Adult Outcomes of Juvenile Idiopathic Arthritis

幼年特发性关节炎的成人结局

• 批准号: 9303191
• 负责人: Aimee O Hersh
• 金额: $ 18.04万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9303191
• 关键词: 16 year old; Adult; Advisory Committees; Affect; Age; Age of Onset; Alleles; Area; Arthritis; Autoimmune Diseases; Award; Behavioral; Biological Factors; Birth Certificates; Cardiovascular Diseases; Cardiovascular system; Caring; Certification; Child; Childhood; Chronic; Chronic Childhood Arthritis; Chronic Disease; Clinical; Clinical Research; Clinical Sciences; Collection; Complex; Data; Data Analyses; Databases; Death Records; Development; Development Plans; Discipline; Disease; Disease Outcome; Disease remission; Enrollment; Ensure; Environment; Event; Funding; Gender; Genealogy; Genetic; Genetic Determinism; Genetic Predisposition to Disease; Genetic Risk; Genotype; Goals; Growth; Health; Health Services Accessibility; Health Services Research; Health behavior; Healthcare; Impairment; Incidence; Individual; Infertility; Intervention; Interview; K-Series Research Career Programs; Lead; Link; Live Birth; Longitudinal Studies; Longitudinal cohort; Malignant Neoplasms; Manuscripts; Measurement; Measures; Medical Records; Mentors; Mentorship; Methodology; Morbidity - disease rate; NCI Scholars Program; Natural History; Oligonucleotides; Operative Surgical Procedures; Orthopedic Procedures; Outcome; Outcomes Research; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Phenotype; Physicians; Population; Population Database; Population Genetics; Preparation; Principal Investigator; Quality of life; Registries; Replacement Arthroplasty; Research; Research Design; Research Personnel; Research Project Grants; Research Proposals; Research Training; Resources; Rheumatism; Risk; Risk Factors; Scientist; Socioeconomic Status; Standardization; Structure; Susceptibility Gene; Time; Training; Training Programs; Translational Research; Treatment outcome; United States; United States National Institutes of Health; Universities; Utah; Vital Statistics; career; career development; certificate program; cohort; comparative effectiveness; complex chronic conditions; design; disability; disease phenotype; effectiveness research; epidemiology study; genetic epidemiology; health related quality of life; improved; improved outcome; joint injury; meetings; mortality; multidisciplinary; outcome prediction; patient population; pediatric department; pediatric patients; personalized health care; personalized medicine; population based; premature; programs; public health relevance; rheumatologist; skills; therapy design; treatment response

DESCRIPTION (provided by applicant): The proposed career development award is designed to support the transition of Dr. Aimee O. Hersh into an independent physician-scientist dedicated to improving outcomes for patients with juvenile idiopathic arthritis (JIA). Dr. Hersh is a pediatric rheumatologist at the University of Utah. She has prior training in health services research and has focused her research career on understanding the adult outcomes of childhood-onset rheumatic disease. This award would allow Dr. Hersh to complete a unique study of the natural history of JIA, as well as to describe the relationship between JIA genotype and disease phenotype. To achieve this, Dr. Hersh's career development plan is to gain advanced methodological skills in outcomes research, and to obtain training in the genetic contribution to disease and outcomes through completion of the Certificate Program in Personalized Health Care at the University of Utah. Dr. Hersh's mentoring team is led by Drs. John Bohnsack and Sampath Prahalad, pediatric rheumatologists with expertise in the outcomes of juvenile idiopathic arthritis and the genetic determinants of this condition. Additionally, she has assembled a multidisciplinary advisory team with expertise in population and genetic epidemiology, including the genetics of complex autoimmune disease, as well as the outcomes of JIA, including the measurement of disability and quality of life for patients with arthritis. Dr. Hersh's overarching career goal is to determine the biologic/genetic and non-biologic predictors of long- terms outcomes of patients with childhood-onset rheumatic disease, and to improve outcomes for this patient population. Her short-term career goal is to become an expert in the area of adult-outcomes of juvenile idiopathic arthritis, including the relationship between genetic susceptibility and outcomes. Dr. Hersh's long-term career goal is to become a successful physician-scientist who will: 1. Be a principal investigator able to lead and collaborate with multidisciplinary teams of researchers to develop the best methodology to measure adult outcomes for patients with childhood-onset rheumatic disease and other pediatric-onset chronic illnesses. 2. Be a national expert and leader designing interventions to improve outcomes for patients with childhood-onset rheumatic disease. 3. Be a mentor for junior investigators across various disciplines. Environment: The University of Utah has several unique resources which Dr. Hersh will utilize for her research proposal and training, including the Intermountain States Database of Childhood Rheumatic Diseases (ISDCRD) and the Utah Population Database (UPDB). She will gain essential research skills through completion of the Certificate Program in Personalized Healthcare. The University of Utah and Department of Pediatrics have outstanding resources dedicated to mentorship and early career development and training in clinical research, including the University's Center for Clinical and Translational Science, the NIH-funded training program in translational and comparative-effectiveness research and a Pediatric Clinical and Translational Scholars Program. Dr. Hersh currently has 75% protected time which will be ensured throughout the award period to utilize these resources in achieving her career development goals. Research: Dr. Hersh's research proposal incorporates three related research projects focused on describing the long-term outcomes of JIA. Juvenile idiopathic arthritis (JIA) is the most common pediatric rheumatic disease; the majority of children with JIA have persistent arthritis into adulthood. JIA is associated with premature morbidities including joint damage, growth impairment, cardiovascular disease and mortality; yet, little is known about the long-term outcomes of this chronic rheumatic disease. The central hypothesis of this proposal is that there are non-modifiable (eg. genetic) and modifiable (eg, treatment, behavioral) risk factors that, if identified, lead to targets for improvd treatment and outcomes for children with JIA. In Aim 1, Dr. Hersh will link the ISDCRD to the UPDB to examine important outcomes of JIA including the incidence of orthopedic procedures, cardiovascular events and malignancy as well as risk of infertility and early mortality. In Aim 2, she will develop a longitudinal cohort of adult patients with JIA to characterize disability and quality of life outcomes for this cohort, as well as predictors for these outcomes. In Aim 3, she will explore the relationship between genetic susceptibility loci and response to treatment in JIA. Preliminary data from this research will be used to develop interventions to improve health outcomes for patients with childhood-onset rheumatic disease. This proposal is designed to facilitate Dr. Hersh's career as an independent investigator devoted to improving care for pediatric patients with a chronic rheumatic disease.

