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Improving Risk-Stratification in Patients with Prolonged ICU Stays

改善长期入住 ICU 患者的风险分层

基本信息

批准号：
10621729
负责人：
Elizabeth Marie Viglianti
金额：
$ 19.66万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-01 至 2026-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10621729
关键词：
Achievement Admission activity American Austria Automobile Driving Award Bed Occupancy Beds Bioethics COVID-19 pandemic Caregivers Caring Chest Clinical Clinical stratification Cognitive Consult Critical Care Critical Illness Data Data Analyses Data Set Decision Making Development Development Plans Distress Ethics Event Evidence based practice Family Funding Goals Grant Healthcare Systems Hospital Mortality Hospitals Hour Institution Intensive Care Units Interview K-Series Research Career Programs Knowledge Learned Helplessness Longitudinal Surveys Longitudinal cohort Lung Manuscripts Medical Medical center Medicine Mental Depression Mentored Clinical Scientist Development Program Mentors Methodology Michigan Minority Morbidity - disease rate National Heart, Lung, and Blood Institute North Carolina Organ failure Outcome Palliative Care Paper Patient Admission Patient Care Patients Peer Review Physicians Population Prevalence Prevention Probability Process Prognosis Prospective cohort Provider Publications Publishing Research Resources Risk Scientist Scotland Shock Societies Source Structure Survey Methodology Surveys Symptoms System Universities Validation Variant Veterans Health Administration Work Writing acute hypoxemic respiratory failure biomarker identification career career development cohort cost design evidence base experience heuristics high risk improved lecturer palliative patient stratification patient subsets predictive tools prevent professor prognostication prospective psychologic response risk prediction risk prediction model risk stratification social systematic review

项目摘要

Project Summary Candidate’s Long-Term Career Goal: To become an independently funded physician-scientist with a clinical expertise in persistent critical illness and bioethics with a methodological expertise in longitudinal surveys. Clinical Problem: Patients with prolonged ICU stays are costly, increasing in prevalence, and resulting in long-term morbidity. Unfortunately, we have not been able to identify this cohort of patients early and subsequently have not been able to institute evidence-based processes to prevent its development. Candidate Background and Achievements: Dr. Viglianti is a Lecturer in Pulmonary and Critical Care Medicine at the University of Michigan (UM). She received her MD from Duke University, MPH from the University of North Carolina Chapel Hill, and MSc from UM. To date she has published 23 papers, including 14 original peer-reviewed manuscripts; 7 of which she is first author. She won a minority grant award from the American Thoracic Society, an F32 and loan repayment award from NHLBI, and an institutional K12. Regardless of the outcome of this proposal, her department anticipates she will be appointed to an assistant professor on or before July 1, 2021, with a start-up package including $250,000 of discretionary research fund. Career Development Plan: Dr. Viglianti proposes to develop new expertise in longitudinal survey methodology and analysis, and bioethics through formal coursework and mentored research. Her primary mentor is Dr. Theodore J. Iwashyna at UM, who has mentored 7 clinician-scientists on K awards, including 4 to R-level funding. She will be co-mentored by Dr. Mick Couper a research professor at the Institute of Social Research at UM who is an expert in design and implementation of longitudinal surveys. Aims: Using both prospective and retrospective surveys and secondary data, she will 1) Determine the accuracy of physicians to prognosticate new late-onset shock and acute hypoxic respiratory failure; 2) Develop hypotheses about sources of prognostication accuracy and inaccuracy by exploring heuristics, cognitive biases and bioethical principles and values; 3) Determine the extent to which variation in hospital rates of persistent critical illness are explained by new late-onset organ failures and palliative care utilization. Deliverables from Aims: The proposed aims will lead to at least 4 publications and prepare Dr. Viglianti to write 2 R01 proposals: 1) Develop and validate a new risk-prediction tool; 2) Identification of evidence-based practices utilized by high performing hospitals in the prevention and management of late-onset organ failures.

项目摘要候选人的长期职业目标：成为一名独立资助的医生-科学家，在持续性危重疾病和生物伦理学方面的专业知识，在纵向调查方面的方法学专业知识。临床问题：长期ICU停留的患者费用昂贵，患病率增加，并导致长期发病率。不幸的是，我们还没有能够早期识别出这组患者，随后，未能建立循证程序来防止其发展。候选人背景和成就：Viglianti博士是肺部和重症监护讲师密歇根大学医学院（UM）。她获得了杜克大学的医学博士学位，北卡罗来纳州查佩尔山大学，密歇根大学理学硕士。迄今为止，她已发表23篇论文，其中包括14篇原始同行评审的手稿; 7其中她是第一作者。她获得了少数民族补助金美国胸科协会，F32和贷款偿还奖从NHLBI，和机构K12。无论这一提议的结果如何，她所在的部门预计她将被任命为助理教授或之前2021年7月1日，与启动包，包括$250，000的自由裁量研究基金。职业发展计划：Viglianti博士建议在纵向调查中发展新的专业知识通过正式的课程和指导研究，学习方法和分析以及生物伦理学。她的主要导师是UM的西奥多J. Iwashyna博士，他指导了7名获得K奖的临床科学家，包括4名 R级融资。她将由社会研究所的研究教授Mick Couper博士共同指导在UM进行研究，他是纵向调查设计和实施方面的专家。目的：使用前瞻性和回顾性调查以及二手数据，她将1）确定医生诊断新发迟发性休克和急性缺氧性呼吸衰竭的准确性; 2）开发通过探索语言学、认知偏差，和生物伦理学原则和价值观; 3）确定在何种程度上变化的医院率的持续危重病的原因是新发迟发性器官衰竭和姑息治疗的利用。目标的可行性：拟定的目标将导致至少4篇出版物，并使Viglianti博士准备编写2个R 01提案：1）开发并验证新的风险预测工具; 2）识别基于证据的高绩效医院在预防和管理迟发性器官衰竭方面的实践。

项目成果

期刊论文数量（15）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Letters of Recommendation for PCCM Fellowship Applicants: Counting Words Is Just the Beginning. Reply to: More than Words? Looking for Gender Bias in Letters of Recommendation.

DOI：
10.34197/ats-scholar.2022-0129le
发表时间：
2023-03
期刊：
ATS scholar
影响因子：
1.9
作者：
Viglianti EM;Byrd KM;Sheffield V;Oliverio AL
通讯作者：
Oliverio AL

Variation by Institution in Sexual Harassment Experiences Among US Medical Interns.

DOI：
10.1001/jamanetworkopen.2023.49129
发表时间：
2023-12-01
期刊：
JAMA NETWORK OPEN
影响因子：
13.8
作者：
Viglianti, Elizabeth M.;Oliverio, Andrea L.;Pereira-Lima, Karina;Frank, Elena;Meeks, Lisa M.;Sen, Srijan;Bohnert, Amy S. B.
通讯作者：
Bohnert, Amy S. B.

Differences in international medical graduates' letters of recommendation by gender in pulmonary and critical care medicine: a cohort analysis.

DOI：
10.1186/s12909-023-04042-5
发表时间：
2023-01-24
期刊：
BMC MEDICAL EDUCATION
影响因子：
3.6
作者：
Byrd, Kaitland M.;Jain, Snigdha;Choudhuri, Irada;coruh, Basak;McSparron, Jakob I.;Viglianti, Elizabeth M.
通讯作者：
Viglianti, Elizabeth M.

Underreported Sexual Harassment Gives False Impression That the Situation Is Better Than It Is-Reply.

未充分报告的性骚扰会给人一种错误的印象，即情况比实际情况要好-回复。