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A Personalized, Patient-Centered Approach to Optimizing Lupus Care

优化狼疮护理的个性化、以患者为中心的方法

基本信息

批准号：
10377522
负责人：
April Jorge
金额：
$ 17.5万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
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：
2021-04-01 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10377522
关键词：
Academy Adverse effects Award Azathioprine Biological Cardiovascular system Caring Clinical Clinical Investigator Clinical Research Decision Analysis Decision Making Disease Doctor of Philosophy Dose Electronic Health Record Environment Epidemiologic Methods Equilibrium Event FDA approved Fellowship Flare Foundations Funding General Hospitals General Population Goals Guidelines Harm Reduction Heterogeneity Hydroxychloroquine Immunosuppressive Agents Infection Internal Medicine K-Series Research Career Programs Life Lupus Machine Learning Maryland Massachusetts Medicine Mentors Mentorship Methodology Methotrexate Modeling Morbidity - disease rate Mycophenolate Ophthalmology Oral Organ Outcome Paper Patient Preferences Patient Recruitments Patients Peer Review Pharmaceutical Preparations Pharmacoepidemiology Physicians Positioning Attribute Premature Mortality Recommendation Research Research Methodology Research Personnel Residencies Retinal Diseases Rheumatology Risk Risk Factors SARS-CoV-2 infection Science Scientist Severity of illness Subgroup Systemic Lupus Erythematosus Training Training Activity Translational Research Treatment outcome Uncertainty United States National Institutes of Health Universities Vision Work adjudicate adverse outcome belimumab care outcomes catalyst clinical decision-making clinical epidemiology cohort comorbidity compliance behavior data access data-driven model dosage experience experimental study improved improved outcome infection risk innovation instructor machine learning prediction algorithm medical schools mortality mortality risk novel patient oriented patient oriented research patient stratification personalized medicine predictive modeling preference renal damage risk prediction risk stratification severe COVID-19 skills therapy adverse effect trend

项目摘要

Candidate: April Jorge, MD is an Instructor in Medicine at Harvard Medical School (HMS) and an Assistant in Medicine in the Rheumatology Unit at Massachusetts General Hospital (MGH). After graduating from the University of Maryland magna cum laude, she received her MD from Georgetown University, and she completed her internal medicine residency at Northwestern University. She completed her rheumatology fellowship at MGH, during which she also completed the Harvard Catalyst Clinical and Translational Research Academy and began working with Hyon Choi, MD, DrPH. Dr. Jorge's prior work has resulted in 15 peer- reviewed original papers, with 13 as the first author or co-first author. Her goal is to become an independent investigator and innovative leader in patient-oriented research of systemic lupus erythematosus (SLE). Mentorship, Training Activities, and Environment: Dr. Jorge will conduct the proposed project at MGH under the mentorship of Hyon Choi, MD, DrPH and co-mentorship of Karen Costenbader, MD, MPH and Karen Sepucha, PhD. Dr. Choi is a world-renowned, NIH-funded physician scientist in advanced clinical epidemiology of rheumatic conditions, ranging from common disorders to rare but serious disorders (e.g., SLE). He has served as a mentor for several prior K awardees. Dr. Costenbader is a clinical investigator and expert in SLE who is also an experienced mentor of K awardees. Dr. Sepucha is a leading expert in patient-centered decision science. Dr. Jorge's research will also benefit from the specific expertise of her key collaborators, including advanced clinical epidemiology methods, machine learning prediction algorithms, and decision- analytic modeling. In addition to receiving excellent mentorship, she will acquire new skills through didactics in advanced clinical epidemiology and pharmacoepidemiology, risk prediction, eliciting patient preferences with a mixed methods research approach, and decision-analytic modeling. Research: SLE carries increased risks of multiple comorbidities and double the risk of death compared to the general population. Current treatment is limited in part by few proven medications and adverse treatment effects. The central goal of this research is to improve long-term SLE outcomes by integrating personalized risks of potential harms and benefits with patient preferences to guide the personalized, patient-centered use of key lupus medications. To achieve this goal, she will risk stratify patients for potential harms of treatment, i.e., hydroxychloroquine retinopathy and infection with belimumab use versus other immunosuppressants, and other adverse outcomes, i.e., severe COVID-19 infection (Aim 1). She will elicit patient preferences for SLE treatment through a discrete choice experiment (Aim 2a) and will integrate patient preferences with personalized risks through a multi-criteria decision analysis to determine the optimal hydroxychloroquine dose in SLE care (Aim 2b). Completion of this proposal and training plan will position Dr. Jorge with the vital experience to become an independent clinical investigator in patient-oriented research of SLE.

候选人：April Jorge，医学博士，哈佛医学院（HMS）医学讲师，哈佛大学医学院（HMS）助理