Natural history, risk prediction and cost of cirrhosis in insured Americans.

受保美国人的肝硬化自然史、风险预测和费用。

基本信息

  • 批准号:
    10346703
  • 负责人:
  • 金额:
    $ 70.35万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2022
  • 资助国家:
    美国
  • 起止时间:
    2022-02-01 至 2026-01-31
  • 项目状态:
    未结题

项目摘要

SUMMARY Cirrhosis is a leading cause of mortality in the United States (US), diagnosed in 1.5-9.4 million Americans and results in over 40,000 deaths each year. Every year 5-7% patients with cirrhosis experience life-threatening decompensating events, such as ascites, hepatic encephalopathy (HE), gastrointestinal bleeding (GIB), or develop hepatocellular carcinoma (HCC). These events often result in hospitalization, disability, or even death. The challenge is to accurately predict those patients who are likely to develop decompensating events and are likely to die. Accurate risk stratification of persons with cirrhosis will allow for early identification and prioritization for guideline recommended care and emerging therapies (e.g., statins). Several predictive models exist but none of them adequately answers this question. Furthermore, no longitudinal cost of care analyses and cost prediction has been performed in the US for persons with cirrhosis. The care of patients with cirrhosis is complex, often involving costly recurrent hospitalizations and procedures. In 2015, the hospital costs alone were reported to be $16.3 billion. Our proposed research will analyze a large national administrative health payer with detailed information on diagnoses, procedures, laboratory tests, medications, in- and outpatient care, as well as standardized costs for insured Americans between 2011 and 2018. Such a large population-based cirrhosis cohort, which includes cost data, offers a unique and unprecedented opportunity to study disease progression, develop highly accurate prediction models, and study costs. Aim 1. To describe the natural history of cirrhosis over time in a large longitudinal cohort of insured Americans with liver cirrhosis in the United States Aim 1.1: Data preparation and variable transformation Aim 1.2: Adjudicate potentially risk-relevant covariates by a cirrhosis stakeholder panel Aim 1.3: Describe the natural history of cirrhosis Aim 2. To predict the risk of decompensation, hospitalization and death in patients with cirrhosis using a large longitudinal administrative dataset (UNITED Health Group) Aim 2.1: Model the risk of decompensation Aim 2.2: Model the risk of hospitalization Aim 2.3: Merge the UHG dataset with the National Death Index and model the risk of death Aim 3: To predict costs associated with all aspects of care in patients with liver cirrhosis Aim 3.1: Ascertain standardized cost stratified by state/phenotypes of liver cirrhosis Aim 3.2: Model the cost of care over time
概括 肝硬化是美国 (US) 死亡的主要原因,有 150 万至 940 万美国人被诊断患有肝硬化, 每年导致超过 40,000 人死亡。每年有 5-7% 的肝硬化患者面临生命危险 失代偿事件,如腹水、肝性脑病 (HE)、胃肠道出血 (GIB) 或 发展为肝细胞癌(HCC)。这些事件通常会导致住院、残疾甚至死亡。 挑战在于准确预测那些可能发生失代偿事件的患者 并且很可能会死亡。肝硬化患者的准确风险分层将有助于早期识别 以及指南推荐护理和新兴疗法(例如他汀类药物)的优先顺序。一些 预测模型是存在的,但没有一个能够充分回答这个问题。此外,没有纵向成本 美国已对肝硬化患者进行了一系列护理分析和费用预测。护理 肝硬化患者的治疗过程很复杂,通常涉及昂贵的反复住院和手术。 2015年, 据报道,仅医院费用就达 163 亿美元。我们提出的研究将分析一个大型国家 行政医疗付款人提供有关诊断、程序、实验室测试、药物、 住院和门诊护理,以及 2011 年至 2018 年间美国参保人员的标准化费用。 基于人群的大型肝硬化队列(包括成本数据)提供了独特且前所未有的机会 研究疾病进展、开发高度准确的预测模型和研究成本。 目标 1. 描述一大群纵向受保人随时间推移的肝硬化自然史 在美国患有肝硬化的美国人 目标 1.1:数据准备和变量转换 目标 1.2:由肝硬化利益相关者小组裁定潜在的风险相关协变量 目标 1.3:描述肝硬化的自然史 目标 2. 使用预测肝硬化患者失代偿、住院和死亡的风险 大型纵向行政数据集(联合健康集团) 目标 2.1:对失代偿风险建模 目标 2.2:住院风险建模 目标 2.3:将 UHG 数据集与国家死亡指数合并并对死亡风险进行建模 目标 3:预测与肝硬化患者护理各方面相关的成本 目标 3.1:确定按肝硬化状态/表型分层的标准化成本 目标 3.2:对随时间变化的护理成本进行建模

