The applicant, Gareth Dulai, is a Clinical Instructor in Digestive Diseases at the University of California Los Angeles (UCLA) who seeks financial support for a program of mentored, patient-oriented clinical research and concurrent multidisciplinary didactic training in the methods of clinical investigation. If given the support necessary to sustain this period of training, the applicant has the personal drive and institutional resources needed to become a successful, independent clinical investigator. His specific area of interest lies in developing means to assess and improve the quality of healthcare provided to patients with Barrett' esophagus (BE) - a common, chronic, costly, and clinically significant pre- cancerous disorder in the United States' population. In order to achieve his academic goals, the applicant and his experienced mentor (Dr. Dennis M. Jensen) have designed a three-phase career development plan. This plan is consistent with the applicant's goals and his previous research experience. Strengths of this plan include the high-level of research and educational support available at UCLA and its General Clinical Research Center (GCRC). The initial phase consists of didactic work in UCLA's School of Public Health. The second phase, overlapping with the first, consists of a series of three studies involving subjects with BE utilizing UCLA's GCRC.
The specific aim of the first study - a cohort study of dysplasia and risk of neoplastic progression in BE - is to estimate the magnitude of cancer risk in BE cases according to baseline dysplasia status.
The specific aims of the second study - patient derived utility valuations of health states in BE - are to identify, characterize, and weight health states in BE using patient preferences.
The specific aims of the third study - a randomized prospective clinical trial of ablation therapy for BE - are to evaluate the relative efficacy, safety, cost, and effect on health related quality of life of two types of novel therapeutic interventions for the removal of BE. The unifying objective of these research projects is to develop rational, cost-effective strategies for cancer prevention and control in patients with BE. The NCRR's K23 Award will provide the salary support necessary to allow the applicant to successfully complete this critical period of mentored study and patient- oriented research. During the third phase of his career development plan, the applicant will use the knowledge, skills, and research base acquired to compete for subsequent independent research support from the National Institutes of Health, Veterans Administration, and other funding agencies. The applicant has no comparable source of salary for the proposed period of research and training.
|Dulai, G S (2006) Rockall redux: retracted or redacted? Gastrointest Endosc 63:613-4|
|Spiegel, Brennan M R; Dulai, Gareth S; Lim, Brian S et al. (2006) The cost-effectiveness and budget impact of intravenous versus oral proton pump inhibitors in peptic ulcer hemorrhage. Clin Gastroenterol Hepatol 4:988-997|
|Kanwal, Fasiha; Gralnek, Ian M; Martin, Paul et al. (2005) Treatment alternatives for chronic hepatitis B virus infection: a cost-effectiveness analysis. Ann Intern Med 142:821-31|
|Spiegel, Brennan M R; Gralnek, Ian M; Bolus, Roger et al. (2005) Is a negative colonoscopy associated with reassurance or improved health-related quality of life in irritable bowel syndrome? Gastrointest Endosc 62:892-9|
|Shaheen, Nicholas J; Dulai, Gareth S; Ascher, Brian et al. (2005) Effect of a new diagnosis of Barrett's esophagus on insurance status. Am J Gastroenterol 100:577-80|
|Dulai, Gareth S; Shekelle, Paul G; Jensen, Dennis M et al. (2005) Dysplasia and risk of further neoplastic progression in a regional Veterans Administration Barrett's cohort. Am J Gastroenterol 100:775-83|
|Dulai, Gareth S; Jensen, Dennis M; Cortina, Galen et al. (2005) Randomized trial of argon plasma coagulation vs. multipolar electrocoagulation for ablation of Barrett's esophagus. Gastrointest Endosc 61:232-40|
|Spiegel, Brennan M R; DeRosa, Vincent P; Gralnek, Ian M et al. (2004) Testing for celiac sprue in irritable bowel syndrome with predominant diarrhea: a cost-effectiveness analysis. Gastroenterology 126:1721-32|
|Spiegel, Brennan M R; Targownik, Laura E; Kanwal, Fasiha et al. (2004) The quality of published health economic analyses in digestive diseases: a systematic review and quantitative appraisal. Gastroenterology 127:403-11|
|Dulai, Gareth S; Jensen, Dennis M (2004) Severe gastrointestinal bleeding of obscure origin. Gastrointest Endosc Clin N Am 14:101-13|
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