Approaches and Outcomes of Shared Decision-making and Patient Centered Care Delivery in Barrett's Esophagus

巴雷特食管的共同决策和以患者为中心的护理服务的方法和结果

• 批准号: 10688102
• 负责人: Swathi Eluri
• 金额: $ 20.03万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10688102
• 关键词: Ablation; Affect; American; Anxiety; Award; Awareness; Barrett Esophagus; Biology; Caring; Clinical; Clinical Investigator; Clinical Sciences; Comparative Effectiveness Research; Cost of Illness; Data; Databases; Decision Aid; Detection; Development; Digestive System Disorders; Disease; Dysplasia; Early Diagnosis; Eligibility Determination; Endoscopy; Ensure; Environment; Epidemiology; Esophageal Adenocarcinoma; Esophageal Diseases; Faculty; Fostering; Foundations; Funding; Funding Opportunities; Future; Gastroenterology; Generations; Goals; High grade dysplasia; Incidence; Institution; International; Interview; Knowledge; Malignant Neoplasms; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Modality; North Carolina; Online Systems; Outcome; Outcome Measure; Pathway interactions; Patient Outcomes Assessments; Patient-Centered Care; Patient-Focused Outcomes; Patients; Phase; Physicians; Prevention; Publications; Qualitative Research; Quality of life; Randomized, Controlled Trials; Research; Research Methodology; Research Personnel; Research Project Grants; Scientist; Standardization; Survival Rate; Symptoms; Teacher Professional Development; Testing; Training; Translational Research; Treatment outcome; United States; United States Agency for Healthcare Research and Quality; United States National Institutes of Health; Universities; administrative database; cancer risk; care delivery; career; career development; cognitive interview; collaborative environment; comparative effectiveness; comparative effectiveness study; design; experience; gastrointestinal; high risk; higher education; implementation science; improved; instrument; interest; large datasets; patient oriented; patient oriented research; patient population; patient-clinician communication; personalized care; preference; prevent; psychosocial; research and development; screening; shared decision making; skill acquisition; skills; tool

PROJECT SUMMARY This is a resubmission application for a five-year mentored patient-oriented research career development award (K23). The candidate is a motivated clinical researcher at the University of North Carolina Chapel Hill (UNC) with a background in digestive disease epidemiology, a strong publication record, and an established commitment to the study of esophageal diseases, specifically Barrett’s esophagus (BE). The objective of the K23 proposal is to obtain advanced mentored training in patient-oriented research methodologies required to achieve the candidate’s long-term career goal of becoming an independently funded physician-scientist improving detection of esophageal adenocarcinoma (EAC) by implementing patient-centered and shared decision care pathways in BE. Specifically, the candidate’s proposed career development goals are: 1) to obtain training in implementation science and development of patient decision aids; 2) to gain experience in the development of patient-reported outcomes (PRO) measures; 3) to develop knowledge in conducting comparative effectiveness research using large real-world databases; and 4) to transition to independence. To achieve these career development goals, the candidate will 1) take advanced, graduate level coursework in implementation science, decision aid design, PRO measures, and comparative effectiveness research; 2) participate in scholarly activities designed to foster independence and national recognition; and 3) conduct mentored research. The candidate’s mentoring team consists of internationally recognized, independently-funded investigators with expertise in Barrett’s esophagus and gastrointestinal epidemiology (Shaheen), implementation science and decision aids (Reuland), PROs (Keefer) and comparative effectiveness (Lund). Each mentor has a track record of commitment to mentoring junior faculty. The specific aims of the research project are: 1) to develop and test a web-based, patient-directed BE screening decision aid to improve screening rates screen-eligible patients; 2) to develop a BE-specific PRO instrument using in-depth interviews for concept elicitation to generate instrument items and perform cognitive interviews to ensure content validity; 3) to evaluate the comparative effectiveness of endoscopic surveillance versus ablation for BE patients with low-grade dysplasia (LGD) using administrative claims data to aid in shared decision making. Finally, the candidate’s research and training environment at UNC, a preeminent academic research institution, is strong and well-established. For fiscal year 2020, UNC ranked sixteenth for National Institutes of Health (NIH) research funding to domestic institutions of higher education, and has access to NIH funded centers (Translational and Clinical Sciences Institute and Center for Gastrointestinal Biology and Disease) that are tailored to support the proposed studies. This collaborative environment, mentorship, didactics, and research experience will provide the candidate with the strong foundation and unique skillset to successfully achieve the proposed research and training goals. Support from the K23 is critical to achieve the candidate’s goal of transitioning to an independent physician-scientist.

