Patient-Oriented Research in Skin Diseases

描述(由申请人提供)：本申请建议续签加州大学旧金山分校(UCSF)皮肤病教授玛丽-玛格丽特·克伦医学博士的以患者为导向研究的职业中期研究员奖。Chren博士的长期职业目标是进行严格的研究，以改善皮肤病患者的健康，并利用她的研究在面向患者的皮肤病研究中培养一流的研究人员。这个新的奖项将以她之前的工作为基础，并实现她近期的职业目标：第一，扩大和完成下一阶段的非黑色素瘤皮肤癌(NMSC)队列研究，这是一项针对NMSC(最常见的恶性肿瘤)治疗方法的为期10年的疗效比较研究；第二，在这些研究结果的基础上开发和进行一项针对NMSC治疗方法的有针对性的多中心临床试验；第三，利用这些研究数据在以患者为导向的研究中指导临床医生研究人员；以及第四，通过在加州大学旧金山分校临床与转化科学研究所(CTSI)的导师关系发展计划中发挥更大的领导作用，扩大她的指导活动范围。这项拟议的研究将填补目前对两种最常见的NMSC治疗方法--手术切除和组织学引导下的系列切除，或称Mohs手术--疗效比较的认识空白。这项研究将采取循序渐进的发展步骤，设计和进行一项多中心随机对照试验，对原发面部基底细胞癌(BCC)进行切除和莫氏手术。这些步骤包括建立研究、临床和利益相关者咨询小组，组成研究工具，起草研究程序，并对程序进行试点测试。在基础设施开发后，1200名患有原发面部基底细胞癌的患者将随机接受手术切除或Mohs手术。主要结果是肿瘤在五年内复发；次要结果是皮肤相关的生活质量。拟议的指导计划包括三个部分：教学课程、实践研究和职业发展；随着新奖项的颁发，教学选项将与CTSI的高度指导课程的综合计划完全整合。Chren博士作为CTSI导师发展计划导师评估计划的领导者，将促进这种强化的整合。研究计划和指导计划共同提供了一个新的五年计划，与NIH和NIAMS追求和应用知识以减少疾病负担以及培训科学家进行此类研究的任务直接相关。

DESCRIPTION (provided by applicant): This application proposes a renewal of a Midcareer Investigator Award in Patient-Oriented Research for Mary-Margaret Chren, MD, Professor of Dermatology at the University of California, San Francisco (UCSF). Dr. Chren's long-term career objectives are to perform rigorous research to improve the health of patients with skin diseases, and to use her research to develop first-rate investigators in patient-oriented research in skin diseases. This renewed award will build on her previous work and accomplish her immediate career objectives: first, to expand and complete the next phase of the Nonmelanoma Skin Cancer (NMSC) Cohort Study, a 10-year comparative effectiveness study of treatments for NMSC (the most common malignancy); second, to build on these findings to develop and perform a targeted multicenter clinical trial of treatments for NMSC; third, to use these research data as a substrate for the mentoring of clinician investigators in patient-oriented research; and fourth, to increase the scope of her mentoring activity by serving an expanded leadership role with the Mentorship Development Program of the UCSF Clinical & Translational Science Institute (CTSI). The proposed research will fill a gap in current knowledge about the comparative efficacy of the two most common treatments for NMSC, surgical excision and histologically-guided serial excision, or Mohs surgery. The research will undertake the incremental developmental steps to design and conduct a multicenter randomized controlled trial of excision and Mohs surgery for primary facial basal cell carcinomas (BCC). These steps include establishment of research, clinical, and stakeholder advisory groups, composition of study tools, drafting of study procedures, and pilot-testing of procedures. After infrastructure development, 1200 patients with primary facial BCC will be randomized to surgical excision or Mohs surgery. The primary outcome is tumor recurrence at five years; secondary outcome is skin-related quality of life. The proposed mentoring plan has three parts: didactic curricula, "hands-on" research, and career development; with the renewed award, didactic options will be fully integrated with CTSI's comprehensive program of highly-directed courses. This enhanced integration will be fostered by Dr. Chren's role as leader of the Mentor Evaluation Plan for the CTSI's Mentorship Development Program. Together, the Research Plan and Mentoring Plan provide a new five-year strategy that is directly relevant to the NIH and NIAMS missions of pursuing and applying knowledge to reduce disease burden, and training scientists to carry out such research.