Novel evidence-accumulation-driven methods for characterizing kidney stone progression

用于表征肾结石进展的新证据积累驱动方法

• 批准号: 10367369
• 负责人: Yu-Lun Liu
• 金额: $ 73.31万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10367369
• 关键词: Accounting; Affect; Algorithmic Software; Algorithms; Characteristics; Chronic Kidney Failure; Clinical; Clinical Research; Clinical Trials; Collection; Competence; Computational algorithm; Data; Data Set; Decision Making; Disease; Disease Progression; Electronic Health Record; End stage renal failure; Enrollment; Event; Foundations; Funding; Goals; Health Care Costs; Hour; Hydration status; Joints; Kidney Calculi; Knowledge; Lead; Link; Medical; Metabolic; Metabolism; Methodology; Methods; Minerals; Modeling; Morbidity - disease rate; National Institute of Diabetes and Digestive and Kidney Diseases; Outcome; Pain; Participant; Patients; Pennsylvania; Pharmaceutical Preparations; Physicians; Population; Prevalence; Prevention; Prevention strategy; Public Health; Recording of previous events; Records; Recurrence; Regimen; Registries; Research; Risk; Risk Factors; Sampling; Science; Time; United States; Universities; University Hospitals; Urinary Calculi; Urine; Validation; Woman; Work; base; clinical decision-making; clinical practice; clinical research site; cohort; experience; high risk; men; modifiable risk; mortality; novel; predictive modeling; predictive tools; prevent; response; risk prediction; risk prediction model; risk stratification; software development; success; tool

PROJECT SUMMARY Preventing kidney stone progression remains a serious obstacle in public health, despite advances unravelling the underlying mechanisms of stone formation. Kidney stone disease, often along with excruciating pain, is highly prevalent around the globe, affecting nearly 12% of the world population. In the United States, the estimated lifetime prevalence of kidney stone disease is approximately 10.6% in men and 7.1% in women. Following their initial episode, stone formers are at higher risk for recurrent stone formation, with more than 50% experiencing a recurrence within 10 years, reflecting the inadequacies of current prevention regimens. In addition, the formation of stone disease is strongly associated with long-term complications of chronic kidney disease and end-stage renal disease, along with significant morbidity, mortality as well as burden of health care cost. In response to PA-20-185, the overarching goal of this proposal is to maximize the efficacy of preventive strategies against kidney stone disease progression by developing clinical prediction tools as well as computational algorithms and software. More specifically, we propose novel evidence-accumulation-driven methods (1) to develop patient-level risk prediction models for kidney stone disease progression accounting for subtypes of stone conditions; and (2) to identify modifiable risk factors for stone disease progression by integrating historically existing prediction models into new EHR or registry datasets. We will apply and validate the proposed methods to real-world data, including the UTSW Mineral Metabolism Stone Registry, the PUSH trial conducting by the Urinary Stone Disease Research Network (which is a clinical research network funded by NIDDK), and the Swiss Kidney Stone Cohort. The success of this project will fill the knowledge gap of kidney stone disease progression, and lead to a predictive toolbox to inform clinicians on the risk of kidney stone progression, thereby facilitating timely clinical decision-making and implementation of targeted strategies to prevent or reduce stone disease progression.

项目概要 尽管取得了进展，但预防肾结石进展仍然是公共卫生的严重障碍 结石形成的基本机制。肾结石疾病通常伴随着难以忍受的疼痛，发病率很高。 该病在全球范围内流行，影响了世界近 12% 的人口。在美国，估计 男性肾结石的终生患病率约为 10.6%，女性约为 7.1%。跟随他们的 初次发作时，结石形成者复发结石的风险较高，超过 50% 的人经历过 10年内复发，反映出当前预防方案的不足。此外， 结石病的形成与慢性肾脏病的长期并发症密切相关 终末期肾病，以及显着的发病率、死亡率以及医疗费用负担。 为了响应 PA-20-185，该提案的总体目标是最大限度地提高预防措施的功效 通过开发临床预测工具来对抗肾结石疾病进展的策略以及 计算算法和软件。更具体地说，我们提出了新的证据积累驱动的方法 方法 (1) 开发肾结石疾病进展的患者级风险预测模型 石材状况的亚型； (2) 通过以下方法确定结石病进展的可改变的危险因素： 将历史上现有的预测模型集成到新的 EHR 或注册表数据集中。我们将申请并验证 所提出的真实世界数据方法，包括 UTSW 矿物质代谢结石登记处、PUSH 由泌尿系结石疾病研究网络（这是一个由以下机构资助的临床研究网络）进行的试验 NIDDK）和瑞士肾结石队列。 该项目的成功将填补肾结石疾病进展的知识空白，并导致 预测工具箱，告知临床医生肾结石进展的风险，从而促进及时的临床 决策和实施有针对性的策略，以预防或减少结石病的进展。