Candidate: Dr. Tedeschi is an Instructor in Medicine at Harvard Medical School (HMS) and Associate Physician in the Division of Rheumatology, Immunology and Allergy?s Section of Clinical Sciences (SCS) at Brigham and Women?s Hospital (BWH). She received an MPH from the Harvard T.H. Chan School of Public Health (HSPH). Her 10 first-author manuscripts, two BWH grants, and foundation award exemplify her productivity and commitment to research. She has assembled an experienced team of mentors and collaborators, led by Dr. Daniel Solomon (primary mentor) and Drs. Katherine Liao and Karen Costenbader (co-mentors), to guide her training in natural language processing and machine learning approaches for clinical research, analysis of linked electronic medical record (EMR) and Medicare claims data, and interpretation of advanced imaging modalities. Focused coursework at HSPH and HMS will complement the experience she gains through her proposed studies of pseudogout risk factors and long-term outcomes. Training in dual- energy CT and ultrasound interpretation for crystalline arthritis will be obtained via one-on-one sessions. Her long-term career goal is to become an independent patient-oriented investigator focused on pseudogout. Environment: Dr. Tedeschi has a commitment from her Division for >75% protected time for research and career development activities during the K23 award period. Support from the Division and her primary mentor?s research funds will supplement her salary and project-related expenses. The SCS, a collaborative clinical research group in the Division of Rheumatology, has extensive infrastructure including the VERITY Bioinformatics Core (NIH-P30-AR072577, PI: Solomon) that will provide resources and expertise for the proposed studies. In addition, the BWH Arthritis Center is one of the largest nationally, facilitating subject recruitment, and the BWH Division of Musculoskeletal Imaging has state-of-the-art equipment and expertise applying dual-energy CT in crystalline arthritis. Coursework at HSPH and HMS, adjacent to BWH, will provide training necessary for Dr. Tedeschi?s development into an independent investigator. Research: Dr. Tedeschi?s long-term objective is to prevent and reduce morbidity from pseudogout, an understudied, painful crystalline arthritis that affects 8-10 million Americans. She will use natural language processing and machine learning approaches to enhance an algorithm for identifying pseudogout in EMR data. She will study risk factors for and long-term outcomes in pseudogout, harnessing vast amounts of information contained in Partners HealthCare EMR data and Medicare claims data, and will gain experience working with linked datasets. Dr. Tedeschi will recruit subjects with pseudogout and other types of mono- and oligoarthritis to test and compare the performance of dual-energy CT scanning, musculoskeletal ultrasound, and x-ray for identifying pseudogout. Her proposed K23 projects will lead to manuscripts and data to be leveraged in an R01 application focused on pseudogout during the award period, leading to independence as a patient-oriented investigator.
The proposed studies will contribute fundamental knowledge about pseudogout, a common, painful crystalline arthritis for which we have little prognostic information and no targeted treatments. Results from the proposed projects could lead to methods for non-invasive, accurate pseudogout diagnosis, development of preventive strategies for pseudogout, and interventions to reduce cardiovascular disease risk. Future work stemming from the proposed projects may include predictive models of pseudogout flares, identification of serum biomarkers for pseudogout, and development of outcomes measures to be used in prospectively recruited pseudogout cohort studies.