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Browsing by Author "Gould, Michael K."
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Item Knowledge Gaps and Research Priorities in Immune Checkpoint Inhibitor–related Pneumonitis. An Official American Thoracic Society Research Statement(American Thoracic Society - AJRCCM, 2019-09-15) Sears, Catherine R.; Peikert, Tobias; Possick, Jennifer D.; Naidoo, Jarushka; Nishino, Mizuki; Patel, Sandip P.; Camus, Philippe; Gaga, Mina; Garon, Edward B.; Gould, Michael K.; Limper, Andrew H.; Montgrain, Philippe R.; Travis, William D.; Rivera, M. Patricia; Medicine, School of MedicineRationale: Immune checkpoint inhibitors (ICIs) have revolutionized cancer care but are associated with unique adverse events, including potentially life-threatening pneumonitis. The diagnosis of ICI-pneumonitis is increasing; however, the biological mechanisms, clinical and radiologic features, and the diagnosis and management have not been well defined. Objectives: To summarize evidence, identify knowledge and research gaps, and prioritize topics and propose methods for future research on ICI-pneumonitis. Methods: A multidisciplinary group of international clinical researchers reviewed available data on ICI-pneumonitis to develop and refine research questions pertaining to ICI-pneumonitis. Results: This statement identifies gaps in knowledge and develops potential research questions to further expand knowledge regarding risk, biologic mechanisms, clinical and radiologic presentation, and management of ICI-pneumonitis. Conclusions: Gaps in knowledge of the basic biological mechanisms of ICI-pneumonitis, coupled with a precipitous increase in the use of ICIs alone or combined with other therapies, highlight the importance in triaging research priorities for ICI-pneumonitis.Item Safely and Effectively Evaluating Computed Tomography–detected Lung Lesions. Much Work to Be Done(ATS, 2019-11) Burks, A. Cole; Gould, Michael K.; Silvestri, Gerard; Yarmus, Lonny B.; Sears, Catherine R.; Arenberg, Douglas A.; Gonzalez, Anne V.; Slatore, Christopher G.; Tanner, Nichole T.; Vachani, Anil; Nana-Sinkam, Patrick; Fuster, Mark M.; Wahidi, Momen M.; Tanoue, Lynn T.; Rivera, M. Patricia; Medicine, School of MedicineItem Training the next generation of learning health system scientists(Wiley, 2022-09-10) Lozano, Paula M.; Lane-Fall, Meghan; Franklin, Patricia D.; Rothman, Russell L.; Gonzales, Ralph; Ong, Michael K.; Gould, Michael K.; Beebe, Timothy J.; Roumie, Christianne L.; Guise, Jeanne-Marie; Enders, Felicity T.; Forrest, Christopher B.; Mendonca, Eneida A.; Starrels, Joanna L.; Sarkar, Urmimala; Savitz, Lucy A.; Moon, JeanHee; Linzer, Mark; Ralston, James D.; Chelsey, Francis D., Jr.; Pediatrics, School of MedicineIntroduction: The learning health system (LHS) aligns science, informatics, incentives, stakeholders, and culture for continuous improvement and innovation. The Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute designed a K12 initiative to grow the number of LHS scientists. We describe approaches developed by 11 funded centers of excellence (COEs) to promote partnerships between scholars and health system leaders and to provide mentored research training. Methods: Since 2018, the COEs have enlisted faculty, secured institutional resources, partnered with health systems, developed and implemented curricula, recruited scholars, and provided mentored training. Program directors for each COE provided descriptive data on program context, scholar characteristics, stakeholder engagement, scholar experiences with health system partnerships, roles following program completion, and key training challenges. Results: To date, the 11 COEs have partnered with health systems to train 110 scholars. Nine (82%) programs partner with a Veterans Affairs health system and 9 (82%) partner with safety net providers. Clinically trained scholars (n = 87; 79%) include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians (n = 29; 26%) represent diverse fields, dominated by population health sciences. Stakeholder engagement helps scholars understand health system and patient/family needs and priorities, enabling opportunities to conduct embedded research, improve outcomes, and grow skills in translating research methods and findings into practice. Challenges include supporting scholars through roadblocks that threaten to derail projects during their limited program time, ranging from delays in access to data to COVID-19-related impediments and shifts in organizational priorities. Conclusions: Four years into this novel training program, there is evidence of scholars' accomplishments, both in traditional academic terms and in terms of moving along career trajectories that hold the potential to lead and accelerate transformational health system change. Future LHS training efforts should focus on sustainability, including organizational support for scholar activities.