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Improving age-related risk assessment and documentation for diverse older adults with cancer

改善不同老年癌症患者的年龄相关风险评估和记录

基本信息

批准号：
10581662
负责人：
Melody K Schiaffino
金额：
$ 13.7万
依托单位：
SAN DIEGO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-03-15 至 2027-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10581662
关键词：
Address Adult Affect Age Aging Algorithms American Award Bioinformatics Biometry Cancer Center Cancer Survivor Caring Cities Classification Client satisfaction Clinic Clinical Clinical Data Clinical Trials Clinical assessments Communication Comprehensive Cancer Center Data Data Science Data Set Decision Making Dedications Development Diagnosis Disease Disparity Doctor of Philosophy Documentation Education Elderly Electronic Health Record English Language Ensure Epidemiology Equity Face Faculty Future Geriatric Assessment Geriatrics Gerontology Goals Health Services Research Health Status Health system Interview K-Series Research Career Programs Knowledge Language Limited English Proficiency Location Machine Learning Malignant Neoplasms Medical Records Medicine Mentors Methods Minority Natural Language Processing Oncologist Oncology Outcome Patient-Focused Outcomes Patients Pattern Persons Prevalence Process Provider Quality of Care Radiation Radiation Oncology Research Research Personnel Risk Risk Assessment Risk Factors Risk Reduction Scientist Series Specific qualifier value Survivors Symptoms System Testing Time Training Translational Research Treatment outcome Treatment-related toxicity Uncertainty Universities Variant age effect age related algorithm development cancer care cancer health disparity cancer risk cancer therapy cancer type care coordination care delivery care fragmentation career career development clinical decision-making clinical examination clinical implementation clinical practice demographics design diverse data evidence base experience health disparity health equity human old age (65+)implementation science improved information gathering medical examination medical specialties member older patient oncology program patient health information patient-clinician communication predictive modeling professor routine practice screening shared decision making skills tenure track tool treatment planning unstructured data

项目摘要

PROJECT SUMMARY Melody K Schiaffino, PhD, MPH is a tenure-track Assistant Professor at San Diego State University (SDSU), a core faculty member in the Center for Health Equity, Education, and Research in Radiation Medicine and Translational Science at UC San Diego, and Associate Member of the UCSD Moores Cancer Center. Dr. Schiaffino received her PhD in Health Services Research in 2014 and MPH in Epidemiology in 2008. As a health disparities systems scientist, Dr. Schiaffino’s goals are to identify organizational and provider-level risk factors that affect how care is delivered to diverse older adults undergoing treatment for cancer to improve sub- optimal care delivery and treatment outcomes. Older, specifically minority, adults are at greater risk due to the higher symptom burden and treatment-related toxicity risk of cancer therapy. The proposal entitled, Improving age-related risk assessment and documentation in diverse older adults diagnosed with cancer, seeks to examine provider and documentation barriers that result in sub-optimal assessment of age-related risk. Age- related risk assessments are a series of evidence based clinical tests and screening that can improve cancer treatment planning for older adults, it is especially salient for older adults experiencing language barriers. There is currently insufficient research on the mechanisms contributing to sub-optimal assessment and documentation of age-related risk in radiation oncology. While evidence supports improved communication and cancer outcomes for patients when age-related risk is assessed, recent clinical trial findings show that only 1 in 4 providers are implementing this assessment in routine practice. Effective assessments are even less common in older adults with English language barriers. Understanding organizational and provider-level perspectives on assessment and documentation practices using electronic health records (EHRs), and qualitatively interviewing and observing oncologists, will help inform future clinic workflow redesign. The proposed career development and training plan supports Dr. Schiaffino’s trajectory toward becoming an independent, aging-systems scientist through the following three goals: 1) Obtain advanced natural language processing (NLP) algorithm development training to extract unstructured text from EHRs, 2) Engage in observation and training in geriatric oncology care delivery, to understand clinical workflow and clinical practices around assessment of age-related risk, and 3) Gain experience in clinical workflow implementation science proposal development. This project will take place at SDSU, UCSD, and City of Hope (Duarte, CA) with mentors who are experts in Geriatrics/Gerontology (Primary: Alison Moore, MD, MS); Radiation Oncology/HSR (Co- Primary: James Murphy, MD, MS, UCSD); Geriatric Oncology/ Decision-Making (Mentor: William Dale, MD, PhD, City of Hope); NLP/Bioinformatics (Mentor: Mike Hogarth, MD, UCSD); Predictive Models/Biostatistics (Collaborator: Barbara Bailey, PhD, SDSU) and clinical implementation science and Limited English Proficiency (LEP) disparities (Collaborator: Alicia Fernandez, MD, UCSF).

项目总结