Real Time Predictive Analytics of Hemodynamic Clinical Deterioration during the Preterm Transition to Extra Uterine Life
早产过渡到宫外生命期间血流动力学临床恶化的实时预测分析
基本信息
- 批准号:9333426
- 负责人:
- 金额:$ 18.16万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2016
- 资助国家:美国
- 起止时间:2016-09-01 至 2021-08-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdverse eventAdvisory CommitteesAffectAnesthesiologyApplications GrantsAwardBedsBirth WeightBlood PressureCardiacCaringCerebrumChildChildhoodClinicalClinical MedicineCommon VentricleComplexCreatinine clearance measurementDataData AnalyticsDatabasesDecision MakingDeteriorationDevelopmentDoppler UltrasoundEchocardiographyEffectivenessEngineeringEquipmentEtiologyEventExtremely Low Birth Weight InfantFaceFeedsFundingFutureGoalsHealthHeart ArrestHeart DiseasesHematological DiseaseHospitalizationHourIncidenceIndividualInfantInternationalInterventionIntestinal PerforationJournalsK-Series Research Career ProgramsKidneyKnowledgeLeftLifeLiquid substanceLogistic RegressionsLung diseasesManuscriptsMaster of ScienceMathematicsMeasurementMeasuresMedicineMentorsMentorshipMethodologyMethodsMissionModalityModelingMonitorNational Heart, Lung, and Blood InstituteNear-Infrared SpectroscopyNecrotizing EnterocolitisNeonatalNeonatologyOrganOutcomePathway interactionsPatient CarePatientsPediatric HospitalsPediatric cardiologyPediatricsPeer ReviewPeriventricular LeukomalaciaPharmaceutical PreparationsPhysiologic MonitoringPhysiologicalPhysiologyPopulationPredictive AnalyticsPremature BirthPremature InfantPreventionProcessPublic HealthPublishingQuality of lifeRandomized Controlled TrialsRecoveryRelative RisksReportingResearchResearch PersonnelResearch Project GrantsResearch SupportResolutionResourcesScientistSeriesSurvivorsTexasTimeTrainingTraining ActivityTraining ProgramsUnited States National Institutes of HealthUpdateValidationWorkadverse outcomeanalytical methodbasecareercareer developmentclinically relevantcohortcollegecostdisabilityeducation researchexperienceextreme prematurityfeedinggastrointestinalhemodynamicsimprovedimproved outcomeindexinginnovationinsightinterestintraventricular hemorrhageknowledge basemultidisciplinarynewsnovelpreventprofessorprogramsprospectivepublic health relevanceresponseresponsible research conductsignal processingskillssuccesstreatment response
项目摘要
DESCRIPTION (provided by applicant): The candidate applying for this award is an Assistant Professor of Pediatrics at Baylor College of Medicine (BCM). She has obtained a Master's of Science degree through the BCM Clinical Scientist Training Program and has published several first-author manuscripts in well-respected peer-reviewed pediatric journals. Her research focus is the hemodynamic status of extremely low birth weight (ELBW) infants. Extreme prematurity is an important public health problem in the U.S. because these infants are disproportionately affected by moderate to severe long-term disabilities, which are quite costly. There is little information, however, on the prevention of the short-term outcomes that result in disabilities in ELBW infants, most of which likely have their genesis from hemodynamic clinical deterioration during the first week of life. The overall objective of this proposed NHLBI Career Development Award application is to develop a series of multivariate clinical deterioration indices (CDIs) which will provide, in real-time, continuous and calibrated measurements of the likelihood of experiencing certain debilitating outcomes (and 1 clinical variable and 1 milestone) in ELBW infants and depict whether the responses to clinical interventions were successful. This will be accomplished through 3 specific aims, which are to: 1) Create independent CDIs from analysis of the physiologic inputs during the first week most associated