Comparative effectiveness of tailored HIV treatment plans and mortality
定制的艾滋病毒治疗计划和死亡率的比较效果
基本信息
- 批准号:10062470
- 负责人:
- 金额:$ 5.92万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2016
- 资助国家:美国
- 起止时间:2016-12-15 至 2021-11-30
- 项目状态:已结题
- 来源:
- 关键词:AccountingAcquired Immunodeficiency SyndromeAddressAdultAgingAwardBayesian AnalysisBayesian MethodBiometryCalendarCaringCause of DeathCenters for Disease Control and Prevention (U.S.)Cessation of lifeCharacteristicsClinicalClinical ResearchCollectionComplementComplexConsensusCoupledDataData SourcesDiagnosisEarly treatmentEpidemiologic MethodsEpidemiologyExposure toFoundationsGoalsGrantHIVHIV InfectionsHIV SeropositivityInformation CentersInstructionIntegrase InhibitorsInternationalLife ExpectancyLogicMentored Research Scientist Development AwardMentorsMentorshipMethodsModelingModernizationOutcomePatientsPharmacotherapyPopulationProbabilityRecording of previous eventsRegimenReportingResearchResearch PersonnelRiskRisk EstimateSample SizeSiteStatistical MethodsStructural ModelsSystemTabletsTechniquesTestingTimeToxic effectTrainingWorkantiretroviral therapybasecareer developmentclinical carecohortcomorbiditycomparativecomparative effectivenessdemographicsdesignexperiencehigh dimensionalityimprovedindividual patientindividualized medicineinsightmembermortalitymortality riskpersonalized medicineprecision medicinesemiparametricsymposiumtheoriestraining projecttreatment comparisontreatment disparitytreatment optimizationtreatment planningtreatment strategy
项目摘要
PROJECT SUMMARY
The overall goal of this K01 application is to optimize clinical care decisions for people living with HIV.
Specifically, this project will explore how cause-specific mortality among people with HIV has changed as
treatment has become more effective and how the choice of antiretroviral therapy (ART) regimen can be
tailored or personalized based on patient characteristics to improve survival. Since 2012, many patients have
initiated regimens containing integrase inhibitors, but overall and cause-specific mortality for patients on these
regimens is uncertain. In addition, the comparative effectiveness of the recommended integrase inhibitor
containing regimens for patients with disparate characteristics and treatment histories has yet to be explored.
Standard epidemiologic methods are insufficient to optimize HIV treatment plans because treatment plans and
tailoring strategies are high dimensional, resulting in sparse data and unstable inference in many data sources,
particularly when treatment plans can change over time. The goal of this career development project is to train
the recipient to perform comparative effective research in settings with many exposure plans and outcomes.
Research aims of this project are to 1) Compare the cause-specific mortality risks among patients with HIV in
the US across three time periods representing the triple drug therapy era, the single tablet era, and the
integrase inhibitor era (i.e., 2000 – 2005, 2006 – 2012, 2013 – 2018); and 2) Estimate all-cause mortality risks
under strategies to optimize selection of an integrase inhibitor containing regimen based on treatment history
and patient characteristics. To address these aims in cohort data, the training component of this grant focuses
on building expertise in semi-Bayesian semiparametric inference in the context of HIV research. Specifically,
training aims include 1) Instruction in statistical techniques to improve inference for tailored treatment plans in
high dimensional settings; 2) Training in applied HIV epidemiology; and 3) Experience and preliminary results
necessary to prepare an R01 application in the fourth year of this award. The training aims will be achieved
through rigorous coursework in advanced biostatistics, mentored and collaborative research, and conference
participation. Research aims will be conducted using data from the Centers for AIDS Research Network of
Integrated Clinical Systems, which includes over 30,000 HIV-seropositive adults engaged in clinical care from
January 1, 1995 to the present at 8 US sites. The project will use semiparametric methods to account for
missing causes of death and will estimate all parameters describing cause-specific mortality accounting for
competing causes of death. Aim 2 will use Bayesian penalization techniques to estimate the causal effects of
tailored treatment plans using marginal structural models and the parametric g-formula. This project will
address an urgent need to optimize treatment plans in the current treatment era with an aging HIV-positive
population with increasing comorbidities.
