This proposed program for the Physician Scientist Award is designed to provide rigorous training in preparation for a career in academic neuro- ophthalmology with an intensive commitment to clinical research. Traditionally, diagnostic and therapeutic decision-making in neurology and neuro-ophthalmology has relied heavily upon descriptive case series data. Despite the recent emergence of clinical trials in neurology, there have been very few controlled trials of potential medical or surgical therapies within the subspecialty of neuro-ophthalmology. This can be attributed in large part to a scarcity of individuals with formal training in neuro-ophthalmology and in clinical epidemiology and research design. This proposed program will provide training in research design and methodology such that the candidate will acquire the knowledge, skills, and experience necessary to conduct high quality clinical research in neuro-ophthalmology. Phase I training will include the completion of graduate courses as part of the Master of Science Program in Clinical Epidemiology at the University of Pennsylvania. The candidate has submitted a formal application to this program. Through didactic coursework, seminars, and participation in a journal clubs, the candidate will develop knowledge of the elements of research design and methodology, biostatistics, clinical economics, and critical appraisal of the medical literature. As a complement to the courses and seminars in clinical epidemiology, Phase I training will also involve work on ongoing clinical research projects in neuro-ophthalmology under the guidance of Dr. Maureen Maguire and Dr. Grant Liu. These projects will focus on disease risk factors/associations and potential treatments for pseudotumor cerebri, a condition of elevated intracranial pressure of unknown etiology which can result in severe and permanent visual loss. Phase H will involve the independent design and implementation of a prospective case-control study to understand the risk factors and disease associations for pseudotumor cerebri. Previous controlled studies have been mostly retrospective and have failed to confirm many of the large numbers of risk factors that have been implicated by case series and anecdotal reports. The present proposal will utilize a larger number of patients in conjunction with a prospective approach to examine suggested associations for which previous studies have had insufficient statistical power. The University of Pennsylvania School of Medicine, University of Pennsylvania Medical Center, and Scheie Eye Institute are strongly committed to the future of clinical research and will therefore provide a superb academic environment for the proposed training program. This overall program will allow the candidate to become an independent clinical investigator, and will place the candidate at the forefront of academic neuro-ophthalmology.
