Non-Endoscopic Surveillance for Barrett's Esophagus Following Ablative Therapy

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DESCRIPTION (provided by applicant): This K24 Mid-Career Investigator Award supports Nicholas J. Shaheen, MD, MPH, a Professor of Medicine at UNC, and an Adjunct Professor of Epidemiology at the School of Public Health. Candidate: Dr. Shaheen completed an NIDDK K23 award six years ago, and now is at the midcareer level. He has a highly successful program in patient-oriented research in the prevention, detection and treatment of esophageal neoplasia, with >100 peer-reviewed publications in these areas, an H index of 33, and almost 800 citations of his work in 2012. He has a breadth of research funding, including his role as a PI of NCI's Barrett's Esophagus Translational Research Network (BETRNet), a major project within a U54 grant, co-investigator status on several other NIH grants, and multiple societal & industry grants. Dr. Shaheen has a documented history of successful mentoring of trainees at the medical student, resident and fellow level, including multiple societal and K awards. Twenty of his 31 peer-reviewed publications in 2012 featured trainee authors. This mid-career investigator award will protect Dr. Shaheen's time to focus on patient-oriented research and on mentoring trainees. His immediate objectives are: 1) To expand a rigorous clinical and translational research program in neoplastic conditions of the esophagus; 2) To provide highly structured, appropriately supervised, and fruitful research opportunities for mentees; 3) To enhance his skills in research methodology; 4) To improve his mentoring and leadership skills; and, 5) To provide career development to trainees. His long-term objectives are: 1) To decrease mortality from esophageal carcinoma by improving screening and therapy; 2) To expand the UNC research center for esophageal diseases; and 3) To contribute to the development of the next generation of clinical researchers in digestive diseases. Environment: There is an outstanding pool of potential mentees, due in part to his institution's T32 program in clinical research (R. Sandler, PI). Other mentees come from UNC's highly competitive and academic internal medicine residency, its outstanding School of Public Health, and the School of Medicine. UNC's CTSA award, its K30 program, the School of Public Health and the GI Division's Digestive Diseases Research Center (P30) provide a remarkably rich environment for patient-oriented research training in digestive diseases and hepatology, as evidenced by the multiple successful past trainees of the program. Research: Dr. Shaheen proposes a novel research plan, aimed at addressing the issue of surveillance following endoscopic ablation for dysplastic Barrett's esophagus (BE). Using a recently-developed non-endoscopic device, the Cytosponge, he will perform a comparative effectiveness trial assessing the accuracy of this device in detecting recurrent BE following successful radiofrequency ablation. If this device is able to detect BE in this group, it will open the door for subsequent investigations assessing its utility in other clincal settings. Importantly, given the purposes of this application, this study offers multiple opportunities for the involvement of his mentees, including roles in the design, implementation and analysis of the study. Currently, Dr. Shaheen's mentoring efforts are unfunded, and occur as his clinical duties and research program allow. His current funding protects no time for mentoring. Given the expansion of both his research program and the clinical requirements of his institution, mentoring is becoming more difficult. This K24 award will provide essential support for the candidate to meet his mentoring and research goals.