Enumerating the Community Burden of Heart Failure

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·艾弗里博士走上了一条独立的道路 研究。候选人是一位训练有素的流行病学家，在艾滋病领域有着显著的研究记录。 心血管疾病流行病学。她的目标是将这些技能与临床上的重点培训结合起来 在基础科学、临床实践和人群之间成为独立科学家的研究 研究。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，候选人将通过与临床互动来扩展她的临床研究技能 在心力衰竭研究方面是富有成效的科学家的专家，从事正式的教学，参加 多学科研讨会、杂志俱乐部和科学会议，与导师一起参加学习活动， 并领导了一个项目，开发适用于临床实践的新型心力衰竭分类工具和 人口研究。这些活动将由凯南的导师Gerardo Heiss博士博士监督 流行病学教授兼共同导师Patricia Chang博士，MHS FACC医学博士， 医学。此外，一个具有互补专业领域的合作者团队将补充Dr。 艾弗里在特定领域的训练。导师、共同导师和合作者共同致力于 协助应聘者实现她的研究、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转变为独立研究员。在独立期间 R00颁奖阶段，候选人将在K99组件期间开发的工具应用于 正在进行的社区动脉粥样硬化风险(ARIC)研究。为此，ARIC研究调查人员 提供有关队列的随访电话、医生就诊、急诊科就诊和 住院治疗和相关诊断。该信息库将与门诊和门诊相结合 住院医疗保险索赔数据和参与者主治医生的报告，以估计心脏负担 ARIC研究参与者的失败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急性/失代偿性心力衰竭事件的转变 需要住院治疗。拟议的研究既是新颖的，又具有重大的翻译潜力， 心力衰竭的早期诊断和积极管理以及健康服务的可能相关性 分配和方案评估。这项研究的短期好处将是对以下方面的贡献： 研究地区心力衰竭患者的门诊负担及其在社区中的长期趋势。

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.