The goals of the proposed projects are to support my continued development and impact as a mentor, to establish a research training program for patient oriented research (POR) in the Section of Rheumatology at my institution, and to expand my current POR program. Regarding the former, I am strongly committed to devoting a significant percent of my career to mentoring. Among the trainees I am currently working with, I am the primary mentor for 2 junior faculty (1 who is a K awardee), 2 rheumatology fellows interested in pursing a career in POR, and 3 residents planning a career in rheumatology. While my primary interest is in the field of decision making, my training and previous practical experience in epidemiology allow me to be an effective mentor for trainees interested in other aspects of POR related to rheumatic disease. Given my commitment to mentoring, Yale's rich resources dedicated to POR, and strong institutional support to create this program, the K24 Award provides an invaluable opportunity to expand my mentoring efforts and to establish a specialized structured POR curriculum. The program will ensure that fellows interested in becoming independent investigators will be supported by an interdisciplinary team of mentors and will acquire training in clinical research methods and biostatistics. In addition, I will establish a biweekly Research in Progress meeting during which trainees and faculty will be expected to present materials at all stages of development and offer constructive critiques during each session. The training program will include formal mentoring sessions which will adhere to a process for moving research forward. The POR training program will also include formal evaluation of trainees and mentors. In addition to mentoring young investigators, one of my important long-term goals is to advance my own research agenda so that I can continue to conduct scientifically rigorous and meaningful POR. I have established a defined area of expertise and a strong network of collaborators with complementary proficiencies that will support and enhance my research program. Current examples include collaborations with Dr. Curtis (UAB) with whom I have recently submitted a grant to develop individualized outcome estimates in rheumatoid arthritis, Drs. Reyna (Cornell) and Peters (Ohio State) who are basic science experts in decision making and are current collaborators on a project to develop a decision aid in rheumatoid arthritis, Dr. Almazor (MD Anderson) with whom I am working on 2 projects examining the value of conjoint analysis in patients with knee OA, and Dr. Street (Baylor College of Medicine) an internationally renowned expert on communication, who is a collaborator on a new research project: Measuring Patients'Risk Perceptions in Real Time. New planned studies will continue to focus on understanding the reasons underlying poor quality decision making in clinical practice and I will expand my current projects to include randomized controlled trials to test the efficacy/effectiveness of the tools developed.

Public Health Relevance

The goals of the proposed project are to support my continued development and impact as a mentor, to establish a research training program for patient oriented research in rheumatology at my institution, and to expand my current research program. I have found that mentoring persons from various backgrounds who share a passion to design high quality studies in order to improve the methods by which we deliver health care to be the most rewarding aspect of my job. The K24 Award would ensure that I have the protected time to be able to expand my current mentoring activities while continuing to advance my own patient oriented research program to improve medical decision making in patients with rheumatic disease.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
Application #
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Witter, James
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Budget End
Support Year
Fiscal Year
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Yale University
Internal Medicine/Medicine
Schools of Medicine
New Haven
United States
Zip Code
Fraenkel, Liana; Miller, Amy S; Clayton, Kelly et al. (2016) When Patients Write the Guidelines: Patient Panel Recommendations for the Treatment of Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 68:26-35
Dubov, Alex; Fraenkel, Liana; Seng, Elizabeth (2016) The Importance of Fostering Ownership During Medical Training. Am J Bioeth 16:3-12
Fraenkel, Liana; Peters, Ellen; Tyra, Shea et al. (2016) Shared Medical Decision Making in Lung Cancer Screening: Experienced versus Descriptive Risk Formats. Med Decis Making 36:518-25
Fraenkel, Liana; Stolar, Marilyn; Swift, Sarah et al. (2016) Subjective Numeracy and the Influence of Order and Amount of Audible Information on Perceived Medication Value. Med Decis Making :
Hsieh, Evelyn; Fraenkel, Liana; Han, Yang et al. (2016) Longitudinal increase in vitamin D binding protein levels after initiation of tenofovir/lamivudine/efavirenz among individuals with HIV. AIDS 30:1935-42
Becker, William C; Fiellin, David A; Black, Anne C et al. (2016) Initial development of patient-reported instrument assessing harm, efficacy, and misuse of long-term opioid therapy. J Rehabil Res Dev 53:127-36
Danila, Maria I; Outman, Ryan C; Rahn, Elizabeth J et al. (2016) A multi-modal intervention for Activating Patients at Risk for Osteoporosis (APROPOS): Rationale, design, and uptake of online study intervention material. Contemp Clin Trials Commun 4:14-24
Toupin-April, Karine; Barton, Jennifer; Fraenkel, Liana et al. (2015) Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making. J Rheumatol 42:2442-7
Sinayev, Aleksandr; Peters, Ellen; Tusler, Martin et al. (2015) Presenting Numeric Information with Percentages and Descriptive Risk Labels: A Randomized Trial. Med Decis Making 35:937-47
Hsieh, E; Fraenkel, L; Xia, W et al. (2015) Increased bone resorption during tenofovir plus lopinavir/ritonavir therapy in Chinese individuals with HIV. Osteoporos Int 26:1035-44

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