Midcareer Investigator Award in Patient-Oriented Research: Yael Schenker, MD, MAS

摘要：患有晚期癌症的老年人人数不断增加，这一点意义重大 公共卫生问题，包括生活质量急剧下降，接受的护理没有反映 患者的价值观和偏好，以及照顾者的高负担率。对病人的关注不够 优先事项和与年龄有关的问题(例如，功能、认知和社会支持)-有助于 这一人群中的发病率。新兴的老年姑息治疗领域寻求解决与年龄相关的问题 在慢性和严重疾病的发展轨迹上，关注并使护理与患者目标保持一致。这个 这项K24提案的首要目标是加强候选人对学生、研究员、 和从事老年姑息治疗研究的初级教员，特别关注识别未满足的 老年姑息护理需求以及开发和测试干预措施以提高生活质量和 为老年晚期癌症患者提供目标一致的护理。作为一名职业生涯中期的成功调查员 凭借领先的成功姑息干预试验在重症老年患者中的记录， 候选人处于有利地位，可以指导下一代老龄化研究人员。这一奖项将 利用400多次音频记录的“初级”姑息治疗访问的出色纵向数据集 老年晚期癌症患者和纵向患者和照顾者报告的结果为 探索最佳的老年姑息治疗干预设计。研究的目的是(1)表征 与患有以下疾病的老年人进行初级姑息治疗中与年龄相关问题的沟通 晚期癌症及其家庭照顾者；(2)识别错过的解决年龄问题的机会- 老年晚期癌症患者及其家人初次姑息治疗中的相关问题 以及(3)完善初级姑息护理提供的概念模型，其中包括年龄- 并可进行优化，以提高晚期癌症老年患者的生活质量。 K24奖励将为候选人提供受保护的时间来更新和扩大她的指导 计划，在老年病学、姑息治疗和肿瘤学的研究人员之间架起桥梁。她会的 利用匹兹堡大学提供的优秀老龄化研究和指导资源； 学习新技能以促进学员的探究、幸福感和应变能力；并创建初级学院 老年姑息治疗研究人员访问教授计划。这项建议意义重大， 创新，因为它将支持新的临床研究人员使用新的指导技术和 开发试点数据，为解决新兴疾病护理质量缺陷的大规模试验提供信息 患有晚期癌症的老年人口。这是非常可行的，因为候选人是一个 坚定的导师，持续提供R01资金，来自出色的研究环境，具有强大的 老年医学项目和一大批潜在的学员。

ABSTRACT: The growing population of older adults with advanced cancer experiences significant public health problems, including steep declines in quality of life, receipt of care that does not reflect patients' values and preferences, and high rates of caregiver burden. Inadequate attention to patient priorities and age-related concerns (e.g., function, cognition, and social support)—contribute to morbidity in this population. The emerging field of geriatric palliative care seeks to address age-related concerns and align care with patient goals over the trajectory of chronic and serious illness. The overarching goal of this K24 proposal is to enhance the candidate's mentorship of students, fellows, and junior faculty pursuing geriatric palliative care research, with a particular focus on identifying unmet geriatric palliative care needs and developing and testing interventions to improve quality of life and goal-concordant care for older patients with advanced cancer. As a successful mid-career investigator with a track record of leading successful palliative intervention trials with seriously ill older patients, the candidate is well-positioned to mentor the next generation of aging researchers. This award will leverage an outstanding longitudinal dataset of over 400 audio-recorded `primary' palliative care visits with older patients with advanced cancer and longitudinal patient- and caregiver-reported outcomes to explore optimal geriatric palliative care intervention designs. The research aims are to (1) characterize communication about age-related concerns in primary palliative care visits with older adults with advanced cancer and their family caregivers; (2) identify missed opportunities for addressing age- related concerns in primary palliative care visits for older adults with advanced cancer and their family caregivers; and (3) refine a conceptual model for primary palliative care delivery that incorporates age- related concerns and can be optimized to improve quality of life for older adults with advanced cancer. The K24 award will provide protected time for the candidate to update and expand her mentorship program, building bridges between researchers in geriatrics, palliative care and oncology. She will leverage outstanding aging research and mentoring resources available at the University of Pittsburgh; learn new skills to foster inquiry, wellbeing and resilience among trainees; and create a Junior Faculty Visiting Professor Program for geriatric palliative care researchers. This proposal is significant and innovative because it will support new clinical investigators using novel mentoring techniques and develop pilot data to inform large-scale trials addressing deficiencies in quality of care for a burgeoning population of older adults with advanced cancer. It is highly feasible because the candidate is a committed mentor with ongoing R01 funding, from an outstanding research environment with strong geriatrics programs and a large pool of potential mentees.