Image based cardiovascular risk communication in high risk patients with diabetes

应聘者描述(由申请人提供)：应聘者是加州大学欧文分校的心脏病专家和初级卫生服务研究员。她的长期目标是作为一名预防心脏病学的研究人员发展一项独立的职业生涯，专注于应用新的工具来预防糖尿病和代谢综合征患者的心血管疾病。拟议的五年培训计划包括授课课程、硕士学位和强大的导师指导，以提供以患者为中心的研究、临床试验设计和现有图像数据的新用途方面的培训。该提案的总体目标是将她在心血管成像方面的专业知识与她在医患关系中进行风险沟通的兴趣结合起来。她将接受以患者为中心的护理专家Sherrie Kaplan博士的指导，并由质量评估领域的专家Sheldon Greenfield博士和心脏CT成像专家Matthew Budoff博士共同指导。我们提出的研究目标是了解心血管风险是如何传递的，以及个性化的风险信息如何激励预防性行为。我们的目标是：1)确定初级保健医生向糖尿病患者传达心血管风险的方式和频率；开发和测试一种措施，以捕获关于心血管风险的医患沟通；以及3.)评估使用已有的冠状动脉心脏CT血管成像和仅使用Framingham Risk Score(FRS)和FRS来传达心血管风险对患者对风险的了解、风险行为的改变和风险因素减少的影响。这项培训赠款研究部分的知识将构成RO1申请的基础，以检验以下假设：亚临床疾病的图像可以有效地进行风险沟通，特别是在有识字、语言或文化障碍的患者中。

DESCRIPTION (provided by applicant): The candidate is a cardiologist and junior health services researcher at University of California, Irvine. Her long-term goal is to develop an independent career as a researcher in preventive cardiology with a focus on applying new tools to prevent cardiovascular disease in those with diabetes and metabolic syndrome. The proposed five year training program includes didactic coursework, a Master's degree, and strong mentorship to provide training in patient-centered research, clinical trial design and novel uses of existing image data. The proposal has an overall aim of the candidate integrating her expertise in cardiovascular imaging with her interest in risk communication within the context of the patient doctor relationship. She will be mentored by Dr. Sherrie Kaplan an expert in patient-centered care and co-mentored by Dr. Sheldon Greenfield, an expert in the field of quality assessment and by Dr. Matthew Budoff who is an expert on cardiac CT imaging. Our proposed study goal is to understand how cardiovascular risk is communicated and how personalized risk information can motivate preventative behavior. We aim to: 1.) Determine how and with what frequency cardiovascular risk is communicated by primary care physicians to their patients with diabetes; 2.) Develop and test a measure to capture physician-patient communication about cardiovascular risk; and 3.) Assess the effect of communicating cardiovascular risk with pre-existing cardiac CT angiogram images of coronary arteries and Framingham Risk Score (FRS) versus FRS only on patient understanding of risk, change in risk behavior, and risk factor reduction. Knowledge from the research portion of this training grant will form the basis of an RO1 application to test the hypothesis that images of subclinical disease can be effective in risk communication, particularly in patients with literacy, linguistic or cultural barriers.