项目摘要
K 01应用程序的总体目标是优化艾滋病毒感染者的临床护理决策。
具体而言,该项目将探讨艾滋病毒感染者的死因特异性死亡率如何随着
治疗已经变得更加有效,如何选择抗逆转录病毒治疗(ART)方案,
根据患者特征定制或个性化,以提高生存率。自2012年以来,许多患者
启动含有整合酶抑制剂的方案,但这些患者的总体和原因特异性死亡率
治疗方案不确定。此外,推荐的整合酶抑制剂的比较有效性
包含用于具有不同特征和治疗史的患者的方案还有待探索。
标准流行病学方法不足以优化艾滋病毒治疗计划,因为治疗计划和
裁剪策略是高维的,导致许多数据源中的稀疏数据和不稳定的推断,
特别是当治疗计划可以随时间改变时。这个职业发展项目的目标是培训
接受者在有许多暴露计划和结果的环境中进行比较有效的研究。
本项目的研究目的是:1)比较以下国家艾滋病病毒感染者的死因特异性死亡风险:
美国跨越三个时期,分别代表三重药物治疗时代、单一片剂时代和
整合酶抑制剂ERA(即,(2000 - 2005年、2006 - 2012年、2013 - 2018年)
在基于治疗史优化包含整合酶抑制剂的方案的选择的策略下
和患者特征。为了在队列数据中实现这些目标,该补助金的培训部分侧重于
在艾滋病毒研究的背景下,建立半贝叶斯半参数推断的专业知识。具体地说,
培训目标包括:1)指导统计技术,以改善对定制治疗计划的推断,
高维环境; 2)应用艾滋病毒流行病学培训; 3)经验和初步结果
在该奖项的第四年准备R 01申请所需的。达到培训目标
通过在先进的生物统计学,指导和合作研究,和会议严格的课程
参与的研究目标将使用来自美国艾滋病研究网络中心的数据进行。
综合临床系统,其中包括30,000多名艾滋病毒血清阳性成年人,
1995年1月1日至今,在美国8个研究中心。该项目将使用半参数方法来解释
缺失死因,并将估计描述死因特异性死亡率的所有参数,
竞争性死因目标2将使用贝叶斯惩罚技术来估计
使用边际结构模型和参数g公式定制治疗计划。该项目将
在当前的治疗时代,迫切需要优化艾滋病毒阳性老年人的治疗计划,
合并症增加的人群。
项目成果
期刊论文数量(27)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Gone But Not Lost: Implications for Estimating HIV Care Outcomes When Loss to Clinic Is Not Loss to Care.
消失但不会丢失:当损失诊所的损失不是护理时,估计艾滋病毒护理结果的影响。
- DOI:10.1097/ede.0000000000001201
- 发表时间:2020-07
- 期刊:
- 影响因子:0
- 作者:Edwards JK;Lesko CR;Herce ME;Murenzi G;Twizere C;Lelo P;Anastos K;Tymejczyk O;Yotebieng M;Nash D;Adedimeji A;Edmonds A
- 通讯作者:Edmonds A
Virologic suppression and CD4+ cell count recovery after initiation of raltegravir or efavirenz-containing HIV treatment regimens.
- DOI:10.1097/qad.0000000000001668
- 发表时间:2018-01-14
- 期刊:
- 影响因子:0
- 作者:Edwards JK;Cole SR;Hall HI;Mathews WC;Moore RD;Mugavero MJ;Eron JJ;CNICS investigators
- 通讯作者:CNICS investigators
Leveraging auxiliary data to improve precision in inverse probability-weighted analyses.
