The applicant, Dr. Samir S. Shah, is requesting five years of funding through the Mentored Research Scientist Development Award to enhance methodological skills required to conduct observational and interventional research on community-acquired pneumonia (CAP), a common and serious infection in children. The proposed training goals, including skills in advanced epidemiology and biostatistical methods, will allow the applicant to pursue methodologically sound, technically feasible, and innovative research approaches. The applicant's strong background of research and clinical training in pediatrics, infectious diseases, and epidemiology provides an excellent foundation for this work. The award will promote the development of Dr. Shah as an independent clinical investigator. The proposal will use an existing practice-based research network to conduct population-based cohort studies with the following specific aims: First, he will determine the incidence of and identify risk factors for adverse outcomes among children with CAP. Second, he will develop a simple and practical clinical prediction rule that would accurately predict the risk of a child with CAP developing an adverse clinical outcome. Third, the clinical prediction rule will be validated in an independent sample of ethnically and geographically diverse children, thus demonstrating its generalizability. Addressing the above specific aims will allow the identification of a high-risk population of children with CAP who may be suitable candidates for subsequent studies of therapeutic interventions (e.g., new antibiotics, immunomodulators) to improve clinical outcomes. The methods for case finding, study recruitment, data abstraction, clinical outcome validation, and patient follow-up established during this study will facilitate the conduct of future observational and interventional studies of children with CAP within this practice-based research network. The mentoring relationships, advanced formal training and education, and protected time afforded by the award will raise the sophistication, rigor, and quality of Dr. Shah's work and significantly facilitate his transition to a highly successful, independent, clinical investigator. Dr. Shah's research will improve our understanding of CAP and, from a public health perspective, will provide methods to risk stratify children with CAP and will establish a rational basis to target prevention efforts at those children at highest risk for developing CAP-related adverse clinical outcomes.
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