Current neuro-oncology research relies on medical outcome measures such as time to tumor progression and survival. However, clarification of the inter-relationships of variables that make up patients' quality of life (QOL), their trajectory over time, and their prognostic value in brain tumors could prove to be superior for decision-making by patients, families, and clinicians. This career development proposal is designed to enhance the Candidate's clinical research skills in the application of multivariate behavioral research methods to the study of QOL and neurocognition in oncology. The Candidate is a fellowship-trained, research-oriented, clinical neuropsychologist, dedicated to a career in patient-oriented, neuropsychological-oncology outcomes research. Strengths of the applicant include interdisciplinary training, a demonstrated ability to engage in programmatic research, experience in clinical service and teaching, and a commitment to the care of patients with malignant brain tumors. Training plan the training will focus on psychological health-outcomes research methodology, behavioral oncology, and observational training in the practice of neurosurgery. The trainee will receive close supervision from experts in psychology, neurosurgery, neuro-oncology, and health evaluation sciences. Specifically, the Candidate will receive training in 1) behavioral health-outcomes research methodology, 2) psycho-oncology and health psychology, and 3) the clinical content of neuro-oncology. In addition, she will receive further training in research ethics, the formation of research collaborations, research presentations, and scientific writing. Research plan the central tenet of the proposed research is that including neuropsychological variables can improve understanding of patients' QOL, elucidate QOL trajectory to end-of-life, and help predict length of survival in malignant brain tumor patient populations. In order to test this proposal, structural equation modeling will be performed to determine inter-relationships of components of QOL, their trajectory over time, and the extent to which QOL predicts patient survival. Environment the University of Virginia, the Department of Neurosurgery, the Cancer Center, and the NeuroOncology Center have outstanding clinical, surgical, and epidemiological resources, and a demonstrated commitment to expanding these assets and supporting the Candidate's research. Results will have implications not only for neuro-oncology, but also for all cancer patients with cognitive impairment, contributing to improved QOL and survivorship for these populations. The ultimate goal is to maximize both survival and QOL.