利用辅助数据提高逆概率加权分析的精度。
- DOI:10.1016/j.annepidem.2022.07.011
- 发表时间:2022
- 期刊:
- 影响因子:5.6
- 作者:Zalla,LaurenC;Yang,JeffY;Edwards,JessieK;Cole,StephenR
- 通讯作者:Cole,StephenR
A Review of Time Scale Fundamentals in the g-Formula and Insidious Selection Bias
- DOI:10.1007/s40471-018-0153-0
- 发表时间:2018-09-01
- 期刊:
- 影响因子:3.3
- 作者:Keil, Alexander P.;Edwards, Jessie K.
- 通讯作者:Edwards, Jessie K.
Dogmatists Cannot Learn.
教条主义者无法学习。
- DOI:10.1097/ede.0000000000000587
- 发表时间:2017
- 期刊:
- 影响因子:0
- 作者:Cole,StephenR;Chu,Haitao;Brookhart,MAlan;Edwards,JessK
- 通讯作者:Edwards,JessK
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Jessie Edwards其他文献
Jessie Edwards的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Jessie Edwards', 18)}}的其他基金
Merging machine learning and mechanistic models to improve prediction and inference in emerging epidemics
融合机器学习和机械模型以改进对新兴流行病的预测和推理
- 批准号:
10709474 - 财政年份:2021
- 资助金额:
$ 5.92万 - 项目类别:
Merging machine learning and mechanistic models to improve prediction and inference in emerging epidemics
融合机器学习和机械模型以改进对新兴流行病的预测和推理
- 批准号:
10334519 - 财政年份:2021
- 资助金额:
$ 5.92万 - 项目类别:
Merging machine learning and mechanistic models to improve prediction and inference in emerging epidemics
融合机器学习和机械模型以改进对新兴流行病的预测和推理
- 批准号:
10539401 - 财政年份:2021
- 资助金额:
$ 5.92万 - 项目类别:
Comparative effectiveness of tailored HIV treatment plans and mortality
定制的艾滋病毒治疗计划和死亡率的比较效果
- 批准号:
9270331 - 财政年份:2016
- 资助金额:
$ 5.92万 - 项目类别:
相似海外基金
RESEARCH SUPPORT SERVICES FOR THE DIVISION OF ACQUIRED IMMUNODEFICIENCY SYNDROME
获得性免疫缺陷综合症分类的研究支持服务
- 批准号:
10219039 - 财政年份:2020
- 资助金额:
$ 5.92万 - 项目类别:
RESEARCH SUPPORT SERVICES FOR THE DIVISION OF ACQUIRED IMMUNODEFICIENCY SYNDROME
获得性免疫缺陷综合症分类的研究支持服务
- 批准号:
9981476 - 财政年份:2019
- 资助金额:
$ 5.92万 - 项目类别:
IGF::OT::IGF RESEARCH SUPPORT SERVICES FOR THE DIVISION OF ACQUIRED IMMUNODEFICIENCY SYNDROME
IGF::OT::IGF 针对获得性免疫缺陷综合症分类的研究支持服务
- 批准号:
9364184 - 财政年份:2016
- 资助金额:
$ 5.92万 - 项目类别:
Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) in Saskatchewan- Where are we now and what does the future hold?
萨斯喀彻温省的人类免疫缺陷病毒(HIV)和获得性免疫缺陷综合症(艾滋病)——我们现在在哪里以及未来会怎样?
- 批准号:
236932 - 财政年份:2011
- 资助金额:
$ 5.92万 - 项目类别:
Miscellaneous Programs
ACQUIRED IMMUNODEFICIENCY SYNDROME RESEARCH REVIEW COMMI
获得性免疫缺陷综合症研究审查委员会
- 批准号:
3554155 - 财政年份:1991
- 资助金额:
$ 5.92万 - 项目类别:
ACQUIRED IMMUNODEFICIENCY SYNDROME RESEARCH REVIEW COMMI
获得性免疫缺陷综合症研究审查委员会
- 批准号:
3554156 - 财政年份:1991
- 资助金额:
$ 5.92万 - 项目类别:
ACQUIRED IMMUNODEFICIENCY SYNDROME RESEARCH REVIEW
获得性免疫缺陷综合症研究综述
- 批准号:
2063342 - 财政年份:1991
- 资助金额:
$ 5.92万 - 项目类别: