Long-term effectiveness of BPH/LUTS pharmacological therapies and using machine learning based predictive analytics to tailor treatment

BPH/LUTS 药物治疗的长期有效性，并使用基于机器学习的预测分析来定制治疗

• 批准号: 10618734
• 负责人: Marvin Epolian Langston
• 金额: $ 15.31万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-04 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10618734
• 关键词: 5 Alpha-Reductase Inhibitor; Acute; Address; Adrenergic Antagonists; Adrenergic alpha-Antagonists; Age; Alternative Therapies; Anti-Cholinergics; Asian Americans; Benign; Benign Prostatic Hypertrophy; Big Data; Caring; Cessation of life; Clinical; Combined Modality Therapy; Complex; Coupled; Data; Data Set; Data Sources; Diagnosis; Disease Progression; Effectiveness; Electronic Health Record; Epidemiology; Etiology; Exhibits; Funding; Future; Goals; Gold; Grant; Health; Healthcare; High Prevalence; Hispanic; Histologic; Hyperplasia; Incidence; Investigation; K-Series Research Career Programs; Laboratories; Machine Learning; Malignant neoplasm of prostate; Methodology; Methods; Modality; Muscle Tonus; Muscle relaxation phase; Newly Diagnosed; Nodule; Observational Study; Operative Surgical Procedures; Outcome; Overactive Bladder; Patients; Pharmacological Treatment; Pharmacology; Phenotype; Population; Predictive Analytics; Predictive Factor; Prevalence; Progressive Disease; Prostate; Prostatic Diseases; Quality of life; Race; Reporting; Research; Research Design; Risk; Scientist; Secondary to; Smooth Muscle; Source; Surveys; Symptoms; Time; Training; Translating; Treatment Effectiveness; Treatment Failure; Urinary Retention; Urology; Validation; Work; associated symptom; base; black men; clinical phenotype; cohort; comparative effectiveness; compare effectiveness; cost; effectiveness evaluation; electronic data; ethnic difference; experience; high risk; improved; individualized medicine; inhibitor; innovation; lower urinary tract symptoms; member; men; novel; older men; personalized approach; personalized medicine; phosphoric diester hydrolase; predictive modeling; prevent; prostatitis; racial and ethnic; risk prediction model; skills; symptom management; tool; translational scientist; treatment strategy; urologic

PROJECT SUMMARY/ABSTRACT This Career Development Award will support Dr. Marvin Langston in his transition to independence as a translational researcher. His long-term research goals include understanding the etiology and outcomes of urologic conditions with an emphasis on prostate diseases (prostate cancer, prostatitis, and lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH/LUTS)); developing and validating clinical tools to improve and personalize treatment options; and implementing these tools in “real world” clinical settings. BPH/LUTS is an extremely common set of conditions among older men and can be considered a progressive disease, mainly characterized by deteriorating LUTS over time which causes considerable bother and decreased quality of life, urinary retention, and death in rare cases. Conventional pharmacological treatment strategies fail in preventing long-term clinical outcomes in about 30% of treated patients. Despite a high volume of pharmacological research, there have been very limited advances in therapy for BPH/LUTS in recent years. Therefore, innovative and well-designed studies are needed to understand the long-term comparative effectiveness of contemporary BPH/LUTS pharmacological therapies while leveraging the clinical covariates that can be captured in “big data” sources such as the electronic health record. To address these limitations, In Aim 1, Dr. Langston will evaluate the long-term comparative effectiveness of BPH/LUTS pharmacological therapies in an observational study drawn from the Kaiser Permanente membership population, a fully integrated healthcare network. If well designed studies demonstrate that contemporary pharmacological approaches are not more effective at preventing long-term BPH/LUTS progression than conventional approaches alone, then personalized treatment options may ultimately provide the best strategy for reducing long-term BPH/LUTS progression. Therefore, in Aim 2 Dr. Langston will develop and validate predictive models using demographic, clinical, and laboratory data available at the time of BPH/LUTS diagnosis to identify patients at increased risk of long-term BPH/LUTS clinical outcomes (acute urinary retention and BPH surgery) using machine learning based predictive analytics. As the volume, availability, and access to electronic data increases, so does the need for scientists with the content and methodologic expertise to correctly use and translate these data into improved urology care. This K01 provides the training for Dr. Langston to meet this challenge as a translational researcher and compete successfully for future R01 funding.

项目概要/摘要 该职业发展奖将支持马文·兰斯顿博士向独立过渡 他的长期研究目标包括了解其病因和结果。 泌尿系统疾病，重点是前列腺疾病（前列腺癌、前列腺炎和下尿路疾病） 良性前列腺增生 (BPH/LUTS) 的继发症状）；开发和验证临床工具 改进和个性化治疗方案；并在“现实世界”的临床环境中实施这些工具。 BPH/LUTS 是老年男性中极为常见的一组病症，可被视为一种 进行性疾病，主要特征是随时间推移 LUTS 恶化，造成相当大的麻烦 在极少数情况下，传统药物会导致生活质量下降、尿潴留和死亡。 尽管治疗策略未能预防约 30% 的治疗患者的长期临床结果。 尽管进行了大量的药理学研究，但 BPH/LUTS 的治疗进展非常有限 因此，需要创新和精心设计的研究来了解长期的情况。 当代 BPH/LUTS 药物疗法的比较有效性，同时利用临床 可以在电子健康记录等“大数据”源中捕获的协变量。 为了解决这些局限性，在目标 1 中，兰斯顿博士将评估长期比较 Kaiser 观察性研究中 BPH/LUTS 药物治疗的有效性 永久会员人口，如果研究设计得当，将是一个完全集成的医疗保健网络。 证明当代药理学方法并不能更有效地预防长期 BPH/LUTS 的进展比单独采用传统方法要好，那么个性化的治疗方案可能会 最终提供减少长期 BPH/LUTS 进展的最佳策略，因此，在目标 2 中。 兰斯顿将利用现有的人口统计、临床和实验室数据开发和验证预测模型 在 BPH/LUTS 诊断时识别长期 BPH/LUTS 临床风险增加的患者 使用基于机器学习的预测分析的结果（急性尿潴留和 BPH 手术）。 随着电子数据的数量、可用性和访问量的增加，对科学家的需求也随之增加 正确使用这些数据并将其转化为改进的泌尿科护理的内容和方法专业知识。 K01 为 Langston 博士提供培训，以应对作为转化研究员的这一挑战 成功竞争未来的 R01 资金。