Cardiovascular Disease Epidemiology in Medicaid Patients with Lupus

描述（由申请人提供）：自从完成她的风湿病学奖学金和研究培训，博士Costenbader一直致力于她的职业生涯，以病人为导向的风湿性疾病的研究。她曾担任33名博士前和博士后学员的初级或二级研究导师。沿着她作为布里格姆妇女医院狼疮中心的联合主任的职位，Costenbader博士的指导是由她与几个哈佛教学和培训计划的联系促进。此外，候选人的多个正在进行的以患者为导向的研究项目和合作，对指导的承诺，以及特殊的机构资源，为以患者为导向的风湿性疾病研究的初级研究人员的发展提供了一个出色的环境。这项K24补助金将保留Costenbader博士受保护的时间，并减轻未来的临床和行政责任。 新的研究目标将建立在过去的工作，在一个大的，全国性的狼疮人口与医疗补助数据从2000年至2010年。根据美国超过66,000名狼疮患者的数据，这些研究将解决关于心血管疾病风险、内科和外科护理以及结果的关键未回答问题。这些重要的问题包括心血管疾病的风险是否随着时间的推移而变化，心脏事件后和干预风险与普通人群相比如何，狼疮患者是否接受最佳的心脏护理，以及羟氯喹是否降低心血管疾病的风险。这一弱势群体固有的社会人口变化和高医疗风险使这些研究与正在进行的关于改善医疗保健和结果的政策讨论极其相关。这些强有力的研究结果将为未来提供信息。此外，拟议的研究将提供极好的指导机会。Costenbader博士每年将继续招募两到三名新学员进入她的风湿病流行病学和成果研究计划，并利用从学员、医疗保健和处方实践以及布里格姆妇女医院和哈佛医学院的研讨会和讲座收到的反馈，扩大和完善她的正式指导计划。基于机构的承诺和资源以及Costenbader博士在研究和指导方面的成功记录，这项K24资助将大大增强她扩大现有研究指导计划的能力，并培养下一代以患者为导向的风湿性疾病研究人员。

DESCRIPTION (provided by applicant): Since completing her rheumatology fellowship and research training, Dr. Costenbader has devoted her career to patient-oriented rheumatic disease research. She has served as primary or secondary research mentor for 33 pre- and post-doctoral trainees. Along with her position as Co-Director of the Brigham and Women's Hospital Lupus Center, Dr. Costenbader's mentoring is facilitated by her affiliations with several Harvard teaching and training programs. Moreover, the candidate's multiple ongoing patient-oriented research projects and collaborations, commitment to mentoring, and exceptional institutional resources provide an outstanding environment for the development of junior investigators in patient-oriented rheumatic disease research. This K24 grant would preserve Dr. Costenbader's protected time and relieve future clinical and administrative responsibilities. The new research aims proposed will build upon past work in a large, nationwide lupus population with Medicaid data from 2000-2010. With data on over 66,000 lupus patients in the U.S., these studies will address key unanswered questions about cardiovascular disease risks, medical and surgical care, and outcomes. These important questions include whether cardiovascular disease risks are changing over time in this population, how post-cardiac event and intervention risks compare to those of the general population, whether lupus patients receive optimal cardiac care, and whether hydroxychloroquine reduces cardiovascular disease risks. The inherent sociodemographic variation and high medical risk of this vulnerable population make these studies extremely relevant for ongoing policy discussions about improving healthcare and outcomes. The findings of these powerful studies will inform future . Moreover, the proposed research studies will provide excellent mentoring opportunities. Dr. Costenbader will continue to recruit two to three new trainees into her rheumatic disease epidemiology and outcomes research program each year, and to expand and refine her formal mentoring program using feedback received from trainees, medical care and prescribing practices and seminars and lectures at the Brigham and Women's Hospital and Harvard Medical School. Based on institutional commitment and resources and Dr. Costenbader's successful record in research and mentoring, this K24 grant would greatly augment her ability to expand her existing research mentoring program and to develop the next generation of patient-oriented rheumatic disease investigators.