This AHRQ K08 project employs big data strategies and geographic information system (GIS) informatics and analytics to fill critical knowledge gaps in determining the individual and hospital quality factors that influence sepsis mortality in the US. The training leverages Dr. Jordan Kempker?s Masters of Science and Clinical Research and KL2 training in Social Epidemiology and R programming for data science. Further training will develop practical expertise in GIS informatics for merging disparate data for new risk factor discoveries and GIS analytics to define and account for disease clustering in the determination of individual and systems-based risk factors for US sepsis deaths. To accomplish this goal Dr. Kempker will take coursework a sequence of semester- long courses at the Emory Rollins School of Public Health in the application of GIS in public health and an Emory Faculty Development Course in Health Services Research application. The proposal includes the continued expert, interdisciplinary mentorship of content-expert Greg S. Martin, MD, MSc from Pulmonary and Critical Care Medicine; GIS-expert Lance A. Waller, PhD from the Department of Biostatistics; and Social Epidemiologist Michael R. Kramer, MPH, PhD from Department of Epidemiology. The mentored research has 2 Specific Aims: 1) to characterize the geographic correlations among sepsis deaths and the identified individual risk factors for sepsis mortality; and 2) to determine the association between hospital quality in sepsis treatment and sepsis case-fatality at both the hospital- and individual-level. This body of knowledge will build a multilevel understanding of the risk factors for sepsis mortality in the US and infuse GIS techniques into sepsis health services research, identifying new opportunities to create large longitudinal cohorts, connect disparate data sources for new discoveries, account for spatial relationships to improve statistical estimates and create heat maps that direct allocation of public resources to areas of most need. This trajectory of innovative work will inform agendas of public agencies such as the National Healthcare Safety Network, the Joint Commission, National Quality Forum and CMS as well as private sector healthcare systems. It is directly relevant to the impacts of quality measures on hospital outcomes. Finally, this project will build the foundation for at least one future R01 examining further how these factors mediate socioeconomic disparities in sepsis.
Sepsis is a major public health problem in the United States and this project aims to use existing national-level big data to identify both: 1) the individual health conditions, behaviors and socioeconomic factors; and 2) the hospital quality factors that contribute to preventable sepsis deaths. Furthermore, this project will utilize geographically coded data to identify the sepsis hotspots in the United States that may benefit from specifically targeted interventions.
| Kempker, Jordan A; Martin, Greg S (2018) Severity and Timing of Onset Drive Economic Costs and Clinical Outcomes With Sepsis. Crit Care Med 46:2043-2044 |
| Kempker, Jordan A; Panwar, Bhupesh; Judd, Suzanne E et al. (2018) Plasma 25-hydroxyvitamin D and the Longitudinal Risk of Sepsis in the REGARDS Cohort. Clin Infect Dis : |
