Improving Kidney Health Assessment in Young Patients with Spina Bifida

项目摘要 这个职业发展奖将帮助大卫一。Chu，MD，MSCE，成为独立的外科医生-科学家 世卫组织将开发证据，以改善年轻脊柱患者的肾脏、膀胱和整体健康。 裂。朱博士将利用这一奖项，以建立他在临床流行病学现有的基础上， 职业发展目标：1）发展以患者为导向的研究（POR）的专业知识; 2）获得经验， 定性研究; 3）获得创建和实施共识战略的知识; 4）加强 研究投资组合和granonymous技能;和5）建立跨学科，多机构的研究 合作。这些技能将使他能够将研究转化为临床实践，以改善结果， 脊柱裂患者。朱博士将通过职业发展计划实现这些职业目标， 包括密集的体验式培训，结构化的教学和研讨会，以及全面的指导 程序.他的主要导师是Tamara Isakova博士，他是慢性肾脏疾病POR的专家， 杰出的校外资助和指导记录他的共同导师是Earl Cheng博士，一位国家领导人， 小儿泌尿外科重建手术和脊柱裂护理。他的顾问委员会包括 肾功能方程的跨学科专家（Susan Furth博士，医学博士，博士），定性研究（Dr. Elisa Gordon，PhD，MPH），外科共识的建立和实施（Mehul Raval博士，MD，MS），以及 高级实施科学方法（Justin Smith博士，博士）。朱博士的职业发展计划 将得到Lurie儿童医院和西北大学的特殊机构环境的支持 大学，包括1）Lurie儿童医院内的专用资源和研究基础设施 泌尿科和外科; 2）强大的，大容量的，多学科的Lurie儿童 医院脊柱裂诊所; 3）来自西北大学临床和 翻译科学研究所和公共卫生和医学研究所。本报告的总体目标 一项科学建议是改善年轻脊柱患者的肾脏健康评估工具和方法， 裂。各种指南优先考虑保护这些患者的肾脏健康，但初步证据表明， 表明目前评估肾脏健康的工具和方法是不准确的，不是以患者为中心， 而不是由供应商统一实现。本提案的目的是：1）比较当前肾脏 功能估计方程金标准碘海醇血浆清除试验，并开发新的，脊柱裂， 2）评估患者对肾脏健康和评估的知识、态度和信念， 在修订后的健康信念模型的指导下; 3）评估提供者的偏好，障碍和促进者 制定肾脏健康监测方法和战略，以建立共识实施做法。的 结合先进的定量，定性和实施研究方法和指导 培训将确保朱博士成为一个非常成功的，独立的研究人员在脊柱裂护理。

PROJECT SUMMARY This Career Development Award will help David I. Chu, MD, MSCE, become an independent surgeon-scientist who will develop the evidence to improve kidney, bladder, and overall health in young patients with spina bifida. Dr. Chu will use this award to build on his existing foundation in clinical epidemiology to achieve five career development goals: 1) Develop expertise in patient-oriented research (POR); 2) Acquire experience in qualitative research; 3) Gain knowledge in creating and implementing consensus strategies; 4) Strengthen research portfolio and grantsmanship skills; and 5) Build inter-disciplinary, multi-institutional research collaborations. These skills will allow him to translate research into clinical practice to improve outcomes in patients with spina bifida. Dr. Chu will achieve these career objectives through a career development plan that consists of intensive experiential training, structured didactics and workshops, and a comprehensive mentoring program. His Primary Mentor is Dr. Tamara Isakova, an expert in POR in chronic kidney disease with an outstanding record of extramural funding and mentorship. His Co-Mentor is Dr. Earl Cheng, a national leader in pediatric urologic reconstructive surgery and spina bifida care. His Advisory Committee includes interdisciplinary experts in kidney function equations (Dr. Susan Furth, MD, PhD), qualitative research (Dr. Elisa Gordon, PhD, MPH), consensus-building and implementation in surgery (Dr. Mehul Raval, MD, MS), and advanced implementation science methodology (Dr. Justin Smith, PhD). Dr. Chu’s career development plan will be supported by the exceptional institutional environment of Lurie Children’s Hospital and Northwestern University, including the 1) Dedicated resources and research infrastructure within Lurie Children’s Hospital’s Division of Urology and Department of Surgery; 2) Robust, high-volume, and multi-disciplinary Lurie Children’s Hospital Spina Bifida Clinic; and 3) Strong research support from Northwestern University’s Clinical and Translation Sciences Institute and the Institute for Public Health and Medicine. The overall objective of this scientific proposal is to improve kidney health assessment tools and approaches in young patients with spina bifida. Various guidelines prioritize preserving kidney health in these patients, but preliminary evidence suggests that current tools and approaches for assessing kidney health are inaccurate, not patient-centered, and not uniformly implemented by providers. The Aims of this proposal are to: 1) Compare current kidney function estimating equations to gold-standard iohexol plasma clearance tests and develop novel, spina-bifida- specific equations; 2) Assess patient knowledge, attitudes, and beliefs towards kidney health and evaluation, guided by the revised Health Belief Model; and 3) Assess provider preferences, barriers, and facilitators towards kidney health surveillance methods and strategies to create consensus implementation practices. The combination of advanced quantitative, qualitative, and implementation research methods and mentored training will ensure Dr. Chu emerges as a highly successful, independent investigator in spina bifida care.