Dr. Dy is an Assistant Professor and the primary physician for the paliative care consultation programs for Johns Hopkins Medicine. Through this award, Dr. Dy would like to conduct health services and decision-making research on an important issue in cancer palliative care: the appropriate use of artificial nutrition at the end of life. She will have the mentorship and support of experts in oncology, palliative care, geriatrics and artificial nutrition, and health services research methods. To complement her research, Dr. Dy will take courses in qualitative research, communication, and advanced health services research and biostatistics methods. The care of terminally ill patients with cancer often involves difficult choices. The use of technology such as artificial nutrition at the end of life is often not helpful and may be detrimental to quality of life. Through a series of 3 research projects, this grant will examine the potential contribution of interventions to improve the appropriateness of technologic use at three different levels. First, on the individual patient level, we will explore the decision-making process for artificial nutrition in terminally ill cancer patients, as well as patients' and surrogates' perceptions of the process and how it might be improved. Secondly, on the hospital level, we will explore whether the growth in palliative care consultation services has impacted the use of artificial nutrition at the local level. Finally, on the regional level, we will examine whether the growth of hospice services has impacted the use of artificial nutrition. The combination of qualitative and quantitative primary data collection and research utilizing existing data sources, the excellent mentorship of senior scientists, the available coursework, research conferences, and observation experiences, and the supportive environment at Johns Hopkins University will provide Dr. Dy with the skills she needs to develop into an independent clinical researcher in oncology palliative care decision-making and health services research.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Academic/Teacher Award (ATA) (K07)
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Study Section
Subcommittee G - Education (NCI)
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Gorelic, Lester S
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Johns Hopkins University
Internal Medicine/Medicine
Schools of Medicine
United States
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Lorenz, Karl A; Dy, Sydney M; Naeim, Arash et al. (2009) Quality measures for supportive cancer care: the Cancer Quality-ASSIST Project. J Pain Symptom Manage 37:943-64
Lorenz, Karl A; Lynn, Joanne; Dy, Sydney M et al. (2008) Evidence for improving palliative care at the end of life: a systematic review. Ann Intern Med 148:147-59
Mularski, Richard A; Dy, Sydney M; Shugarman, Lisa R et al. (2007) A systematic review of measures of end-of-life care and its outcomes. Health Serv Res 42:1848-70
Dy, Sydney Morss; Shore, Andrew D; Hicks, Rodney W et al. (2007) Medication errors with opioids: results from a national reporting system. J Opioid Manag 3:189-94
Snyder, Claire F; Dy, Sydney M; Hendricks, Danetta E et al. (2007) Asking the right questions: investigating needs assessments and health-related quality-of-life questionnaires for use in oncology clinical practice. Support Care Cancer 15:1075-85
Wolff, Jennifer L; Dy, Sydney M; Frick, Kevin D et al. (2007) End-of-life care: findings from a national survey of informal caregivers. Arch Intern Med 167:40-6
Dy, Sydney M; Wolff, Jennifer L; Frick, Kevin D (2007) Patient characteristics and end-of-life health care utilization among Medicare beneficiaries in 1989 and 1999. Med Care 45:926-30
Dy, Sydney M; Sharkey, Phoebe; Herbert, Robert et al. (2006) Comorbid illnesses and health care utilization among Medicare beneficiaries with lung cancer. Crit Rev Oncol Hematol 59:218-25
Dy, Sydney Morss (2006) Enteral and parenteral nutrition in terminally ill cancer patients: a review of the literature. Am J Hosp Palliat Care 23:369-77