项目概要 这是一份为期五年的以患者为导向的研究职业发展奖的重新提交申请 （K23）。该候选人是北卡罗来纳大学教堂山分校 (UNC) 积极进取的临床研究员 具有消化系统疾病流行病学背景、良好的发表记录和成熟的 致力于食管疾病的研究，特别是巴雷特食管（BE）。该计划的目标 K23 提案是获得以患者为中心的研究方法方面的高级指导培训， 实现候选人成为独立资助的医师科学家的长期职业目标 通过实施以患者为中心和共享的方法来改善食管腺癌 (EAC) 的检测 BE 中的决策护理路径。具体来说，候选人提出的职业发展目标是： 1) 获得实施科学和患者决策辅助开发方面的培训； 2）获得相关经验 制定患者报告结果（PRO）措施； 3）培养进行比较的知识 使用大型现实世界数据库进行有效性研究； 4）过渡到独立。为了实现这些 职业发展目标，候选人将 1) 参加高级研究生水平课程的实施 科学、决策辅助设计、PRO 措施和比较有效性研究； 2）参加学术活动 旨在促进独立和国家认可的活动； 3) 进行指导研究。这 候选人的指导团队由国际公认的、独立资助的研究人员组成 巴雷特食管和胃肠道流行病学 (Shaheen)、实施科学和 决策辅助 (Reuland)、PRO (Keefer) 和比较有效性 (Lund)。每个导师都有一个记录 致力于指导初级教师。该研究项目的具体目标是：1）开发和测试 基于网络、以患者为导向的 BE 筛查决策辅助工具，以提高筛查率、筛查符合条件的患者； 2） 使用深度访谈进行概念启发来开发特定于 BE 的 PRO 工具以生成工具 项目并进行认知访谈以确保内容的有效性； 3）评估比较有效性 使用行政管理对患有低度不典型增生 (LGD) 的 BE 患者进行内镜监测与消融比较 声称数据有助于共同决策。最后，候选人的研究和培训环境 北卡罗来纳大学是一所卓越的学术研究机构，实力雄厚且信誉良好。 2020 财年，北卡罗来纳大学 美国国立卫生研究院 (NIH) 对国内高等院校的研究资助排名第 16 位 教育，并可以进入 NIH 资助的中心（转化与临床科学研究所和中心） 胃肠生物学和疾病），旨在支持拟议的研究。此次合作 环境、指导、教学和研究经验将为候选人提供强大的支持 成功实现拟议研究和培训目标的基础和独特技能。支持来自 K23 对于实现候选人过渡为独立医师科学家的目标至关重要。

项目成果

Association of eosinophilic esophagitis with autoimmune and connective tissue disorders, and the impact on treatment response.

嗜酸性粒细胞性食管炎与自身免疫和结缔组织疾病的关联以及对治疗反应的影响。

• DOI: 10.1093/dote/doac043
• 发表时间: 2022
• 期刊: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
• 作者: Xue,Zeyun;Miller,TalyaL;Abramson,Lior;Thakkar,KisanP;Ketchem,CoreyJ;Reddy,Sumana;Greenberg,SydneyB;Abichandani,Sonia;Chang,NicoleC;Eluri,Swathi;Reed,CraigC;Dellon,EvanS
• 通讯作者: Dellon,EvanS

Management of Dysplastic Barrett's Esophagus and Early Esophageal Adenocarcinoma.

• DOI: 10.1016/j.gtc.2022.06.004
• 发表时间: 2022-09
• 期刊: GASTROENTEROLOGY CLINICS OF NORTH AMERICA
• 影响因子: 3.7
• 作者: Cotton, Cary C.;Eluri, Swathi;Shaheen, Nicholas J.
• 通讯作者: Shaheen, Nicholas J.

Association between eosinophilic esophagitis and esophageal dysmotility: A systematic review and meta-analysis.

嗜酸性粒细胞性食管炎与食管运动障碍之间的关联：系统评价和荟萃分析。

• DOI: 10.1111/nmo.14475
• 发表时间: 2023
• 期刊: Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
• 作者: Reddy,SumanaB;Ketchem,CoreyJ;Dougherty,MichaelK;Eluri,Swathi;Dellon,EvanS
• 通讯作者: Dellon,EvanS