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（由适用提供）：拟议的研究活动的目标是3倍：1）支持我作为心理的持续影响，2）进一步在我机构的风湿病学部分增进临床研究培训计划，以及3），继续进步我自己的以患者为导向的研究（POR）计划。我对心理的承诺是我申请续签K24奖的主要原因。对心理的要求继续增加，并续签该奖项将确保我有受保护的时间，能够继续鼓励，支持，教学，教学和建议来自对未来职业兴趣的各种背景的学员。尽管我的主要兴趣是决策领域，但我的培训使我成为风湿病研究其他方面有趣的受训者的有效心理。 K24奖在设立风湿病学部分的临床研究培训计划中至关重要。现在，我们采用了一种系统的方法来帮助各个层面的受训者制定个性化的发展计划，从事适当的教学和专家研究活动，并监视他们向特定目标的发展。已经接受了基础培训的学员有机会参加更高级的课程，并获得卫生科学或调查医学博士学位的硕士学位。新获得的资源包括耶鲁大学以患者为中心的成果研究学者计划跨学科修补了由AHRQ资助的K12职业发展计划，该计划的重点是开发对比较有效性研究方法感兴趣的研究人员。风湿病培训计划包括用于评估学员和卫生员的正式过程。根据过去四年来我们的经验，我们将开始进行几项重要的更改，以改善该计划，包括将教学培训推进到奖学金的第一年，在奖学金的第二年中降低了研究员的临床责任，并添加了两项激进活动：1）同伴LED对基本技能的评论（例如，特定目的，抽象的发展，抽象的发展），摘要介绍） 2）正式的赠款模拟评论。除了指导年轻的研究人员外，我的重要长期目标之一是提高自己的研究议程，以便我可以继续进行科学严格且有意义的POR。在过去的四年中，我发表了论文，这些论文强调了临床实践中决策不良的后果，描述了患者和医生如何做出关键决策的差异，并在一项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算术对风险感知的影响。我在职业生涯的下一阶段的目标是开发更好的方法至1）测量并报告患者偏好的异质性，以及2）开发新的方法，通过获得进一步的培训和进行新的研究，开发出有效地向患者传达风险效益信息的新方法。