CORA_TM_A Personalized Cardiac Counselor for Optimal Therapy

CORA_TM_最佳治疗的个性化心脏咨询师

• 批准号: 8995683
• 负责人: JAMES F. ANTAKI
• 金额: $ 93.49万
• 依托单位: CARNEGIE-MELLON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-01-15 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8995683
• 关键词: Address; Admission activity; Adverse effects; Adverse event; Affect; Algorithms; American; American Heart Association; Anxiety; Attitude; Belief; Benefits and Risks; Biomedical Engineering; Cardiac; Cardiac Surgery procedures; Cardiology; Caregiver Burden; Caregiver support; Caregivers; Caring; Cessation of life; Clinical; Clinical Data; Clinical Decision Support Systems; Collaborations; Colorado; Communication; Comprehension; Computer software; Computers; Congestive Heart Failure; Consensus; Consultations; Data; Databases; Decision Making; Decision Modeling; Dependency; Destinations; Devices; Disease; Dyspnea; Electronics; Environment; Family; Family Caregiver; Foundations; Frequencies; Funding; Future; Guidelines; Health; Health Personnel; Heart failure; Heart-Assist Devices; Heart-Lung Transplantation; Hospitals; Imagery; Implant; Incidence; Infection; Institution; Intention; Interagency Registry for Mechanically Assisted Circulatory Support; International; Intervention; Interview; Knowledge; Lead; Length of Stay; Life; Life Expectancy; Machine Learning; Mechanics; Medical; Medical Ethics; Medicare; Mental Depression; Meta-Analysis; Morbidity - disease rate; Multicenter Studies; Multicenter Trials; Muscular Atrophy; Outcome; Palliative Care; Patient-Focused Outcomes; Patients; Physicians; Probability; Process; Professional counselor; Provider; Publishing; Quality of life; Risk; Risk Assessment; Societies; Staging; Stents; Stress; Supervision; System; Technology; Time; Touch sensation; Training; United States National Institutes of Health; Universities; Woman; Work; base; clinical research site; computer program; computer science; cost effectiveness; data mining; data visualization; design; discount; experience; implantable device; improved; individual patient; interactive tool; left ventricular assist device; literacy; medical specialties; meetings; mortality; non-compliance; outcome forecast; predictive modeling; preference; prognostic; prospective; response; satisfaction; shared decision making; stroke therapy; technology validation; tool; treatment planning; treatment strategy; usability; user-friendly; ventricular assist device; willingness

DESCRIPTION (provided by applicant): This project aims to introduce a clinical decision support system, CORA (Cardiac Outcomes Risk Assessment) for advanced heart failure (HF) a devastating disease affecting over 5 million Americans, and a leading cause of Medicare hospital admissions. The project specifically aims to moderate the deployment ventricular assist devices (VADs) which have been recently approved as destination (DT) such that patients most likely to benefit will be prioritized, while those better served with palliative care will be spare from unnecessary risks of debilitating side effects. The proposed system will leverage proven prognostic models based on advanced data mining and machine learning algorithms, and be packaged as a user-friendly computer application that would be used at key decision points in the course of treatment. It would provide both physician and patient with prognostic assessment based on the fusion of: patient-specific data, expert knowledge, and retrospective meta-analysis. This four-year project will develop a multi-platform software application that integrates modules for: forecasting, decision support, communication, decision making and visualization of data. This will be achieved through completion of four specific aims: (SA1) Expand existing inference (prognostic) algorithms and develop expert decision models to compute personalized estimate of life expectancy and risk of adverse events; (SA2) Create a computer application to assist patients to navigate their treatment options as they reflect their personal preferences and beliefs; (SA3) Incorporate these prognostic and decision models into user-friendly user interfaces for physicians, patients and their family caregivers; and (SA4) Conduct a multi- center study with respect to both qualitative and quantitative metrics of efficacy related to mortality, morbidity and quality of life. Training data capitalizing upon the NIH-funded Interagency Registry for Mechanical Circulatory Support (INTERMACS) as well as recently published guidance documents by the American Heart Association (AHA) and International Society of Heart & Lung Transplantation (ISHLT.) This project will involve a multi-disciplinary group of specialties including: bioengineering, advanced heart failure cardiology, cardiac surgery, computer science (machine learning/data mining), medical ethics, and palliative care. Carnegie Mellon University, one of the Nation's leading institutions for Computer Science will coordinate this project to assure a productive collaboration with four clinical sites: Allegheny Health Network (Pittsburgh), U. Colorado Denver, Duke University, and Harvard/Brigham & Women's hospital. By achieve consensus amongst stakeholders, we hope to assure the acceptance of CORA into practice and ultimately improve the efficiency, efficacy, and cost- effectiveness of the treatment of end-stage heart failure.

描述（由申请人提供）：该项目旨在为晚期心力衰竭（HF）引入临床决策支持系统CORA（心脏结局风险评估），这是一种影响超过500万美国人的毁灭性疾病，也是医疗保险住院的主要原因。该项目特别旨在缓和最近被批准为目的地（DT）的心室辅助装置（vad）的部署，以便最可能受益的患者将被优先考虑，而那些更好地接受姑息治疗的患者将免于不必要的衰弱副作用风险。该系统将利用基于先进数据挖掘和机器学习算法的成熟预测模型，并打包为用户友好的计算机应用程序，用于治疗过程中的关键决策点。它将为医生和患者提供基于患者特定数据、专家知识和回顾性荟萃分析的预后评估。这个为期四年的项目将开发一个多平台软件应用程序，集成