Developing Patient-Centered Decision Support for Eosinophilic Esophagitis

项目摘要 候选人的长期职业目标：成为一名独立资助的医生科学家， 并测试以患者为中心的干预措施，以支持慢性食管癌患者的共同决策（SDM） 疾病 研究背景：作为一种慢性疾病，其患病率、发病率、医疗费用和 嗜酸性食管炎（EoE）是一个研究不足的、具有挑战性的治疗领域， 患者和提供者都需要在教育、决策和沟通方面的支持， 复杂的治疗选择，以防止昂贵的并发症。由于临床平衡存在于药物 了解利益相关者的决策驱动因素并应用SDM至关重要 以患者为中心的EoE护理的差距，并需要改善长期疾病的结果。 候选人背景和成就：张博士是大学胃肠病学讲师 密歇根大学（UM）和嗜酸性胃肠疾病研究者联盟的获奖者。 她获得了马里兰州大学的医学博士学位和密歇根大学的理学硕士学位。迄今为止，她已经出版了13本原创作品。 同行评审的手稿和一本书的章节，其中10个她是第一或资深作者。 职业发展计划：张博士建议在混合方法，高级 定性研究方法，决策科学，临床试验的实施和评估，以评估影响 对结果进行决策支持干预。她的职业发展目标得到了 指导、高级教学课程以及参加讲习班和专业会议 旨在促进合作，确保成功完成学习，并支持她无缝过渡到 一个成功的独立研究者 目的：1）揭示影响患者EoE管理决策的多层次因素， 2）开发一个多层次的决策支持干预原型，支持SDM选择 EoE治疗，以及3）初步测试和评估可行性、可接受性和初步患者报告的疗效 与使用决策支持干预相关的结果。 研究计划：Dr. Chang将1）使用混合方法设计访问EoE患者，以确定影响因素 2）对胃肠病学家和过敏症专家进行定性访谈， 描述提供商对EoE管理和支持决策的观点，3）制定 多层次决策支持干预，以促进患者和提供者之间的SDM，以及4）评估 决策干预的可行性、可接受性以及对初步疗效结果的影响， 接受决策支持的患者与接受对照内容的20名患者。

PROJECT SUMMARY Candidate’s Long-term Career Goal: To become an independently funded physician-scientist developing and testing patient-centered interventions to support shared decision making (SDM) in chronic esophageal diseases. Research Context: As a chronic disease with rapidly rising prevalence, incidence, healthcare costs, and burdens to patient quality of life, eosinophilic esophagitis (EoE) is an understudied, challenging area of care for both patients and providers that requires support in education, decision making, and communication around complex treatment choices to prevent costly complications. As clinical equipoise exists between medication and dietary therapies, understanding stakeholder drivers of decision making and applying SDM are critical gaps in patient-centered EoE care, and are needed to improve long-term disease outcomes. Candidate Background and Achievements: Dr. Chang is an Instructor in Gastroenterology at the University of Michigan (UM) and an awardee of a Consortium of Eosinophilic Gastrointestinal Disease Researchers grant. She received her MD from the University of Maryland and MS from UM. To date she has published 13 original peer-reviewed manuscripts and one book chapter, 10 of which she is first or senior author. Career Development Plan: Dr. Chang proposes to develop new expertise in mixed methods, advanced qualitative research methods, decision sciences, and clinical trial conduct and evaluation to assess the impact of a decision support intervention on outcomes. Her career development goals are supported by stellar mentorship, advanced didactic coursework, and participation in workshops and professional meetings designed to foster collaboration, ensure successful study completion, and support her seamless transition into a successful independent researcher. Aims: 1) Elicit the multilevel factors that influence decision making for EoE management among patients and providers, 2) Develop a multilevel decision support intervention prototype that supports SDM for selection of EoE therapy, and 3) Pilot test and evaluate feasibility, acceptability, and preliminary patient-reported efficacy outcomes associated with use of the decision support intervention. Research Plan: Dr. Chang will 1) use a mixed methods design to interview patients with EoE to identify factors that drive treatment decision making, 2) conduct qualitative interviews of gastroenterologists and allergists to characterize provider perspectives about EoE management and supported decision making, 3) develop a multilevel decision support intervention to facilitate SDM between patients and providers, and 4) assess decision intervention feasibility, acceptability, and influence on preliminary efficacy outcomes comparing 20 patients receiving decision support to 20 patients receiving control content.