Cardiovascular Disease Epidemiology in Medicaid Patients with Lupus

描述（由申请人提供）：自从完成风湿病学奖学金和研究培训后，Costenbader博士致力于以患者为导向的风湿病研究。先后担任了33名在读前后博士生的一级或二级研究导师。除了担任布里格姆妇女医院狼疮中心的联合主任外，她还参与了哈佛大学的几个教学和培训项目，为她提供指导。此外，候选人的多个正在进行的面向患者的研究项目和合作，对指导的承诺，以及特殊的机构资源，为面向患者的风湿病研究的初级研究者的发展提供了良好的环境。这笔K24拨款将保留科斯滕巴德博士的受保护时间，并减轻未来的临床和行政责任。提出的新研究目标将建立在过去对2000-2010年全国范围内大量狼疮患者的研究基础上。这些研究收集了美国66,000多名狼疮患者的数据，将解决有关心血管疾病风险、医疗和手术护理以及结果的关键问题。这些重要的问题包括：在这一人群中，心血管疾病风险是否随着时间的推移而改变；与一般人群相比，心脏事件和干预风险如何；狼疮患者是否接受了最佳的心脏护理；羟氯喹是否降低了心血管疾病风险。这些弱势群体固有的社会人口差异和高医疗风险使得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非常相关。这些强有力的研究结果将为未来提供信息。此外，拟议的研究将提供良好的指导机会。Costenbader博士每年将继续为她的风湿病流行病学和结果研究项目招募两到三名新学员，并利用从学员、医疗保健和处方实践以及布莱根妇女医院和哈佛医学院的研讨会和讲座中收到的反馈，扩大和完善她的正式指导计划。基于机构承诺和资源以及Costenbader博士在研究和指导方面的成功记录，K24资助将极大地增强她扩展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.