This is an application for the renewal of a K24 mentoring award for patient-oriented research (POR) from Anne Cappola, MD, ScM, Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania (Penn). The candidate has had a strong record of mentorship, leadership, and research productivity during the initial award period. Her research program encompasses POR studies at the intersection of endocrinology and geriatrics. The scientific goals of this proposal are to investigate the age- specificity of the cardiovascular risks of mild subclinical hypothyroidism and to examine thyroid stimulating hormone (TSH) testing and levothyroxine prescribing patterns in older individuals. These studies are required to support a change in the upper limit of the TSH reference range for individuals aged 65 years and older. This change would improve the health and reduce health care costs for millions of older Americans through prevention of unnecessary prescription of thyroid hormone treatment, reduction in excessive TSH monitoring, and avoidance of iatrogenic thyrotoxicosis. The mentoring goals of this application are to support the candidate?s six current K-award mentees? transition to R01 funded independence and to engage a new generation of Penn fellows and junior faculty to conduct POR in aging. The career development goal of this application is to support the candidate?s professional development and program building in clinical investigation. This will be achieved through focused learning about biomedical informatics, engagement in Penn?s CTSA to enhance lifespan research, and ongoing leadership to promote the visibility of aging research in the endocrine community. The institutional environment for clinical and translational science at Penn is outstanding, and the proposal integrates multiple programs from Penn?s CTSA. The Department of Medicine at Penn has made a substantial commitment, including protected time and dedicated space, toward the candidate?s sustained success as a patient-oriented researcher responsible for training a new generation of junior investigators who conduct POR in older participants. Renewal of this application will allow the candidate to cement the programmatic gains achieved during the initial award period and to assure their sustainability after the renewal has completed.

Public Health Relevance

Dr. Cappola proposes to augment her scientific skills and program building, continue to develop the local environment for mentoring new clinical investigators who perform patient-oriented research in older people, and conduct studies that will impact the diagnosis and treatment of hypothyroidism in older individuals.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Neuroscience of Aging Review Committee (NIA)
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Zieman, Susan
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University of Pennsylvania
Internal Medicine/Medicine
Schools of Medicine
United States
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Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P J et al. (2016) Thyroid Function Within the Reference Range and the Risk of Stroke: An Individual Participant Data Analysis. J Clin Endocrinol Metab 101:4270-4282
Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P J et al. (2015) Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis. J Clin Endocrinol Metab 100:2181-91
Cappola, Anne R; Arnold, Alice M; Wulczyn, Kendra et al. (2015) Thyroid function in the euthyroid range and adverse outcomes in older adults. J Clin Endocrinol Metab 100:1088-96
Åsvold, Bjørn O; Vatten, Lars J; Bjøro, Trine et al. (2015) Thyroid function within the normal range and risk of coronary heart disease: an individual participant data analysis of 14 cohorts. JAMA Intern Med 175:1037-47