Enumerating the Community Burden of Heart Failure

摘要 这是一个国家卫生研究院途径独立奖（K99/R00）赠款提案，旨在促进职业生涯， 博士北卡罗来纳州大学博士后克里斯蒂·艾弗里博士走上了独立自主的道路。 research.候选人是一名训练有素的流行病学家，在以下领域有着重要的研究记录： 心血管疾病流行病学她的目标是将这些技能与临床培训相结合， 研究成为一个独立的科学家在基础科学，临床实践和人口的接口 research.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，候选人将通过与临床研究人员的互动来扩展其临床研究技能。 专家是心力衰竭研究中富有成效的科学家，从事正式的教学，参加 多学科研讨会、期刊俱乐部和科学会议，与导师一起参加学习活动， 并领导一个项目，开发适用于临床实践的新型心力衰竭分类工具， 人口研究。这些活动将由导师Gerardo Heiss博士，凯南博士， 流行病学教授和共同导师Patricia Chang博士，MD MHS FACC，助理教授 药此外，一个具有互补专业领域的合作者团队将补充博士。 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 协助候选人达到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到独立研究员的成功过渡。在独立期间 R00奖励阶段，候选人将在 社区动脉粥样硬化风险研究（ARIC）为此，ARIC研究者 提供关于队列随访电话、医生就诊、急诊科就诊的可用数据， 住院和相关诊断。该信息库将与门诊和 住院医疗保险索赔数据和参与者治疗医生的报告，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 从门诊治疗的心力衰竭转变为急性/失代偿性心力衰竭事件 需要住院治疗。这项研究既新颖又具有巨大的翻译潜力， 可能与心力衰竭的早期诊断和积极管理以及卫生服务相关 分配和项目评估。这项研究的短期效益将是对下- 量化HF门诊负担及其在社区的长期趋势的研究领域。

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.