NRSA Postdoctoral Comparative Effectiveness Development Training Award

描述（由申请人提供）：布朗大学老年学和卫生保健研究中心寻求补充其25年ahrq资助的博士后培训计划，包括三个额外的比较有效性研究（CER）博士后培训名额。我们中心的研究重点是影响老年人的疾病，如癌症、心血管疾病和痴呆症。在美国，这些疾病是导致死亡和发病的主要原因之一，占全国医疗保健支出的很大一部分。我们的研究组合跨越多个环境（VA，医院，疗养院，流动设施），并专注于1)癌症成像的比较有效性；2)养老院痴呆患者的临床治疗选择；3)各州医疗补助政策对重要临床结果的比较有效性；4)不同保险福利设计对医疗管理医保参保人结局的影响比较。我们已取得超过三千五百万元，资助这四个范畴的CER研究。为了促进这一研究议程，我们在大规模数据库分析和尖端分析技术方面建立了专业知识，包括复杂的多层模型。这些工具需要理解生物、社会和行为因素之间的相互作用。培训计划强调个性化的、基于能力的方法，其基础是将研究员与导师及其现有研究相匹配。研究员将作为一个经验丰富的研究团队的成员，在一个重大项目中发挥领导作用，从而使我们的研究数据和项目基础设施受益。这项提议的CER培训计划利用了我们成功的，长期的博士后培训计划，广泛的相关课程和研讨会，以及一个充满活力和不断扩大的研究环境，为卫生服务和外部资助的研究增加了新的教师。

DESCRIPTION (provided by applicant): The Brown University's Center for Gerontology and Health Care Research seeks to supplement its 25-year AHRQ-funded post-doctoral training program to include three additional post-doctoral training slots for Comparative Effectiveness Research (CER). Our Center's research focuses on diseases that impact the elderly, such as cancer, cardiovascular disease, and dementia. These conditions are among the leading causes of mortality and morbidity in the United States and account for a substantial proportion of national health care spending. Our research portfolio spans multiple settings (VA, hospitals, nursing homes, ambulatory facilities) and focuses on 1) Comparative effectiveness of cancer imaging; 2) Clinical treatment choices for nursing home residents with dementia; 3) Comparative effectiveness of states' Medicaid policies on important clinical outcomes; and 4) Comparisons of different insurance benefit designs on outcomes among Medicare managed care enrollees. We have obtained over $35 million to fund CER studies in these four areas. To facilitate this research agenda, we have built expertise in large-scale database analyses and cutting-edge analytic techniques, including complex multilevel models. These tools require an understanding of the interaction of biological, social, and behavioral factors. The training program emphasizes an individualized, competency-based approach rooted in matching fellows to mentors and their existing research. Fellows will take a leadership role on a major project as a member of an experienced research team, thereby benefiting our research data and project infrastructure. This proposed CER training initiative leverages our successful, long-standing post-doctoral training program, wide array of relevant available courses and seminars, and a vibrant and expanding research environment that has added new faculty for health services and externally-funded research. PUBLIC HEALTH RELEVANCE: Comparative Effectiveness Research (CER) is an important tool for the value-based purchasing of health care needed to "bend the cost curve." To apply CER to the growing number of areas of need, it is essential to have trained investigators in the field. Brown University has been training successful post-doctoral fellows in health services research for a quarter century and is poised to extend this effort to the special needs of CER.