Career Development in Outcomes Assessment in Congenital Heart Surgery

先天性心脏病手术结果评估的职业发展

• 批准号: 8589152
• 负责人: Sara Pasquali
• 金额: $ 12.39万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-20 至 2014-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8589152
• 关键词: Career; Development; Outcomes; Assessment; Congenital

DESCRIPTION (provided by applicant): This Career Development proposal will provide a structured environment with expert mentorship that will allow Dr. Sara Pasquali to develop into an independent investigator in pediatric cardiovascular outcomes research. Congenital heart defects are common, and a leading cause of morbidity and mortality in children. Although surgery is the cornerstone of therapeutic management, there are limited data regarding optimal strategies for outcomes assessment in patients undergoing congenital heart surgery, and limited evidence to guide optimal care. Administrative datasets are often utilized to evaluate outcomes and compare quality at pediatric heart centers. However, accuracy of case ascertainment, risk stratification, and outcomes assessment in administrative data is unknown. Dr. Pasquali will utilize a novel methodology to evaluate the use of administrative vs. clinical databases in outcomes and quality assessment for patients undergoing congenital heart surgery to address these knowledge gaps. This will involve linking a large clinical (Society of Thoracic Surgeons Congenital Heart Surgery Database; STS-CHS) and administrative (Pediatric Health Information Systems Database; PHIS) database to compare case ascertainment and post-operative outcomes assessment in these two datasets, using the clinical database as the gold standard. These data, along with empiric risk stratification methodology previously developed by our group, will be used to develop and validate an evidence-based algorithm for accurate case ascertainment and risk stratification for use in future analyses. In addition to these advanced research skills, Dr. Pasquali will complete formal training in epidemiology and biostatics in the Duke Clinical Research Training Program toward a Masters degree. She will also complete advanced training in leadership and scientific writing. These career development activities will be supported by a multidisciplinary mentorship team with a successful history of conducting cardiovascular outcomes research. The mentoring team has extensive experience in the analysis and linkage of clinical and administrative datasets, and was recently awarded an NHLBI ARRA Challenge Grant to conduct comparative effectiveness research using the linked STS-CHS and PHIS Databases which will also be used for this proposed project. Dr. Eric Peterson, project mentor, is an internationally renowned expert in cardiovascular outcomes research. Other team members will provide expertise in multicenter pediatric research (Li), outcomes analysis (O'Brien, DeLong), and linking and analysis of STS-CHS (M Jacobs, J Jacobs) and PHIS (Hall) data. The project will be conducted at the Duke Clinical Research Institute, the world's largest academic research organization. Dr. Pasquali's long-term goal is to become an expert in pediatric cardiovascular outcomes assessment, with an overall aim of defining best practices and improving quality of care in this patient population. Upon completion of this Career Development proposal under the guidance of an exceptional team of mentors, she will have the additional formal training and advanced research skills necessary to achieve these goals. PUBLIC HEALTH RELEVANCE: Relevance Congenital heart defects are the most common birth defects, and a leading cause of morbidity and mortality in children. However, evidence to guide optimal care in this population is limited. This proposal will utilize a novel approach to link a large clinical and administrative dataset in order to evaluate optimal strategies for outcomes assessment in patients undergoing congenital heart surgery.

描述（由申请人提供）：本职业发展提案将提供一个结构化的环境，专家指导，使Sara Pasquali博士能够发展成为儿科心血管结局研究的独立研究者。先天性心脏缺陷是常见的，并且是儿童发病率和死亡率的主要原因。虽然手术是治疗管理的基石，但关于接受先天性心脏病手术的患者结局评估的最佳策略的数据有限，并且指导最佳护理的证据有限。管理数据集通常用于评估儿科心脏中心的结果和比较质量。然而，行政数据中病例确定、风险分层和结局评估的准确性尚不清楚。Pasquali博士将利用一种新的方法来评估行政与临床数据库在接受先天性心脏病手术的患者的结局和质量评估中的使用，以解决这些知识差距。这将涉及将大型临床（胸外科学会先天性心脏手术数据库; STS-CHS）和行政（儿科健康信息系统数据库; PHIS）数据库连接起来，以比较这两个数据集中的病例确定和术后结局评估，使用临床数据库作为金标准。这些数据，沿着我们小组以前开发的经验性风险分层方法，将用于开发和验证一种基于证据的算法，用于准确的病例确定和风险分层，以供将来的分析使用。除了这些先进的研究技能，Pasquali博士将完成正式的培训，在流行病学和生物静力学在杜克临床研究培训计划，以硕士学位。她还将完成领导力和科学写作方面的高级培训。这些职业发展活动将得到一个多学科导师团队的支持，该团队具有进行心血管结局研究的成功历史。指导团队在临床和管理数据集的分析和链接方面拥有丰富的经验，最近获得了NHLBI ARRA挑战赠款，用于使用链接的STS-CHS和PHIS数据库进行比较有效性研究，该数据库也将用于该拟议项目。项目导师Eric Peterson博士是国际知名的心血管结局研究专家。其他团队成员将提供多中心儿科研究（李），结果分析（奥布莱恩，德隆），以及STS-CHS（M雅各布斯，J雅各布斯）和PHIS（霍尔）数据的链接和分析方面的专业知识。该项目将在世界上最大的学术研究机构杜克临床研究所进行。Pasquali博士的长期目标是成为儿科心血管结局评估专家，总体目标是定义最佳实践并提高该患者人群的护理质量。在一个特殊的导师团队的指导下完成这个职业发展建议后，她将获得实现这些目标所需的额外正式培训和先进的研究技能。 公共卫生相关性：先天性心脏缺陷是最常见的出生缺陷，也是儿童发病率和死亡率的主要原因。然而，指导这一人群最佳护理的证据有限。该提案将利用一种新的方法来链接大型临床和管理数据集，以评估接受先天性心脏病手术的患者结局评估的最佳策略。