R01AG070194

LivOpt -- Liver Cirrhosis - Optimizing Prediction of Patient Outcomes - Project Abstract

Cirrhosis is a leading cause of mortality in the United States (US), diagnosed in millions of people and resulting in over 40,000 deaths each year, predominantly in older people. These patients are at higher risk of serious complications (e.g., infection, ascites, hepatic encephalopathy), hospitalization, and death. Little is known about the epidemiology and disease progression, and older patients are more vulnerable and might have different risk profiles. The clinical challenge is to accurately and early predict who is at highest risk for requiring hospitalization and/or death and understanding how this might be different in older versus younger adults.

One barrier to date has been the lack of an epidemiologically representative patient sample that captures those with cirrhosis and goes beyond one health system, as many data repositories are skewed or limited: CMS only captures the elderly and those with debility, NIS does not allow longitudinal observation, UNOS represents less than one percent of those with cirrhosis. Hence, we will build on our previous work to use a unique dataset, the Chicago Area Patient-Centered Outcomes Research Network (CAPRICORN).

CAPRICORN captures the electronic health records (EHR) from nine health systems from 2011-present (incl. academic center, county, VA, and private), catching most of the diverse patient population in the greater Chicago metropolitan area, namely ~160,000 patients with liver cirrhosis. The dataset is extensive, allowing the use of traditional (e.g., regression) and novel analytical techniques (e.g., deep learning) to pursue the aims of the study.

We aim to model cirrhosis progression in the elderly and to predict the risk of hospitalization and death in older patients with cirrhosis. We also aim to perform sub-group analyses focusing on race and socioeconomic factors in the elderly. The impact of accurate and early prediction of mortality and hospitalization risk in elderly patients with cirrhosis allows for targeted interventions of the most vulnerable patients to improve outcomes.

Northwestern University

TO ENCOURAGE BIOMEDICAL, SOCIAL, AND BEHAVIORAL RESEARCH AND RESEARCH TRAINING DIRECTED TOWARD GREATER UNDERSTANDING OF THE AGING PROCESS AND THE DISEASES, SPECIAL PROBLEMS, AND NEEDS OF PEOPLE AS THEY AGE. THE NATIONAL INSTITUTE ON AGING HAS ESTABLISHED PROGRAMS TO PURSUE THESE GOALS. THE DIVISION OF AGING BIOLOGY EMPHASIZES UNDERSTANDING THE BASIC BIOLOGICAL PROCESSES OF AGING. THE DIVISION OF GERIATRICS AND CLINICAL GERONTOLOGY SUPPORTS RESEARCH TO IMPROVE THE ABILITIES OF HEALTH CARE PRACTITIONERS TO RESPOND TO THE DISEASES AND OTHER CLINICAL PROBLEMS OF OLDER PEOPLE. THE DIVISION OF BEHAVIORAL AND SOCIAL RESEARCH SUPPORTS RESEARCH THAT WILL LEAD TO GREATER UNDERSTANDING OF THE SOCIAL, CULTURAL, ECONOMIC AND PSYCHOLOGICAL FACTORS THAT AFFECT BOTH THE PROCESS OF GROWING OLD AND THE PLACE OF OLDER PEOPLE IN SOCIETY. THE DIVISION OF NEUROSCIENCE FOSTERS RESEARCH CONCERNED WITH THE AGE-RELATED CHANGES IN THE NERVOUS SYSTEM AS WELL AS THE RELATED SENSORY, PERCEPTUAL, AND COGNITIVE PROCESSES ASSOCIATED WITH AGING AND HAS A SPECIAL EMPHASIS ON ALZHEIMER'S DISEASE. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.866 - Aging Research

National Institute on Aging (NIA) [HHS - NIH]

Chicago, Illinois 606112927 United States

Single Zip Code

Secondary Analyses of Existing Cohorts, Data Sets and Stored Biospecimens to Address Clinical Aging Research Questions (R01) (PA-17-088)

Amendment Since initial award the total obligations have increased 387% from $627,274 to $3,057,044.