Mentored Patient Oriented Research in ARDS and Critical Illness Outcomes

项目概要/摘要 这个以患者为导向的研究的中期职业研究者奖的目标是提供关键的指导， 资源和保护的时间，以加强凯瑟琳霍夫博士在指导学生的成功，后， 博士研究员和初级教员在急性疾病和损伤后以患者为中心的结果科学， 重点是急性呼吸窘迫综合症和危重病。虽然住院后死亡率 在过去的几十年里，危重病有了显着改善，人们越来越认识到，恢复是 不完整，残疾负担沉重，功能和健康相关生活质量受损 重症监护室的幸存者改善这些以患者为中心的结局的干预措施在很大程度上 然而，这些研究并不成功，对ICU后损伤机制的理解仍然非常有限。最近， 人们越来越认识到，病前的健康和残疾是疾病发生后的重要因素， ICU的损害和恢复的异质性轨迹，但研究和临床实践已经 由于在ICU入院时难以评估病前因素而停滞不前。将领域向前推进 将需要创新的方法，利用临床数据和临床技术对患者进行表型分析， 流行病学和卫生服务研究。霍夫博士是在这一领域提供指导的理想人选。 她是一名职业生涯中期的研究者，擅长观察性和干预性研究， ARDS和危重病，她有一个强大的和不断增长的记录，在成功的指导病人- 研究方向，以及强大的现有研究计划。在这个奖项中，霍夫博士将提高和 他的职业生涯从三个方面展开。她将参加有组织的活动，以发展她的指导技能， 包括与兰迪·柯蒂斯博士的一对一会议，当地的面对面研讨会和全国性的基于网络的 程序.她将获得有关肌肉生物学的内容知识，计算机断层扫描图像的使用， 评估肌肉质量和质量。此外，她将与方法专家合作，学习如何将 共病和医疗保健利用的临床和管理数据， 预测残疾和康复的病前疾病。这个项目的科学目标是调查 发病前肌肉质量和质量之间的关系，通过分析现有的计算 断层扫描，以及危重病后的短期和长期结果，包括肌肉力量，功能 和残疾。该项目将利用两个正在进行的R 01资助的前瞻性队列，Hough博士是其中的一员。 PI，包含对合并症和病前医疗保健利用的详细评估，前瞻性 评估危重病期间和之后的肌肉力量和功能，并将创造新的机会 用于指导研究。霍夫博士的职业发展和科学目标将提供一个杰出的 为培训以患者为导向的研究人员提供环境，重点是改善危重病后的结果。

PROJECT SUMMARY/ABSTRACT The goal of this Midcareer Investigator Award in Patient Oriented Research is to provide key mentorship, resources and protected time to strengthen Dr. Catherine Hough's success in mentoring students, post- doctoral fellows and junior faculty in the science of patient-centered outcomes after the acute illness and injury, with a focus on the acute respiratory distress syndrome and critical illness. Although hospital mortality after critical illness has improved significantly over the past decades, there is increasing recognition that recovery is incomplete, with a substantial burden of disability and impairments in function and health-related quality of life among ICU survivors. Interventions to improve these patient-centered outcomes have been largely unsuccessful, and understanding of the mechanisms of post-ICU impairments remains quite limited. Recently, there has been increased recognition that pre-morbid health and disability are significant contributors to post- ICU impairment and to the heterogeneous trajectories of recovery, but research and clinical practice have been stalled by the difficulty of assessing pre-morbid factors at the time of ICU admission. Moving the field forward will require innovative approaches to phenotyping patients using clinical data and techniques from clinical epidemiology and health services research. Dr. Hough is an ideal candidate to provide mentorship in this area. She is a mid-career investigator with expertise in observational and interventional studies of outcomes after ARDS and critical illness, and she has a strong and growing track record in successful mentorship in patient- oriented research as well as a strong existing research program. In this award, Dr. Hough will enhance and advance her career in three ways. She will participate in structured activities to develop her mentoring skills, including one-on-one sessions with Dr. Randy Curtis, local in-person workshops and national web-based programs. She will gain content knowledge on muscle biology, use of computed tomography images in assessing muscle mass and quality. Additionally, she will work with methods experts to learn to incorporate clinical and administrative data of co-morbidity and health-care utilization into developing phenotypes of premorbid disease that predict disability and recovery. The scientific goal of this project is to investigate the relationship between premorbid muscle mass and quality, assessed via analysis of existing computed tomography scans, and short and long-term outcomes after critical illness, including muscle strength, function and disability. This project will leverage two ongoing R01-funded prospective cohorts for which Dr. Hough is a PI which contain detailed assessment of co-morbidities and pre-morbid health care utilization, prospective assessments of muscle strength and function during and after critical illness, and will create new opportunities for mentored research. Dr. Hough's career development and scientific aims will provide an outstanding environment for training of patient-oriented researchers focused on improving outcomes after critical illness.