with short-term outcomes (or the clinical variable/milestone) in ELBW infants; 2) Measure changes in each CDI prior to and after interventions used to treat hemodynamic clinical deterioration; and 3) Validate each CDI prospectively in a separate cohort of ELBW infants. In Aim 1, CDIs will be developed based on normalized logistic regression models. Separate models will be developed for each of 6 specific outcomes/clinical variable/milestone (intraventricular hemorrhage, periventricular leukomalacia, maternal creatinine clearance, necrotizing enterocolitis, intestinal perforation, and time to reach
full feeds). For Aim 2, in the subset of this cohort who received interventions (e.g. fluid boluses
or vasoactive medications), the CDI will be analyzed prior to and after each intervention to evaluate responses to treatment of perceived hemodynamic clinical deterioration. The final portion (Specific Aim 3) of the proposed research is validation of the CDIs in a separate cohort. Upon completion of the proposed research, the CDIs can be used in real-time to manage therapies with an evidence- and physiology-based approach never before available to clinicians or researchers. This will promote a shift from population-centric to individualized data- driven approaches, providing more effective care and surveillance for complex patients. The candidate will acquire important skills on her pathway to independence. Training activities during the award period include coursework and training in targeted neonatal echocardiography, training and practice in near-infrared spectroscopy and cerebral Doppler ultrasound, training in physiologic waveform analysis and predictive analytics, and training in the responsible conduct of research. Immediate career goals include becoming an expert in targeted neonatal echocardiography and proficient in the other monitoring modalities. The candidate is fortunate to have the facilities and resources available to her at BCM and Texas Children's Hospital (TCH). BCM had total research support of nearly $200 million from NIH in 2014 and is ranked # 1 in Texas for NIH funding. TCH is an internationally recognized 650-bed pediatric hospital affiliated with BCM. The mission of TCH, which is ranked nationally in all 10 pediatric subspecialties in the 2014-15 U.S. News & World Report, is to support excellence in patient care, education, and research with a commitment to enhance the health and well-being of children locally, nationally, and internationally. U.S. News & World Report ranked both the Neonatology Section and the Section of Pediatric Cardiology at TCH as #2 of U.S. programs in 2014-15. The candidate has assembled a scientific advisory committee with complementary intellect and content expertise that can guide her throughout the award period. The committee combines clinical insights from investigators in neonatology, pediatric cardiology, and pediatric anesthesiology with engineering and mathematical expertise in both physiologic signal processing and data analytics. The innovative approach in this proposal uses multiple monitoring methods, automated data capture, and real- time analysis to address a significant public health need for improving the knowledge base required to prevent common, costly, debilitating outcomes of ELBW infants. The proposed award is consistent with the NHLBI mission to promote the prevention and treatment of heart, lung, and blood diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives. The exceptional resources and institutional support at BCM and TCH, outstanding multi-disciplinary mentorship team, and the proposed career development activities, will allow the candidate to achieve her long-term goal of becoming an independent investigator and nationally recognized expert in neonatal hemodynamics.
