The Department of Medicine is delighted to announce the winning Chair’s Research Awards proposals for 2022.
“We have been very delighted with the work and outcomes of the prior recipients of this award and anticipate an equally successful and productive course for this year’s winners,” said Kathleen Cooney, MD, MCAP, chair, Department of Medicine. “Congratulations to each award recipient!”
“The investment in the Chair’s Award represents our DOM commitment to train and support the next generation of outstanding clinical, translational and basic investigators at Duke,” adds Scott Palmer, MD, MHS, vice-chair for research in the Department of Medicine.
The 2022 Chair’s Research Award recipients are:
Deepshikha Ashana, MD, MBA, MS, assistant professor, (Pulmonary, Allergy, and Critical Care): “Racial Disparities in Shared Decision Making for Patients with Acute Respiratory Failure,” is funded in the amount of $70,062.69 starting July 1, 2022, for one year.
Patients in the intensive care unit often cannot speak for themselves, therefore their families and clinicians work together to make medical decisions on their behalf, a process known as shared decision making. Ideally, clinicians share medical information, families share information about their loved one’s values and goals, and together, they make medical decisions that are aligned with what the patient would have chosen for themselves. Although shared decision-making is a critical component of patient-centered care, it is known that Black patients and families experience less shared decision-making than others. For example, in outpatient settings, over a decade of research has repeatedly shown that when clinicians are talking to Black patients, they provide fewer treatment options, less prognostic information, and less emotional support for difficult decisions. However, similar research has not been conducted in the intensive care unit.
Ashana hypothesizes that that racial disparities in shared decision-making are amplified in the ICU because clinicians often do not have long-standing relationships with patients or families, and decisions are complex, emotional, and time pressed. To test the hypothesis, a unique database of conversations between ICU clinicians and families from a previous clinical trial will be used for a comparison to see how ICU clinicians make medical decisions with Black and White families. Understanding how clinicians currently engage families of different races in medical decision making will be the first step to developing tools to support clinicians with a goal of promoting equitable shared decision making, she says.
Christopher Mosher, MD, MHS, medical instructor, (Pulmonary, Allergy, and Critical Care): “Longitudinal Outcomes of COPD Metabolism Targeted by Exercise Intervention (LOCOMOTION)” is funded in the amount of $94,595 starting July 1, 2022, for one year.
Mosher’s research will investigate the relationship between metabolism and clinical outcomes among older adults living with chronic obstructive pulmonary disease (COPD) following an exercise intervention. Over 16 million people in the US have COPD and it is a leading cause of hospitalization and death. Disease progression and response to treatment in COPD is variable. Therefore, there is a need to develop predictive biomarkers to identify patients at high risk of disease progression and reflect response to treatment. Identifying biomarkers would enable development of novel therapeutic strategies and refinement of existing strategies through biomarker directed feedback.
The project will investigate changes in metabolism and functional outcomes following completion of pulmonary rehabilitation (PR). PR offers a structured, supervised exercise training program and is considered one of the most-effective COPD treatments. However, despite its proven benefits, the biological mechanism which underlies the treatment response to PR is not well understood. Therefore, the research team plans to use PR as an interventional model system to identify biomarkers associated with functional status and quality of life (QoL) at baseline and in response to PR. Identifying predictive biomarkers for patients at high risk of disease progression will allow for earlier intervention and treatment responsive biomarkers will support the development of novel therapeutic strategies to improve patient outcomes, he says.
Daniel Parker, MD, assistant professor (Geriatrics): “Calories on the Brain: Leveraging Insights from Calorie Restriction to Promote Healthy Brain Aging,” is funded in the amount of $95,000 starting July 1, 2022 for one year.
Alzheimer’s disease is the leading cause of dementia yet there are currently limited treatments for the disease. Diet modification interventions, such as calorie restriction without malnutrition, have shown promise in improving brain health and reducing Alzheimer’s disease risk. The objective of Parker’s proposal is to determine the impact of calorie restriction on biomarkers of brain aging and Alzheimer’s disease risk, and to define the metabolic changes that are responsible for its beneficial effects. Understanding exactly how calorie restriction promotes brain health and reduces Alzheimer’s disease risk, he posits, may help find new ways to prevent and treat this disease.
Matthew Sinclair, MD, medical instructor (Nephrology): “Promoting Equity in Hispanic/Latinx and Black Patients with Type 2 Diabetes” is funded in the amount of $95,000 starting July 1, 2022, for one year.
Sinclair’s research will seek to determine primary care provider-facing barriers and facilitators to optimized care among Hispanic/Latinx and non-Hispanic Black patients with Type 2 diabetes via the conduction of semi-structured interviews. The project will then incorporate the knowledge learned in interviews to develop and test a provider-facing intervention, integrating English and Spanish-language materials with tailored clinical and pharmacy guidance, including the utilization of novel agents, to optimize type 2 diabetes care for Hispanic/Latinx and non-Hispanic Black patients.
There is a great need to better understand factors that contribute to inequities in care among racial and ethnic minorities with type 2 diabetes, as well as develop strategies that will help to improve outcomes among these patient populations, Sinclair says. His project aims to do both, with the anticipation that the results will prove feasibility and provide valuable data that will help promote a consistent and streamlined approach for optimized, provider-facing Type 2 diabetes care to reduce healthcare disparities in the Hispanic/Latinx and non-Hispanic Black patient populations.
Special thanks goes to Christina Wyatt, MD, (Nephrology) and Christopher Holley, MD, PhD, (Cardiology) for their support of the DOM’s junior faculty and administration of the Chair’s Research Awards program. Thanks also to the faculty grant reviewers for their commitment to the department’s research mission.