Improving Decision Making in Patients with Rheumatic Disease

改善风湿病患者的决策

• 批准号: 9302693
• 负责人: Liana Fraenkel
• 金额: $ 18.35万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9302693
• 关键词: Accelerometer; Advisory Committees; Award; Benefits and Risks; Biometry; Clinical; Clinical Practice Guideline; Clinical Research; Communication; Data; Decision Making; Development; Development Plans; Doctor of Philosophy; Ensure; Epidemiology; Evaluation; Faculty; Fellowship; Foundations; Funding; Future; Goals; Grant; Health Sciences; Healthcare; Heterogeneity; Hospitals; Individual; Institution; Master' s Degree; Measures; Medical; Medicine; Mentors; Methodology; Methods; Mid-Career Clinical Scientist Award (K24); Modeling; NCI Scholars Program; Occupations; Outcomes Research; Paper; Patient Preferences; Patient-Focused Outcomes; Patients; Persons; Pharmaceutical Preparations; Phase; Physicians; Policies; Positioning Attribute; Process; Program Development; Publishing; Randomized Controlled Trials; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Research Project Grants; Research Training; Resources; Rewards; Rheumatism; Rheumatology; Risk; Role; SECTM1 gene; Time; Training; Training Programs; United States Agency for Healthcare Research and Quality; Work; base; career; career development; clinical development; clinical practice; comparative effectiveness; design; experience; improved; interest; mathematical ability; novel; novel strategies; patient oriented research; peer; point of care; preference; programs; public health relevance; risk perception; skills; support tools; theories

 DESCRIPTION (provided by applicant): The goals of the proposed research activities are 3-fold: 1) to support my continued impact as a mentor, 2) to further grow the clinical research training program in the Section of Rheumatology at my institution, and 3) to continue to advance my own patient-oriented research (POR) program in medical decision making. My commitment to mentoring is the primary reason I am applying for a renewal of the K24 Award. Requests for mentoring continue to increase, and a renewal of this award would ensure that I have the protected time to be able to continue to encourage, support, teach, and advise trainees from various backgrounds interested in a future career involving POR. While my primary interest is in the field of decision making, my training and has allowed me to be an effective mentor for trainees interested in other aspects of rheumatologic research. The K24 award has been critical in the establishment a clinical research training program in the Section of Rheumatology. We now have a systematic approach to help trainees at various levels develop an individualized development plan, engage in the appropriate didactic and experiential research activities and monitor their progression towards their specific goals. Trainees who have already undergone basic training have the opportunity to take more advanced courses and to obtain a Masters' degree in Health Sciences or PhD in Investigative Medicine. Newly acquired resources include The Yale Patient-Centered Outcomes Research Scholars Program interdisciplinary mentored K12 career development program funded by AHRQ, which focuses on developing investigators with an interest in comparative effectiveness research methods. The Rheumatology POR training program includes formal processes for evaluation of both trainees and mentors. Based on our experience over the past four years, we will initiate several important changes to improve the program including advancing didactic training to the first year of fellowship, decreasing fellows' clinical responsibilities during their second year of fellowship, and adding two activitie: 1) peer led review of essential skills (e.g., development of specific aims, abstract presentations) and 2) formal grant mock reviews. In addition to mentoring young investigators, one of my important long-term goals is to advance my own research agenda so that I can continue to conduct scientifically rigorous and meaningful POR. Over the past four years, I have published papers which highlight the consequences of poor decision making in clinical practice, describe the differences in how patients and physicians approach critical decisions, and demonstrate the efficacy of a theory-based decision support tool in a randomized controlled trial. My recent work has also demonstrated the limitations associated with reporting preferences in the aggregate and the impact of low numeracy on risk perceptions. My goals during the next phase of my career are to develop better methods to 1) measure and report heterogeneity in patient preferences, and 2) develop novel approaches to effectively communicate risk-benefit information to patients by obtaining further training and conducting novel research.

 描述（由申请人提供）：拟议研究活动的目标有 3 个方面：1）支持我作为导师的持续影响力，2）进一步发展我所在机构风湿病科的临床研究培训计划，3）继续推进我自己的医疗决策中以患者为导向的研究（POR）计划。我对指导的承诺是我申请续签 K24 奖的主要原因。对指导的要求不断增加，续订该奖项将确保我有受保护的时间，能够继续鼓励、支持、教导和建议来自不同背景、对未来涉及 POR 的职业感兴趣的学员。虽然我的主要兴趣是决策领域，但我的培训使我能够成为对风湿病研究其他方面感兴趣的学员的有效导师。 K24 奖项对于风湿病科临床研究培训计划的建立至关重要。我们现在有一个系统的方法来帮助不同级别的学员制定个性化的发展计划，参与适当的教学和体验研究活动，并监控他们实现特定目标的进展。已经接受过基础培训的学员有机会参加更高级的课程并获得健康科学硕士学位或研究医学博士学位。新获得的资源包括由 AHRQ 资助的耶鲁大学以患者为中心的结果研究学者计划跨学科指导的 K12 职业发展计划，该计划重点培养对比较有效性研究方法感兴趣的研究人员。风湿病学 POR 培训计划包括对学员和导师进行评估的正式流程。根据我们过去四年的经验，我们将启动几项重要的变革来改进该计划，包括将教学培训推进到研究员的第一年，减少研究员在研究员第二年的临床责任，并增加两项活动：1）同行主导的基本技能审查（例如，制定具体目标、抽象演示） 2) 正式拨款模拟评审。除了指导年轻的研究人员之外，我重要的长期目标之一是推进我自己的研究议程，以便我能够继续进行科学严谨且有意义的 POR。在过去的四年里，我发表了一些论文，这些论文强调了临床实践中决策失误的后果，描述了患者和医生处理关键决策的差异，并在随机对照试验中证明了基于理论的决策支持工具的有效性。我最近的工作还证明了与总体报告偏好相关的局限性以及低计算能力对风险认知的影响。我职业生涯下一阶段的目标是开发更好的方法来 1) 测量和报告患者偏好的异质性，2) 通过获得进一步的培训和开展新的研究，开发新的方法来有效地向患者传达风险收益信息。