Colon Cancer Risk Modification by PPI and HRI Therapy

描述（由申请人提供）： 候选人是宾夕法尼亚大学临床流行病学和生物统计学中心（CCEB）胃肠病学的初级教员和临床流行病学的教员研究员。他正在申请这个指导临床科学家发展奖的赞助下，博士布赖恩L。Strom博士是临床药物流行病学的权威，也是在生物医学研究中使用计算机化医学数据的先驱。 候选人的主要职业目标是成为胃肠病学领域的独立临床研究者，主要关注酸性消化道疾病，胃肠道恶性肿瘤和药物流行病学。候选人还对利用大型计算机数据源回答以患者为中心的研究问题感兴趣。在拟议的培训期间，候选人将使用经过验证的“90%研究/ 10%临床”职业模式，这将提供临床研究问题的来源以及进行以患者为导向的研究的基础设施。他将完成流行病学和生物统计学的高级课程。他还将在一个大型计算机化医学研究数据库中进行一项病例对照研究。在该奖项的最后阶段，候选人将开发额外的研究思路，进行试点研究，并申请联邦研究（例如，R 01）资金。 拟进行的巢式病例对照研究将调查长期（> 5年）质子泵抑制剂（PPI）治疗是否增加结直肠癌的风险，以及长期（> 5年）HMG-CoA还原酶抑制剂（HRI）治疗是否降低结直肠癌的风险。本研究的数据将来自全科医学研究数据库（GPRD），这是一个来自英国的大型人口代表性医疗记录计算机系统。这些病例将包括GPRD中的所有结直肠癌患者，这些患者在首次结直肠癌诊断之前在GPRD中随访> 5年。将通过从GPRD中随访> 5年的所有患者中进行发病率密度采样来选择对照。关注的主要暴露是> 5年的PPI或HRI暴露。候选人将在CCEB生物统计分析中心的协助下，提取和调查原始数据并创建分析数据集。候选人将使用条件逻辑回归对数据进行分析。 该奖项将使候选人能够完成发展成为独立学术调查员所需的技能和经验。

DESCRIPTION (provided by applicant): The candidate is a junior faculty member in Gastroenterology and a faculty-fellow in Clinical Epidemiology at the Center for Clinical Epidemiology and Biostatistic (CCEB) of the University of Pennsylvania. He is applying for this Mentored Clinical Scientist Development Award under the sponsorship of Dr. Brian L. Strom, an authority on clinical pharmacoepidemiology and a pioneer in the use of computerized medical data in biomedical research. The candidate's principal career goal is to become an independent clinical investigator in the field of gastroenterology, with a primary focus on acid peptic disease, gastrointestinal malignancies and pharmacoepidemiology. The candidate is also interested in utilizing large computerized data sources to answer patient focused research questions. During the proposed training period, the candidate will use the proven "90% research / 10% clinical" career model, which will provide a source of clinical research questions as well as the infrastructure to conduct patient-oriented research. He will complete advanced courses in epidemiology and biostatistics. He will also conduct a case-control study nested within a large computerized medical research database. In the last phase of the award, the candidate will develop additional research ideas, perform pilot studies, and apply for federal research (e.g., R01) funding. The proposed nested case-control study will investigate whether long-term (> 5 years) proton pump inhibitor (PPI) therapy increases the risk of colorectal cancer, and whether long-term (> 5 years) HMG-CoA reductase inhibitor (HRI) therapy reduces the risk of colorectal cancer. Data for the study will come from the General Practice Research Database (GPRD), a large population-representative computerized system of medical records from the United Kingdom. The cases will consist of all colorectal cancer patients in the GPRD who have > 5 years of follow-up in the GPRD prior to their initial colorectal cancer diagnoses. The controls will be selected through incidence density sampling from all patients with > 5 years of follow-up in the GPRD. The primary exposure of interest is > 5 years of PPI or HRI exposure. The candidate will, with the assistance of the Biostatistical Analysis Center at the CCEB, extract and survey the raw data and create analytical datasets. The candidate will perform the analysis of the data using conditional logistic regression. This award will enable the candidate to complete the development of the skills and experience necessary to evolve into an independent academic investigator.