描述(由申请人提供):申请该奖项的候选人是贝勒医学院(Baylor College of Medicine,简称BCL)的儿科助理教授。她已获得理学硕士学位,通过临床科学家培训计划,并已发表了几篇第一作者手稿在备受尊敬的同行评审儿科期刊。她的研究重点是极低出生体重(ELBW)婴儿的血流动力学状态。极早产是美国的一个重要公共卫生问题,因为这些婴儿受到中度至重度长期残疾的影响不成比例,而这些残疾的代价相当高。然而,关于预防导致ELBW婴儿残疾的短期结局的信息很少,其中大多数可能源于出生后第一周内的血流动力学临床恶化。本次拟议的NHLBI职业发展奖申请的总体目标是开发一系列多变量临床恶化指数(CDIs),以实时、连续和校准的方式测量ELBW婴儿发生某些衰弱结局(1个临床变量和1个里程碑)的可能性,并描述临床干预的反应是否成功。这将通过3个具体目标来实现,即:1)通过分析第一周期间与短期结局最相关的生理输入,创建独立的CDI 2)测量用于治疗血流动力学临床恶化的干预前后每个CDI的变化;和3)在单独的ELBW婴儿队列中前瞻性地检测每个CDI。在目标1中,将根据标准化逻辑回归模型开发CDIs。将为6个特定结局/临床变量/里程碑(脑室内出血、脑室周围白质软化、母体肌酐清除率、坏死性小肠结肠炎、肠穿孔和至达到终点的时间)中的每一个开发单独的模型
全饲料)。对于目标2,在接受干预(例如,液体推注)的该队列子集中
或血管活性药物),将在每次干预之前和之后分析CDI,以评价对感知的血流动力学临床恶化的治疗反应。拟议研究的最后一部分(具体目标3)是在一个单独的队列中验证CDIs。在完成拟议的研究后,CDIs可以实时用于管理治疗,并采用临床医生或研究人员从未使用过的基于证据和生理学的方法。这将促进从以人群为中心向个性化数据驱动方法的转变,为复杂患者提供更有效的护理和监测。候选人将获得重要的技能,她的道路上的独立。授予期间的培训活动包括针对新生儿超声心动图的课程和培训,近红外光谱和脑多普勒超声的培训和实践,生理波形分析和预测分析的培训,以及负责任的研究行为的培训。近期的职业目标包括成为有针对性的新生儿超声心动图专家,并精通其他监测模式。这位候选人很幸运,她在德克萨斯州儿童医院(TCH)拥有可用的设施和资源。2014年,美国国立卫生研究院(NIH)为他提供了近2亿美元的研究支持,在德克萨斯州的NIH资助中排名第一。TCH是一家国际公认的650张床位的儿科医院,隶属于美国儿科学会。TCH的使命是在2014-15年《美国新闻与世界报道》的所有10个儿科亚专科中排名全国,旨在支持卓越的患者护理、教育和研究,致力于提高当地、国家和国际儿童的健康和福祉。《美国新闻与世界报道》将TCH的新生儿科和儿科心脏科列为2014-15年度美国项目的第二名。候选人已经组建了一个科学咨询委员会,具有互补的智力和内容专业知识,可以在整个颁奖期间指导她。该委员会将儿科学、儿科心脏病学和儿科麻醉学研究人员的临床见解与生理信号处理和数据分析方面的工程和数学专业知识相结合。本提案中的创新方法使用多种监测方法、自动化数据采集和真实的实时分析,以满足改善知识基础的重大公共卫生需求,以预防ELBW婴儿常见、昂贵、衰弱的结局。拟议的奖项是符合NHLBI的使命,以促进心脏,肺和血液疾病的预防和治疗,并提高所有个人的健康,使他们能够活得更长,更充实的生活。卓越的资源和机构支持,杰出的多学科导师团队,以及拟议的职业发展活动,将使候选人能够实现她的长期目标,成为一名独立的研究者和全国公认的新生儿血液动力学专家。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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DANIELLE RAE RIOS其他文献
DANIELLE RAE RIOS的其他文献
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{{ truncateString('DANIELLE RAE RIOS', 18)}}的其他基金
Real Time Predictive analytics of Hemodynamic Clinical Deterioration during the Preterm Transistion to Extra Uterine Life
早产过渡到宫外寿命期间血流动力学临床恶化的实时预测分析
- 批准号:
10054442 - 财政年份:2019
- 资助金额:
$ 18.16万 - 项目类别:
Real Time Predictive Analytics of Hemodynamic Clinical Deterioration during the Preterm Transition to Extra Uterine Life
早产儿过渡到宫外生命期间血流动力学临床恶化的实时预测分析
- 批准号:
9012981 - 财政年份:2016
- 资助金额:
$ 18.16万 - 项目类别:
Real Time Predictive Analytics of Hemodynamic Clinical Deterioration during the Preterm Transition to Extra Uterine Life
早产过渡到宫外生命期间血流动力学临床恶化的实时预测分析
- 批准号:
9548726 - 财政年份:2016
- 资助金额:
$ 18.16万 - 项目类别:
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