NRSA Postdoctoral Comparative Effectiveness Development Training Award

描述(由申请人提供)：布朗大学老年学和医疗保健研究中心寻求补充其由AHRQ资助的25年博士后培训计划，包括三个额外的比较有效性研究(CER)博士后培训时段。我们中心的研究重点是影响老年人的疾病，如癌症、心血管疾病和痴呆症。这些疾病是美国死亡和发病的主要原因之一，占全国卫生保健支出的很大比例。我们的研究组合跨越多个环境(退伍军人管理局、医院、疗养院、门诊设施)，重点关注1)癌症成像的比较有效性；2)患有痴呆症的疗养院居民的临床治疗选择；3)各州医疗补助政策对重要临床结果的比较有效性；以及4)不同保险福利设计对联邦医疗保险管理保健参与者结果的比较。我们已筹得超过3,500万元，以资助这四个范畴的环境影响研究。为了促进这一研究议程，我们建立了大规模数据库分析和尖端分析技术方面的专业知识，包括复杂的多级模型。这些工具需要了解生物、社会和行为因素之间的相互作用。该培训计划强调个性化的、基于能力的方法，根植于研究员与导师及其现有研究的匹配。研究员将作为经验丰富的研究团队的成员在重大项目中发挥领导作用，从而使我们的研究数据和项目基础设施受益。这一拟议的CER培训计划利用了我们成功的、长期存在的博士后培训计划、广泛的相关课程和研讨会，以及充满活力和不断扩大的研究环境，为卫生服务和外部资助的研究增加了新的教员。 公共卫生相关性：比较有效性研究(CER)是“弯曲成本曲线”所需的基于价值的医疗保健购买的重要工具。要将CER应用于越来越多的需要领域，必须对该领域的调查人员进行培训。25年来，布朗大学一直在培养健康服务研究方面的成功博士后研究员，并准备将这一努力扩展到CER的特殊需求。

DESCRIPTION (provided by applicant): The Brown University's Center for Gerontology and Health Care Research seeks to supplement its 25-year AHRQ-funded post-doctoral training program to include three additional post-doctoral training slots for Comparative Effectiveness Research (CER). Our Center's research focuses on diseases that impact the elderly, such as cancer, cardiovascular disease, and dementia. These conditions are among the leading causes of mortality and morbidity in the United States and account for a substantial proportion of national health care spending. Our research portfolio spans multiple settings (VA, hospitals, nursing homes, ambulatory facilities) and focuses on 1) Comparative effectiveness of cancer imaging; 2) Clinical treatment choices for nursing home residents with dementia; 3) Comparative effectiveness of states' Medicaid policies on important clinical outcomes; and 4) Comparisons of different insurance benefit designs on outcomes among Medicare managed care enrollees. We have obtained over $35 million to fund CER studies in these four areas. To facilitate this research agenda, we have built expertise in large-scale database analyses and cutting-edge analytic techniques, including complex multilevel models. These tools require an understanding of the interaction of biological, social, and behavioral factors. The training program emphasizes an individualized, competency-based approach rooted in matching fellows to mentors and their existing research. Fellows will take a leadership role on a major project as a member of an experienced research team, thereby benefiting our research data and project infrastructure. This proposed CER training initiative leverages our successful, long-standing post-doctoral training program, wide array of relevant available courses and seminars, and a vibrant and expanding research environment that has added new faculty for health services and externally-funded research. PUBLIC HEALTH RELEVANCE: Comparative Effectiveness Research (CER) is an important tool for the value-based purchasing of health care needed to "bend the cost curve." To apply CER to the growing number of areas of need, it is essential to have trained investigators in the field. Brown University has been training successful post-doctoral fellows in health services research for a quarter century and is poised to extend this effort to the special needs of CER.