项目成果

期刊论文数量(0)
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会议论文数量(0)
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Daniela P Ladner其他文献

Transforming the Future of Surgeon-Scientists
改变外科医生科学家的未来
  • DOI:
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    9
  • 作者:
    Daniela P Ladner;Allan M. Goldstein;Tim Billiar;Andrew M Cameron;Darren R Carpizo;Daniel I Chu;Craig M Coopersmith;Ronald P DeMatteo;Sandy Feng;Katherine A Gallagher;W. Gillanders;B. Lal;G. Lipshutz;Annie Liu;Ronald V. Maier;E. Mittendorf;Arden M. Morris;J. Sicklick;O. Velazquez;Bryan A. Whitson;Lee G Wilke;Sam S Yoon;Martha A. Zeiger;Diana L Farmer;E. S. Hwang
  • 通讯作者:
    E. S. Hwang

Daniela P Ladner的其他文献

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{{ truncateString('Daniela P Ladner', 18)}}的其他基金

Natural history, risk prediction and cost of cirrhosis in insured Americans.
受保美国人的肝硬化自然史、风险预测和费用。
  • 批准号:
    10557845
  • 财政年份:
    2022
  • 资助金额:
    $ 70.35万
  • 项目类别:
The Northwestern Summer Research Program for Medical Students
西北医学生夏季研究计划
  • 批准号:
    10090216
  • 财政年份:
    2021
  • 资助金额:
    $ 70.35万
  • 项目类别:
LIVOPT -- LIVer cirrhosis - Optimizing Prediction of Patient OuTcomes
LIVOPT——肝硬化——优化患者结果的预测
  • 批准号:
    10490243
  • 财政年份:
    2021
  • 资助金额:
    $ 70.35万
  • 项目类别:
LIVOPT -- LIVer cirrhosis - Optimizing Prediction of Patient OuTcomes
LIVOPT——肝硬化——优化患者结果的预测
  • 批准号:
    10666608
  • 财政年份:
    2021
  • 资助金额:
    $ 70.35万
  • 项目类别:
The Northwestern Summer Research Program for Medical Students
西北医学生夏季研究计划
  • 批准号:
    10391427
  • 财政年份:
    2021
  • 资助金额:
    $ 70.35万
  • 项目类别:
Transplant Regimen Adherence for Kidney Recipients by Engaging Information Technologies: The TAKE IT Trial
通过利用信息技术提高肾受者的移植方案依从性:TAKE IT 试验
  • 批准号:
    9309767
  • 财政年份:
    2017
  • 资助金额:
    $ 70.35万
  • 项目类别:
Transplant Regimen Adherence for Kidney Recipients by Engaging Information Technologies: The TAKE IT Trial
通过利用信息技术提高肾受者的移植方案依从性:TAKE IT 试验
  • 批准号:
    9906214
  • 财政年份:
    2017
  • 资助金额:
    $ 70.35万
  • 项目类别:
A2ALL- Patient Safety System Improvements in Living Donor Liver Transplantation
A2ALL-活体肝移植中患者安全系统的改进
  • 批准号:
    8477034
  • 财政年份:
    2011
  • 资助金额:
    $ 70.35万
  • 项目类别:
A2ALL- Patient Safety System Improvements in Living Donor Liver Transplantation
A2ALL-活体肝移植中患者安全系统的改进
  • 批准号:
    8731865
  • 财政年份:
    2011
  • 资助金额:
    $ 70.35万
  • 项目类别:
A2ALL- Patient Safety System Improvements in Living Donor Liver Transplantation
A2ALL-活体肝移植中患者安全系统的改进
  • 批准号:
    8188248
  • 财政年份:
    2011
  • 资助金额:
    $ 70.35万
  • 项目类别:

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