Stadardized Assesment of Swallowing Impairment

描述（由申请人提供）：候选人对该奖励机制的兴趣源于她的职业道路，包括将有意义的以患者为导向的研究整合到评估和治疗吞咽障碍患者的临床实践中。该候选人的最终职业目标是独立研究和确定成人慢性肺部疾病患者的功能性吞咽障碍；然而，目前还没有经过验证或可靠的测量工具来检测和量化吞咽损伤。对于慢性肺部疾病患者独立吞咽研究的未来途径，需要开发一种用于改良钡吞咽评估的吞咽损害测量工具。该工具（MBSImP）将具有临床意义，实际执行，可靠评分，对观察到的吸入情况以及健康和生活质量的外部指标敏感。该奖项的结构提供了一个工具，以促进这些短期和长期目标的实现，并使候选人从临床卓越和早期临床科学家成功发展为独立的临床研究人员。研究计划中提出了一种复杂的还原和聚合策略，该策略需要应用多元统计分析、测量理论和量表开发、因子分析和潜在变量建模等知识。在她的职业规划中，候选人有一位导师和外部顾问来监督她的综合课程，包括教学课程和统计设计、测量和因素分析领域的独立研究。要实现候选人的既定职业目标，需要对上消化道的大体解剖、生理和病理生理有全面的了解。作为吞咽和吞咽障碍领域的高级临床科学家，需要理解和应用重叠吞咽生理学。虽然Martin-Harris博士在口咽吞咽动力学和肺功能的临床研究方面表现出很强的临床熟练程度，但她对颈椎、胸椎和食管远端结构和功能的了解不足。肺部疾病患者和本研究计划拟研究的患者往往同时存在口咽吞咽障碍和食管吞咽障碍。因此，候选人包括了高级头颈部和胸部解剖，头颈部手术旋转的教学课程，以及她的主要导师，世界知名的临床医生和食道吞咽障碍研究员的独立研究。

DESCRIPTION (provided by applicant): The origin of the candidate's interest in this award mechanism stems from her career pathway that has included the integration of meaningful patient-oriented research into the clinical practice of evaluating and treating patients with swallowing disorders. The ultimate career goal of the candidate is to independently study and define functional swallowing impairment in adult patients with chronic pulmonary disease; however, there exists no validated or reliable measurement tool that permits the detection and quantification of swallowing impairment. A preliminary step toward the future pathway of independent swallowing research of patients with chronic pulmonary disease will require the development of a swallowing impairment measurement tool to be used during the modified barium swallowing evaluation. This tool (the MBSImP) will be clinically meaningful, practically implemented, reliably scored and sensitive to the presence of observed aspiration and to external indicators of health and quality of life. The structure of this award provides a vehicle to facilitate achievement of these short-term and long-term goals, and to the candidate's successful progression from clinical excellence and early stage clinical scientist to an independent clinical researcher. A complex reduction and aggregation strategy is proposed in the research plan that requires knowledge of applied multivariate statistical analyses, measurement theory and scale development, factor analysis and latent variable modeling. The candidate has included a mentor and external advisor to oversee a comprehensive curriculum in her Career Plan that includes didactic coursework and independent studies in the areas of statistical design, measurement, and factor analysis. Achievement of the candidate's stated career goals will require comprehensive understanding of the gross anatomy, physiology and pathophysiology of the upper aerodigestive tract in its entirety. Advanced competency as a clinical scientist in the area of swallowing and swallowing disorders will require understanding and application of overlapping swallowing physiology. While Dr. Martin-Harris demonstrates strong clinical proficiency in the clinical study of oropharyngeal swallowing dynamics and pulmonary function, she has insufficient knowledge of cervical, thoracic and distal esophageal structure and function. Patients with pulmonary disease and the prospective patients to be studied in the research plan often present with coexisting oropharyngeal and esophageal swallowing disorders. Therefore, the Candidate has included didactic coursework in advanced head, neck and chest anatomy, head and neck surgical rotations, and independent studies with her primary mentor, a world renowned clinician and researcher of esophageal swallowing disorders.