Developing a framework to individualize surgical decision-making for older adults with primary hyperparathyroidism
开发一个框架,为患有原发性甲状旁腺功能亢进症的老年人提供个性化的手术决策
基本信息
- 批准号:10337961
- 负责人:
- 金额:$ 24.3万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-09-30 至 2026-05-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAffectAgingBenefits and RisksCaringCharacteristicsChronic Kidney FailureClinicalClinical TrialsComparative Effectiveness ResearchCounselingDataDecision MakingDevelopmentEducational workshopElderlyEndocrine System DiseasesEndocrinologistEnsureFeedbackFocus GroupsFractureFundingFutureGoalsHealthHybridsHyperparathyroidismIncidenceInternationalK-Series Research Career ProgramsKidney CalculiKnowledgeLeadershipMedicalMethodologyMethodsMorbidity - disease rateOperative Surgical ProceduresOutcomeParathyroidectomyPatient SelectionPatient-Centered CarePatientsPerioperativePopulationPositioning AttributePrimary Care PhysicianProceduresProviderRecommendationResearchResearch MethodologyResearch PriorityResearch TrainingRiskRisk EstimateRisk ReductionSeverity of illnessStandardizationSurgical ManagementTestingTrainingVeterans Health AdministrationVulnerable Populationscareercareer developmentcomparative effectivenessdesigneffectiveness implementation studyeffectiveness implementation trialeffectiveness trialevidence baseexpectationexperiencefracture riskfrailtyimplementation scienceimprovedindividual patientindividualized medicineinnovationmortality risknoveloperationosteoporosis with pathological fracturepatient orientedpersonalized carepersonalized decisionpersonalized risk predictionpredictive modelingpreventprogramsrisk predictionskillssupport toolssurgical risktooltreatment centertreatment choicetreatment effect
项目摘要
PROJECT SUMMARY/ABSTRACT
This K76 Career Development award will address the large unmet need for patient-specific decision support
tools for surgical interventions in older adults and provide a platform for the applicant to become a leader in
geriatric surgery. Primary hyperparathyroidism (PHPT) is a common endocrine disorder in older adults that is
associated with serious long-term morbidity, including osteoporotic fractures, kidney stones, and chronic
kidney disease (CKD). Parathyroidectomy can prevent these morbid sequelae. However, increased surgical
risk associated with advanced age and frailty, in addition to the competing risk of death prior to achieving
benefit from surgical intervention, raises the question of whether the short-term risks of parathyroidectomy
outweigh long-term risk reduction in this group. Identifying older adults likely to benefit from surgical
interventions, such as parathyroidectomy, while preventing overuse of surgery in this vulnerable group, is
critical to improve patient-centered care. Currently, there is no standardized methodology for developing
surgical decision support for older adults that incorporates individualized risk prediction and stakeholder input
to facilitate informed, patient-centered decision-making. Therefore, this coordinated research and training
proposal aims to: 1) compare the effects of parathyroidectomy vs. medical management on the incidence of
fractures, symptomatic kidney stones, and CKD in older adults with PHPT; 2) develop and validate predictive
models for the perioperative risks of parathyroidectomy and long-term risks of fractures, kidney stones, and
CKD specific to older adults with PHPT; and 3) design and test with stakeholder feedback a PHPT decision
support tool that describes the tradeoffs of parathyroidectomy vs. non-operative management. To accomplish
these aims, Dr. Seib will obtain training in comparative effectiveness and predictive modeling, qualitative and
mixed methods research to develop decision support, and implementation science. Upon completion of this
research, Dr. Seib will have a user-tested risk/benefit calculator that will form the basis of a decision support
tool to improve individualized, patient-centered treatment recommendations for older adults with PHPT. In
addition, this research will establish a framework for developing patient-centered decision support that can be
applied to other conditions to promote appropriate surgical management of older adults. This proposal is
significant because it directly addresses the gap in decision support tools for PHPT and other surgically
managed conditions in older adults. This project is innovative because it proposes a paradigm shift to
incorporate geriatric principles to individualize treatment decisions in older adults with PHPT to optimize clinical
outcomes. At the end of the proposed research, Dr. Seib will have the data and skills necessary to successfully
pursue R01 funding for a hybrid type 1 effectiveness-implementation trial to test this decision support tool and
apply this methodology to other conditions with surgical treatment options that affect older adults.
项目总结/文摘
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Carolyn Dacey Seib其他文献
Carolyn Dacey Seib的其他文献
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{{ truncateString('Carolyn Dacey Seib', 18)}}的其他基金
Developing a framework to individualize surgical decision-making for older adults with primary hyperparathyroidism
开发一个框架,为患有原发性甲状旁腺功能亢进症的老年人提供个性化的手术决策
- 批准号:
10493450 - 财政年份:2021
- 资助金额:
$ 24.3万 - 项目类别:
Developing a framework to individualize surgical decision-making for older adults with primary hyperparathyroidism
开发一个框架,为患有原发性甲状旁腺功能亢进症的老年人提供个性化的手术决策
- 批准号:
10661770 - 财政年份:2021
- 资助金额:
$ 24.3万 - 项目类别:
The Impact of Treatment Choice on Long-term Outcomes in Older Adults with Primary Hyperparathyroidism
治疗选择对患有原发性甲状旁腺功能亢进症的老年人长期预后的影响
- 批准号:
9751150 - 财政年份:2018
- 资助金额:
$ 24.3万 - 项目类别:
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