Enumerating the Community Burden of Heart Failure

描述(由申请人提供)： 摘要这是一项NIH独立之路奖(K99/R00)拨款提案，旨在促进北卡罗来纳大学博士后克里斯蒂·艾弗里博士的职业生涯进入独立研究之路。候选人是一位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，成为一名从事基础科学、临床实践和人口研究的独立科学家。建议的体验式发展的主题领域是心力衰竭的转化性研究。在指导的K99阶段，候选人将通过与心力衰竭研究中富有成效的科学家的临床专家互动，参与正式的教学，参加多学科研讨会、杂志俱乐部和科学会议，与导师一起参与研究活动，以及领导一个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的项目，来扩展她的临床研究技能。这些活动将由导师Gerardo Heiss医学博士博士、凯南流行病学教授和共同导师Patricia Chang博士监督，他是医学MHS FACC医学助理教授。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，并确保候选人成功地从博士后研究员过渡到独立研究员。在独立的R00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)研究的队列中应用在K99部分期间开发的工具。为此，ARIC研究调查人员正在提供有关队列的随访电话、医生就诊、急诊科就诊和住院治疗以及相关诊断的数据。这个信息库将与参与者的治疗医生的门诊和住院医疗保险索赔数据和报告结合起来，以估计ARIC研究参与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管理的心力衰竭到需要住院的急性/失代偿性心力衰竭事件的转变。这项拟议的研究既是新颖的，也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计划评估有关。这项研究的短期好处将是对未被研究的地区量化心力衰竭的门诊负担及其在社区中的长期趋势的贡献。 公共卫生相关性：项目叙述心力衰竭是一种常见的、代价高昂的、致残的、往往是致命的疾病，给世界各地的医疗保健系统带来了巨大的负担。对社区心力衰竭负担的估计对于卫生服务分配和计划评估是必不可少的，但目前很少有量化心力衰竭负担的计划存在。这项研究的结果将有助于衡量美国心力衰竭的患病率以及随着时间的推移它是如何变化的。

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.