描述（由申请人提供）：拟议的职业发展奖旨在支持博士的过渡。赫什成为一个独立的医生，科学家致力于改善青少年特发性关节炎（JIA）患者的结果。赫什博士是 他是犹他州大学的儿科风湿病学家。她曾接受过卫生服务研究方面的培训，并将其研究生涯集中在了解儿童期发病的风湿性疾病的成人结局上。这一奖项将使赫什博士完成一个独特的研究JIA的自然史，以及描述JIA基因型和疾病表型之间的关系。为了实现这一目标，赫什博士的职业发展计划是获得成果研究的先进方法技能，并通过完成犹他州大学的个性化医疗保健证书课程，获得遗传对疾病和成果的贡献方面的培训。Hersh博士的指导团队由John Bohnsack博士和Sampath Prahalad博士领导，他们是儿科风湿病学家，在青少年特发性关节炎的结果和这种疾病的遗传决定因素方面具有专业知识。此外，她还组建了一个多学科咨询团队，拥有人口和遗传流行病学方面的专业知识，包括复杂自身免疫性疾病的遗传学，以及JIA的结果，包括关节炎患者的残疾和生活质量的测量。Hersh博士的首要职业目标是确定儿童期发作的风湿性疾病患者长期结局的生物学/遗传学和非生物学预测因子，并改善该患者人群的结局。她的短期职业目标是成为青少年特发性关节炎成人结局领域的专家，包括遗传易感性和结局之间的关系。赫什博士的长期职业目标是成为一名成功的物理学家，科学家谁会：1。作为一名主要研究者，能够领导多学科研究团队并与之合作，开发最佳方法来衡量儿童期发病的风湿性疾病和其他儿童期发病的慢性疾病患者的成人结局。 2.成为全国性的专家和领导者，设计干预措施，以改善儿童期风湿性疾病患者的预后。 3.成为不同学科的初级调查人员的导师。工作环境：犹他州大学有几个独特的资源，赫什博士将利用她的研究计划和培训，包括儿童风湿性疾病的山间国家数据库（ISDCRD）和犹他州人口数据库（CSB）。她将通过完成个性化医疗保健证书课程获得必要的研究技能。犹他州大学和儿科系拥有杰出的资源，致力于指导和早期职业发展以及临床研究培训，包括大学的临床和转化中心。 科学，NIH资助的转化和比较有效性研究培训计划以及儿科临床和转化学者计划。Hersh博士目前有75%的受保护时间，在整个奖励期间将确保利用这些资源实现她的职业发展目标。研究：赫什博士的研究计划包括三个相关的研究项目，重点是描述JIA的长期结果。幼年特发性关节炎（JIA）是最常见的小儿风湿性疾病;大多数患有JIA的儿童在成年后仍有持续性关节炎。JIA与过早发病有关，包括关节损伤、生长障碍、心血管疾病和死亡率;然而，对这种慢性风湿性疾病的长期结局知之甚少。这个建议的核心假设是，有不可修改的（如。遗传）和可改变（如治疗，行为）的风险因素，如果确定，导致目标的改善治疗和结果的儿童与JIA。在目标1中，Hersh博士将把ISDCRD与JIA B联系起来，以检查JIA的重要结局，包括骨科手术、心血管事件和恶性肿瘤的发生率以及不孕和早期死亡的风险。在目标2中，她将开发一个JIA成人患者的纵向队列，以描述该队列的残疾和生活质量结局，以及这些结局的预测因素。在目标3中，她将探讨遗传易感基因座与JIA治疗反应之间的关系。 这项研究的初步数据将用于制定干预措施，以改善儿童期发病的风湿性疾病患者的健康状况。该提案旨在促进Hersh博士作为一名独立研究者的职业生涯，致力于改善慢性风湿性疾病儿科患者的护理。