This is a NIH Pathway to Independence Award (K99/R00) grant proposal, intended to promote the career ofDr. Christy Avery, PhD, a post-doctoral fellow at the University of North Carolina, into a path of independentresearch. The Candidate is a trained epidemiologist with a significant track record of research in the field ofcardiovascular disease epidemiology. Her goal is to integrate these skills with focused training in clinicalresearch to become an independent scientist at the interface of basic science, clinical practice, and populationresearch. The topical area for the proposed experiential development is translational research in heart failure.During the mentored K99 phase the Candidate will expand her clinical research skills by interacting with clinicalspecialists who are productive scientists in heart failure research, engaging in formal didactics, attendingmultidisciplinary seminars, journal clubs, and scientific meetings, participating study activities with her mentors,and by leading a project that develops novel heart failure classification tools applicable to clinical practice andpopulation research. These activities will be supervised by mentor Dr. Gerardo Heiss MD PhD, KenanProfessor of Epidemiology and co-mentor Dr. Patricia Chang, MD MHS FACC, Assistant Professor ofMedicine. In addition, a team of collaborators with complementary areas of expertise will supplement Dr.Avery's training in specific areas. Together, the mentor, co-mentor, and collaborators are fully committed toassisting the Candidate reach her research training and career development goals and to ensuring theCandidate's successful transition from postdoctoral fellow to independent researcher. During the independentR00 award phase, the Candidate will apply the tools developed during the K99 component in the cohort of theongoing Atherosclerosis Risk in Communities (ARIC) Study. For this purpose the ARIC study investigators aremaking available data on the cohort's follow-up calls, their physician visits, emergency department visits andhospitalizations, and the associated diagnoses. This information base will be combined with outpatient andinpatient Medicare claims data and reports by participant's treating physicians to estimate the burden of heartfailure and its patterns of diagnosis and care in ARIC Study participants. The Candidate also will characterizethe transition from heart failure managed in outpatient settings to acute/decompensated heart failure eventsrequiring hospitalization. The proposed research is both novel and of major potential for translation, withpossible relevance for early diagnosis and proactive management of heart failure as well as for health servicesallocation and program evaluation. The short term benefits from this study will be a contribution to the under-studied area of quantifying the outpatient burden of HF and its secular trends in communities.

Public Health Relevance

Heart failure is a common, costly, disabling, and often fatal disorder that places a tremendous burden on healthcare systems worldwide. Estimates of the community heart failure burden are essential for health services allocation and program evaluation, yet few programs quantifying the burden of heart failure currently exist. Results from this study will help measure the prevalence of heart failure and how it has changed through time in the United States.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Transition Award (R00)
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Special Emphasis Panel (NSS)
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Cooper, Lawton S
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University of North Carolina Chapel Hill
Public Health & Prev Medicine
Schools of Public Health
Chapel Hill
United States
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Seyerle, Amanda A; Young, Alicia M; Jeff, Janina M et al. (2014) Evidence of heterogeneity by race/ethnicity in genetic determinants of QT interval. Epidemiology 25:790-8
Avery, Christy L; Der, Jane S; Whitsel, Eric A et al. (2014) Comparison of study designs used to detect and characterize pharmacogenomic interactions in nonexperimental studies: a simulation study. Pharmacogenet Genomics 24:146-55
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