Improving Kidney Health Assessment in Young Patients with Spina Bifida

项目总结 这一职业发展奖将帮助医学博士朱成为一名独立的外科医生和科学家 世卫组织将提出改善年轻脊柱患者肾脏、膀胱和整体健康的证据 先天性裂。朱博士将利用这一奖项，在他现有的临床流行病学基础上，实现五个 职业发展目标：1)培养以患者为中心的研究(POR)方面的专业知识；2)获得以下方面的经验 定性研究；3)获得制定和实施共识战略的知识；4)加强 研究组合和技能；以及5)建立跨学科、多机构的研究 合作。这些技能将使他能够将研究转化为临床实践，以改善 脊柱裂患者。朱博士将通过职业发展计划实现这些职业目标 包括密集的体验式培训、结构化的教学和研讨会，以及全面的指导 程序。他的主要导师是Tamara Isakova博士，她是慢性肾脏疾病POR方面的专家， 杰出的校外资助和指导记录。他的共同导师是郑伯爵博士，他是中国 小儿泌尿外科重建手术与脊柱裂的护理。他的咨询委员会包括 肾功能方程式的跨学科专家(Susan Furth博士，医学博士，博士)、定性研究(Dr。 医学博士，医学博士，医学硕士)，以及 高级实施科学方法论(博士贾斯汀·史密斯博士)。朱博士的职业发展计划 将得到Lurie儿童医院和西北大学特殊机构环境的支持 大学，包括Lurie儿童医院内的专用资源和研究基础设施 泌尿外科和外科；2)健壮、大容量、多学科的鲁丽儿童 医院脊柱裂临床；3)西北大学临床和研究中心的大力支持 翻译科学研究所和公共卫生与医学研究所。这样做的总体目标是 科学建议改进年轻脊柱患者肾脏健康评估工具和方法 先天性裂。不同的指南优先保护这些患者的肾脏健康，但初步证据 表明目前评估肾脏健康的工具和方法是不准确的，不是以患者为中心的， 并且不是由提供商统一实现的。这项建议的目的是：1)比较现有肾脏 金标准碘海醇血浆清除试验的函数估计方程和开发新的脊柱裂 具体公式；2)评估患者对肾脏健康和评估的知识、态度和信念， 以修订的健康信念模型为指导；以及3)评估提供者的偏好、障碍和促进者 制定肾脏健康监测方法和战略，形成共识实施做法。这个 结合先进的定量、定性和实施研究方法和指导 培训将确保朱博士在脊柱裂护理领域成为一名非常成功的独立研究员。

PROJECT SUMMARY This Career Development Award will help David I. Chu, MD, MSCE, become an independent surgeon-scientist who will develop the evidence to improve kidney, bladder, and overall health in young patients with spina bifida. Dr. Chu will use this award to build on his existing foundation in clinical epidemiology to achieve five career development goals: 1) Develop expertise in patient-oriented research (POR); 2) Acquire experience in qualitative research; 3) Gain knowledge in creating and implementing consensus strategies; 4) Strengthen research portfolio and grantsmanship skills; and 5) Build inter-disciplinary, multi-institutional research collaborations. These skills will allow him to translate research into clinical practice to improve outcomes in patients with spina bifida. Dr. Chu will achieve these career objectives through a career development plan that consists of intensive experiential training, structured didactics and workshops, and a comprehensive mentoring program. His Primary Mentor is Dr. Tamara Isakova, an expert in POR in chronic kidney disease with an outstanding record of extramural funding and mentorship. His Co-Mentor is Dr. Earl Cheng, a national leader in pediatric urologic reconstructive surgery and spina bifida care. His Advisory Committee includes interdisciplinary experts in kidney function equations (Dr. Susan Furth, MD, PhD), qualitative research (Dr. Elisa Gordon, PhD, MPH), consensus-building and implementation in surgery (Dr. Mehul Raval, MD, MS), and advanced implementation science methodology (Dr. Justin Smith, PhD). Dr. Chu’s career development plan will be supported by the exceptional institutional environment of Lurie Children’s Hospital and Northwestern University, including the 1) Dedicated resources and research infrastructure within Lurie Children’s Hospital’s Division of Urology and Department of Surgery; 2) Robust, high-volume, and multi-disciplinary Lurie Children’s Hospital Spina Bifida Clinic; and 3) Strong research support from Northwestern University’s Clinical and Translation Sciences Institute and the Institute for Public Health and Medicine. The overall objective of this scientific proposal is to improve kidney health assessment tools and approaches in young patients with spina bifida. Various guidelines prioritize preserving kidney health in these patients, but preliminary evidence suggests that current tools and approaches for assessing kidney health are inaccurate, not patient-centered, and not uniformly implemented by providers. The Aims of this proposal are to: 1) Compare current kidney function estimating equations to gold-standard iohexol plasma clearance tests and develop novel, spina-bifida- specific equations; 2) Assess patient knowledge, attitudes, and beliefs towards kidney health and evaluation, guided by the revised Health Belief Model; and 3) Assess provider preferences, barriers, and facilitators towards kidney health surveillance methods and strategies to create consensus implementation practices. The combination of advanced quantitative, qualitative, and implementation research methods and mentored training will ensure Dr. Chu emerges as a highly successful, independent investigator in spina bifida care.