Improving Decision Making in Patients with Rheumatic Disease

描述(由申请人提供)：建议项目的目标是支持我作为导师的持续发展和影响，在我的机构风湿科建立以患者为导向的研究培训计划，并扩大我目前的POR计划。对于前者，我坚定地致力于将我职业生涯的相当大一部分时间投入到指导工作中。在我目前工作的实习生中，我是2名初级教员(1名K奖获得者)的主要导师，2名有兴趣在POR追求职业生涯的风湿病研究员，以及3名计划在风湿病领域工作的住院医生。虽然我的主要兴趣是决策领域，但我在流行病学方面的培训和之前的实践经验使我能够成为对POR与风湿病相关的其他方面感兴趣的学员的有效导师。考虑到我对指导的承诺，耶鲁大学致力于POR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来扩大我的指导努力，并建立专门的结构化POR课程。该计划将确保有兴趣成为独立调查人员的研究员将得到一个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，我将设立一个每两周一次的研究进展会议，在会议期间，学员和教职员工将在每个会议期间提交所有发展阶段的材料，并提出建设性的批评意见。培训计划将包括正式的指导会议，这将坚持一个推动研究向前发展的过程。POR培训计划还将包括对学员和导师的正式评估。除了指导年轻的研究人员，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合作者网络，他们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，他们最近提交了一笔赠款以开发类风湿关节炎的个体化结果估计；Reyna博士(康奈尔大学)和Peter博士(俄亥俄州立大学)，他们是决策方面的基础科学专家，目前是一个开发类风湿关节炎决策辅助工具项目的合作者；Almazor博士(MD Anderson)，我正在与他合作进行两个项目，研究联合分析在膝盖骨关节炎患者中的价值；以及Street博士(贝勒医学院)，他是一项新的研究项目的合作者，该研究项目是：实时测量患者的风险感知。新的计划中的研究将继续侧重于了解临床实践中导致低质量决策的原因，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有效性/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.