Enumerating the Community Burden of Heart Failure

描述（由申请人提供）： 摘要这是一个NIH独立之路奖（K99/R 00）的资助提案，旨在促进北卡罗来纳州大学博士后Christy Avery博士的职业生涯，使其走上独立研究的道路。候选人是一名训练有素的流行病学家，在心血管疾病流行病学领域有着重要的研究记录。她的目标是将这些技能与临床研究的重点培训相结合，成为基础科学，临床实践和人口研究界面的独立科学家。拟议的经验发展的主题领域是心力衰竭的转化研究。在指导K99阶段，候选人将通过与心力衰竭研究领域的临床专家互动，参与正式教学，参加多学科研讨会，期刊俱乐部和科学会议，与导师一起参加研究活动，并领导一个项目，开发适用于临床实践和人群研究的新型心力衰竭分类工具。这些活动将由导师Gerardo Heiss博士，医学博士，凯南流行病学教授和共同导师Patricia Chang博士，医学博士MHS FACC，医学助理教授监督。此外，一个具有互补专业领域的合作者团队将补充艾弗里博士在特定领域的培训。导师、共同导师和合作者共同致力于帮助候选人实现她的研究培训和职业发展目标，并确保候选人从博士后研究员成功过渡到独立研究员。在独立R 00奖励阶段，候选人将在正在进行的社区动脉粥样硬化风险（ARIC）研究的队列中应用K99部分开发的工具。为此，ARIC研究人员正在提供有关队列随访电话、医生就诊、急诊科就诊和住院以及相关诊断的数据。该信息库将与门诊和住院医疗保险索赔数据和受试者治疗医生的报告相结合，以估计ARIC研究受试者的心力衰竭负担及其诊断和护理模式。候选人还将描述从门诊治疗的心力衰竭到需要住院治疗的急性/失代偿性心力衰竭事件的转变。拟议的研究既新颖又具有重大的翻译潜力，可能与心力衰竭的早期诊断和积极管理以及卫生服务分配和项目评估相关。本研究的短期受益将有助于量化HF门诊负担及其在社区中的长期趋势。 公共卫生相关性：心力衰竭是一种常见、昂贵、致残且往往致命的疾病，给全球医疗保健系统带来巨大负担。社区心力衰竭负担的估计是必不可少的卫生服务分配和项目评估，但目前很少有项目量化心力衰竭的负担。这项研究的结果将有助于衡量心力衰竭的患病率以及它在美国的变化。

DESCRIPTION (provided by applicant): ABSTRACT This is a NIH Pathway to Independence Award (K99/R00) grant proposal, intended to promote the career of Dr. Christy Avery, PhD, a post-doctoral fellow at the University of North Carolina, into a path of independent research. The Candidate is a trained epidemiologist with a significant track record of research in the field of cardiovascular disease epidemiology. Her goal is to integrate these skills with focused training in clinical research to become an independent scientist at the interface of basic science, clinical practice, and population research. The topical area for the proposed experiential development is translational research in heart failure. During the mentored K99 phase the Candidate will expand her clinical research skills by interacting with clinical specialists who are productive scientists in heart failure research, engaging in formal didactics, attending multidisciplinary seminars, journal clubs, and scientific meetings, participating study activities with her mentors, and by leading a project that develops novel heart failure classification tools applicable to clinical practice and population research. These activities will be supervised by mentor Dr. Gerardo Heiss MD PhD, Kenan Professor of Epidemiology and co-mentor Dr. Patricia Chang, MD MHS FACC, Assistant Professor of Medicine. In addition, a team of collaborators with complementary areas of expertise will supplement Dr. Avery's training in specific areas. Together, the mentor, co-mentor, and collaborators are fully committed to assisting the Candidate reach her research training and career development goals and to ensuring the Candidate's successful transition from postdoctoral fellow to independent researcher. During the independent R00 award phase, the Candidate will apply the tools developed during the K99 component in the cohort of the ongoing Atherosclerosis Risk in Communities (ARIC) Study. For this purpose the ARIC study investigators are making available data on the cohort's follow-up calls, their physician visits, emergency department visits and hospitalizations, and the associated diagnoses. This information base will be combined with outpatient and inpatient Medicare claims data and reports by participant's treating physicians to estimate the burden of heart failure and its patterns of diagnosis and care in ARIC Study participants. The Candidate also will characterize the transition from heart failure managed in outpatient settings to acute/decompensated heart failure events requiring hospitalization. The proposed research is both novel and of major potential for translation, with possible relevance for early diagnosis and proactive management of heart failure as well as for health services allocation and program evaluation. The short term benefits from this study will be a contribution to the under- studied area of quantifying the outpatient burden of HF and its secular trends in communities. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE Heart failure is a common, costly, disabling, and often fatal disorder that places a tremendous burden on healthcare systems worldwide. Estimates of the community heart failure burden are essential for health services allocation and program evaluation, yet few programs quantifying the burden of heart failure currently exist. Results from this study will help measure the prevalence of heart failure and how it has changed through time in the United States.