病注册表，国家社会生活健康和衰老项目，国家医疗补助和 Medicare主张），支持慢性疾病模拟模型的构建和评估， 制定决策支持干预措施的指南，并促进对基于乌奇加哥实践的访问 研究网络。黄博士在自己在老年糖尿病方面的研究中将追求以下目的：1） 进步研究糖尿病发作，并发症和治疗反应的变异 研究； 2）推进糖尿病并发症模拟模型的发展； 3）推进 开发糖尿病的决策支持，以个性化老年人的护理。在两个正在进行的观察 研究（R01 AG060756，R01 AG063391），黄博士将探索人口水平的变化。 糖尿病及其并发症以及响应实现的葡萄糖靶标和治疗的变化。作为 AIM 2的一部分，黄博士是由他的受训者Neda Laiteerapong博士领导的调查团队的一部分（R01 MD013420）使用来自多种族的数据开发新的糖尿病并发症模型 Kaiser注册表。该模型将由一系列个人结果预测模型组成 （心血管事件，低血糖症，痴呆，死亡率），它们交织在一起。在AIM 3下，黄博士 将首先完成对决策支持工具的试验（我的糖尿病目标）的评估 K24。该工具嵌入了电子病历中，旨在使患者参与个性化 在护士的支持下，目标设定和疾病管理。他还将开发一个更新 利益相关者信息的糖尿病决策支持老年人个性化护理的干预措施，解决 目标设定和治疗选择。这个K24奖将使黄博士能够加强他的指导 慢性疾病医疗决策的计划，并将其研究组合扩展到新方向 这将指导针对患有糖尿病患者的不同人群的护理个性化。