Colon Cancer Risk Modification by PPI and HRI Therapy

描述(由申请人提供)： 候选人是胃肠病学初级教员和宾夕法尼亚大学临床流行病学和生物统计中心(CCEB)的临床流行病学教员。他是在布莱恩·L·斯特罗姆博士的赞助下申请这一指导临床科学家发展奖的，斯特罗姆博士是临床药物流行病学方面的权威，也是在生物医学研究中使用计算机化医疗数据的先驱。 应聘者的主要职业目标是成为胃肠病领域的独立临床研究员，主要专注于酸性消化系统疾病、胃肠道恶性肿瘤和药物流行病学。应聘者还对利用大型计算机化数据源回答以患者为中心的研究问题感兴趣。在拟议的培训期间，应聘者将使用经过验证的“90%研究/10%临床”的职业模式，这将提供临床研究问题的来源以及进行以患者为中心的研究的基础设施。他将完成流行病学和生物统计学的高级课程。他还将进行一项嵌套在大型计算机化医学研究数据库中的病例对照研究。在奖项的最后阶段，候选人将发展更多的研究想法，进行试点研究，并申请联邦研究(例如，R01)资助。 拟议的嵌套病例对照研究将调查长期(5年)质子泵抑制剂(PPI)治疗是否会增加结直肠癌的风险，以及长期(&>5年)HMG-CoA还原酶抑制剂(HRI)治疗是否会降低结直肠癌的风险。这项研究的数据将来自全科医学研究数据库(GPRD)，这是一个具有人口代表性的大型计算机系统，来自英国的医疗记录。这些病例将包括GPRD地区所有在首次确诊为结直肠癌之前在GPRD进行了5年随访的结直肠癌患者。对照将通过发病率密度抽样从所有在GPRD随访5年的患者中选择。利息的主要敞口是&gt；5年的PPI或HRI敞口。候选人将在生物统计分析中心的协助下，提取和调查原始数据，并创建分析数据集。应聘者将使用条件逻辑回归对数据进行分析。 这一奖项将使候选人能够完成必要的技能和经验的发展，以发展成为一名独立的学术研究人员。

DESCRIPTION (provided by applicant): The candidate is a junior faculty member in Gastroenterology and a faculty-fellow in Clinical Epidemiology at the Center for Clinical Epidemiology and Biostatistic (CCEB) of the University of Pennsylvania. He is applying for this Mentored Clinical Scientist Development Award under the sponsorship of Dr. Brian L. Strom, an authority on clinical pharmacoepidemiology and a pioneer in the use of computerized medical data in biomedical research. The candidate's principal career goal is to become an independent clinical investigator in the field of gastroenterology, with a primary focus on acid peptic disease, gastrointestinal malignancies and pharmacoepidemiology. The candidate is also interested in utilizing large computerized data sources to answer patient focused research questions. During the proposed training period, the candidate will use the proven "90% research / 10% clinical" career model, which will provide a source of clinical research questions as well as the infrastructure to conduct patient-oriented research. He will complete advanced courses in epidemiology and biostatistics. He will also conduct a case-control study nested within a large computerized medical research database. In the last phase of the award, the candidate will develop additional research ideas, perform pilot studies, and apply for federal research (e.g., R01) funding. The proposed nested case-control study will investigate whether long-term (> 5 years) proton pump inhibitor (PPI) therapy increases the risk of colorectal cancer, and whether long-term (> 5 years) HMG-CoA reductase inhibitor (HRI) therapy reduces the risk of colorectal cancer. Data for the study will come from the General Practice Research Database (GPRD), a large population-representative computerized system of medical records from the United Kingdom. The cases will consist of all colorectal cancer patients in the GPRD who have > 5 years of follow-up in the GPRD prior to their initial colorectal cancer diagnoses. The controls will be selected through incidence density sampling from all patients with > 5 years of follow-up in the GPRD. The primary exposure of interest is > 5 years of PPI or HRI exposure. The candidate will, with the assistance of the Biostatistical Analysis Center at the CCEB, extract and survey the raw data and create analytical datasets. The candidate will perform the analysis of the data using conditional logistic regression. This award will enable the candidate to complete the development of the skills and experience necessary to evolve into an independent academic investigator.