NRSA Postdoctoral Comparative Effectiveness Development Training Award

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，包括三个额外的博士后培训名额，用于比较有效性研究（CER）。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。这些疾病是美国死亡率和发病率的主要原因之一，占国家卫生保健支出的很大一部分。我们的研究组合跨越多个设置（VA，医院，疗养院，门诊设施），重点是1）癌症成像的比较有效性; 2）老年痴呆症疗养院居民的临床治疗选择; 3）各州医疗补助政策对重要临床结果的比较有效性;和4）不同保险福利设计对医疗保险管理护理登记者结果的比较。我们已获得超过3，500万元，资助这四个范畴的核证减排研究。为了促进这一研究议程，我们建立了大规模数据库分析和尖端分析技术，包括复杂的多级模型的专业知识。这些工具需要了解生物、社会和行为因素的相互作用。培训计划强调个性化，基于能力的方法，植根于匹配研究员导师和他们现有的研究。研究员将作为经验丰富的研究团队的一员，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。这项拟议的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。 公共卫生相关性：比较效果研究（CER）是一个重要的工具，为基于价值的医疗保健购买需要“弯曲的成本曲线。“为了将核证的排减量应用于越来越多的需要领域，必须在实地配备训练有素的调查人员。布朗大学已经成功地培养了四分之一世纪的卫生服务研究博士后研究员，并准备将这一努力扩展到CER的特殊需要。

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.