Improving Decision Making in Patients with Rheumatic Disease

描述（由申请人提供）：拟议项目的目标是支持我作为导师的持续发展和影响，在我所在机构的风湿病学部门建立一个面向患者的研究（POR）的研究培训计划，并扩展我目前的POR计划。对于前者，我坚定地承诺将我职业生涯的很大一部分用于指导。在我目前合作的学员中，我是2名初级教师（1名是K奖获得者）的主要导师，2名有兴趣在POR从事职业的风湿病学研究员，以及3名计划从事风湿病学职业的住院医生。虽然我的主要兴趣是在决策领域，但我在流行病学方面的培训和以前的实践经验使我能够成为对与风湿病相关的POR其他方面感兴趣的学员的有效导师。鉴于我对辅导工作的承诺，耶鲁大学对贫困教育的丰富资源，以及创建这个项目的强大机构支持，K24奖为我提供了一个宝贵的机会，可以扩大我的辅导工作，并建立一个专门的结构化贫困教育课程。该项目将确保有兴趣成为独立研究者的研究员将得到跨学科导师团队的支持，并将获得临床研究方法和生物统计学方面的培训。此外，我将建立一个每两周一次的研究进展会议，在会议期间，学员和教师将在每个会议期间展示所有发展阶段的材料，并提供建设性的批评。培训计划将包括正式的指导课程，这将坚持一个推动研究向前发展的过程。贫困人口培训计划还将包括对受训人员和导师的正式评估。除了指导年轻的研究者，我的一个重要的长期目标是推进我自己的研究议程，这样我就可以继续进行科学严谨和有意义的POR。我已经建立了一个明确的专业领域和一个强大的协作网络，这些协作网络具有互补的熟练程度，将支持和加强我的研究计划。目前的例子包括与柯蒂斯博士（UAB）的合作，我最近与他一起提交了一项资助，用于开发类风湿关节炎的个性化结果评估。Reyna（康奈尔大学）和Peters（俄亥俄州立大学）他们是决策方面的基础科学专家目前正在合作开发类风湿性关节炎决策辅助工具的项目，Almazor博士（MD Anderson）和我一起合作了两个项目，研究膝关节OA患者联合分析的价值，Street博士（贝勒医学院）是国际知名的沟通专家，他是一个新研究项目的合作伙伴实时测量患者的风险感知。新的计划研究将继续专注于了解临床实践中低质量决策的原因，我将扩大我目前的项目，包括随机对照试验，以测试所开发工具的功效/有效性。

DESCRIPTION (provided by applicant): The goals of the proposed projects are to support my continued development and impact as a mentor, to establish a research training program for patient oriented research (POR) in the Section of Rheumatology at my institution, and to expand my current POR program. Regarding the former, I am strongly committed to devoting a significant percent of my career to mentoring. Among the trainees I am currently working with, I am the primary mentor for 2 junior faculty (1 who is a K awardee), 2 rheumatology fellows interested in pursing a career in POR, and 3 residents planning a career in rheumatology. While my primary interest is in the field of decision making, my training and previous practical experience in epidemiology allow me to be an effective mentor for trainees interested in other aspects of POR related to rheumatic disease. Given my commitment to mentoring, Yale's rich resources dedicated to POR, and strong institutional support to create this program, the K24 Award provides an invaluable opportunity to expand my mentoring efforts and to establish a specialized structured POR curriculum. The program will ensure that fellows interested in becoming independent investigators will be supported by an interdisciplinary team of mentors and will acquire training in clinical research methods and biostatistics. In addition, I will establish a biweekly Research in Progress meeting during which trainees and faculty will be expected to present materials at all stages of development and offer constructive critiques during each session. The training program will include formal mentoring sessions which will adhere to a process for moving research forward. The POR training program will also include formal evaluation of trainees and mentors. In addition to mentoring young investigators, one of my important long-term goals is to advance my own research agenda so that I can continue to conduct scientifically rigorous and meaningful POR. I have established a defined area of expertise and a strong network of collaborators with complementary proficiencies that will support and enhance my research program. Current examples include collaborations with Dr. Curtis (UAB) with whom I have recently submitted a grant to develop individualized outcome estimates in rheumatoid arthritis, Drs. Reyna (Cornell) and Peters (Ohio State) who are basic science experts in decision making and are current collaborators on a project to develop a decision aid in rheumatoid arthritis, Dr. Almazor (MD Anderson) with whom I am working on 2 projects examining the value of conjoint analysis in patients with knee OA, and Dr. Street (Baylor College of Medicine) an internationally renowned expert on communication, who is a collaborator on a new research project: Measuring Patients' Risk Perceptions in Real Time. New planned studies will continue to focus on understanding the reasons underlying poor quality decision making in clinical practice and I will expand my current projects to include randomized controlled trials to test the efficacy/effectiveness of the tools developed.