Developing Patient-Centered Decision Support for Eosinophilic Esophagitis

项目总结 候选人的长期职业目标：成为一名独立资助的医生-科学家 以及测试以患者为中心的干预措施，以支持慢性食管病的共享决策(SDM) 疾病。 研究背景：作为一种慢性病，患病率、发病率、医疗费用和 对患者生活质量的负担，嗜酸性食管炎(EoE)是一个研究不足、具有挑战性的护理领域 患者和提供者都需要在教育、决策和沟通方面提供支持 复杂的治疗选择，以防止昂贵的并发症。由于临床平衡存在于用药之间 和饮食疗法，了解利益相关者决策的驱动因素并应用SDM是至关重要的 以患者为中心的EoE护理方面的差距，是改善长期疾病结果所必需的。 候选人背景和成就：张博士是该大学的胃肠病学讲师 密歇根大学(UM)和嗜酸性胃肠道疾病联盟的获奖者，研究人员授予。 她在马里兰大学获得医学博士学位，在密歇根大学获得硕士学位。到目前为止，她已经出版了13本原著 同行评议的手稿和书中的一个章节，其中10章是她的第一作者或资深作者。 职业发展计划：张博士建议发展混合方法方面的新专长，高级 定性研究方法、决策科学、临床试验实施和评估，以评估影响 对结果的决策支持干预。她的职业发展目标得到了Stellant的支持 指导，高级教学课程，以及参加研讨会和专业会议 旨在促进协作，确保成功完成研究，并支持她无缝过渡到 一个成功的独立研究人员。 目标：1)得出影响患者和患者的EoE管理决策的多层次因素 提供者，2)开发支持SDM的多层次决策支持干预原型，用于选择 EoE疗法，以及3)试点测试和评估可行性、可接受性和患者报告的初步疗效 与使用决策支持干预措施相关的结果。 研究计划：张博士将1)使用混合方法设计访问EoE患者以确定影响因素 推动治疗决策，2)对胃肠病专家和过敏专家进行定性访谈，以 描述提供商对EoE管理和支持决策的看法，3)制定 多层次决策支持干预，以促进患者和提供者之间的SDM，以及4)评估 决策干预的可行性、可接受性和对初步疗效结果的影响比较20 接受决策支持的患者20例，接受控制内容的患者20例。

PROJECT SUMMARY Candidate’s Long-term Career Goal: To become an independently funded physician-scientist developing and testing patient-centered interventions to support shared decision making (SDM) in chronic esophageal diseases. Research Context: As a chronic disease with rapidly rising prevalence, incidence, healthcare costs, and burdens to patient quality of life, eosinophilic esophagitis (EoE) is an understudied, challenging area of care for both patients and providers that requires support in education, decision making, and communication around complex treatment choices to prevent costly complications. As clinical equipoise exists between medication and dietary therapies, understanding stakeholder drivers of decision making and applying SDM are critical gaps in patient-centered EoE care, and are needed to improve long-term disease outcomes. Candidate Background and Achievements: Dr. Chang is an Instructor in Gastroenterology at the University of Michigan (UM) and an awardee of a Consortium of Eosinophilic Gastrointestinal Disease Researchers grant. She received her MD from the University of Maryland and MS from UM. To date she has published 13 original peer-reviewed manuscripts and one book chapter, 10 of which she is first or senior author. Career Development Plan: Dr. Chang proposes to develop new expertise in mixed methods, advanced qualitative research methods, decision sciences, and clinical trial conduct and evaluation to assess the impact of a decision support intervention on outcomes. Her career development goals are supported by stellar mentorship, advanced didactic coursework, and participation in workshops and professional meetings designed to foster collaboration, ensure successful study completion, and support her seamless transition into a successful independent researcher. Aims: 1) Elicit the multilevel factors that influence decision making for EoE management among patients and providers, 2) Develop a multilevel decision support intervention prototype that supports SDM for selection of EoE therapy, and 3) Pilot test and evaluate feasibility, acceptability, and preliminary patient-reported efficacy outcomes associated with use of the decision support intervention. Research Plan: Dr. Chang will 1) use a mixed methods design to interview patients with EoE to identify factors that drive treatment decision making, 2) conduct qualitative interviews of gastroenterologists and allergists to characterize provider perspectives about EoE management and supported decision making, 3) develop a multilevel decision support intervention to facilitate SDM between patients and providers, and 4) assess decision intervention feasibility, acceptability, and influence on preliminary efficacy outcomes comparing 20 patients receiving decision support to 20 patients receiving control content.