Establishing the Value of Treatment Strategies in Spondyloarthritis

 描述（由申请人提供）：Maureen Dubreuil，MD是波士顿大学医学院（BUSM）的一名流变学家和医学讲师，其研究重点是脊柱关节炎（SpA），这是一种可导致脊柱融合的炎性关节炎，导致脊柱活动受限，从而导致严重残疾。她的长期目标是确定管理策略，最大限度地提高SpA患者的满意度，功能和生活质量，同时最大限度地减少不良后果和成本。Dubreuil博士提出的研究将从患者偏好和社会层面的成本效益角度评估SpA治疗。这项工作将i）通过更好地了解SpA患者对症状控制和药物副作用的价值来改善SpA的治疗决策，ii）建立美国现有SpA治疗的成本效益。这项工作将包括SpA患者焦点小组，以确定影响药物选择的因素，以及离散选择实验，以量化和优先考虑对SpA患者最重要的治疗属性。成本效益分析将比较治疗策略，纳入美国SpA患者衍生值。拟议的研究将从美国患者和社会的角度促进对SpA治疗成本和收益的理解，并将影响共同的决策和治疗政策。研究和培训计划将主要在BUSM的临床流行病学部门进行，该部门是NIH资助的一个高效部门，已培训了许多成功的以患者为导向的研究人员。共同主要的导师，Tuhina Neogi，医学博士，博士和Elena Losina，博士，硕士，将根据他们在联合分析和流行病学以及成本效益方面的经验指导Dubreuil博士的工作。该培训计划包括具体的课程和研讨会在病人报告的结果和先进的成本效益建模，并参与定期研究电话与一组从事成本效益研究。Dubreuil博士的专业发展将通过定期的教师发展和临床研究研讨会，以及与共同主要导师和顾问的一致会议得到加强。拟议的研究和职业发展计划将为Dubreuil博士提供必要的经验和技能，使其成为一名成功的风湿病学独立临床研究人员，重点是SpA。

 DESCRIPTION (provided by applicant): Maureen Dubreuil, MD is a rheumatologist and Instructor of Medicine at Boston University School of Medicine (BUSM) whose research is focused on spondyloarthritis (SpA), an inflammatory arthritis that can cause fusion of the spine, leading to limitation in spinal mobility with resultant substantial disability. Her long-term goal s to identify management strategies that maximize SpA patients' satisfaction, function and quality of life, while minimizing adverse outcomes and costs. Dr. Dubreuil's proposed research will assess SpA treatment from the perspectives of patient preference and cost-effectiveness on a societal level. This work will i) improve treatment decision-making in SpA through greater understanding of the value that SpA patients place on symptom control and medication side effects, and ii) establish the cost-effectiveness of available SpA treatments in the US. The work will include SpA patient focus groups to determine factors that impact medication choice, and discrete choice experiments to quantify and prioritize treatment attributes of greatest importance to SpA patients. A cost-effectiveness analysis will compare treatment strategies, incorporating American SpA patient-derived values. The proposed research will advance the understanding of SpA treatment costs and benefits from both the American patient and societal perspectives, and will impact both shared decision-making and treatment policy. The research and training plan will take place primarily in the Clinical Epidemiology Unit at BUSM, a highly productive NIH-funded section that has trained many successful patient-oriented researchers. Co-primary mentors, Tuhina Neogi, MD, PhD, and Elena Losina, PhD, MSc, will guide Dr. Dubreuil's work based on their experience in conjoint analysis and epidemiology, and in cost-effectiveness, respectively. The training plan includes specific coursework and workshops in patient-reported outcomes and advanced cost effectiveness modeling, and participation in regular study calls with a group engaged in cost-effectiveness research. Dr. Dubreuil's professional development will be enhanced through regular Faculty Development and Clinical Research seminars, as well as consistent meetings with the co-primary mentors and advisors. The proposed research and career development plan will provide Dr. Dubreuil with the experience and skills necessary to become a successful independent clinical researcher in rheumatology with a focus in SpA.