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Principal Investigator: Yewande Odeyemi
Organization: MAYO CLINIC ROCHESTER
Fiscal Year: 2024
Award: $169,020
Funding agency: National Heart Lung and Blood Institute
PROJECT SUMMARY/ABSTRACT
Pneumonia is the leading infectious cause of death worldwide. While inflammation is a hallmark pathologic
feature of pneumonia, the use of corticosteroids to blunt the profound inflammatory response remains
undefined. Decades of studies in heterogeneous populations failed to show a consistent benefit, leading to
conflicting guidelines on the use of corticosteroids. Although corticosteroids have been shown to be effective in
COVID-19 pneumonia, the use of corticosteroids in other infectious pneumonia remains unclear with high
variability in clinical practice. This variability in practice presents an opportunity to see how corticosteroid
administration in pneumonia can be optimized and tailored to patient specific characteristics. The objective of
this study is to adapt advanced statistical and machine learning methods to already available robust
observational data from the electronic health record to identify predictors of clinical deterioration and to develop
an individualized treatment rule for steroid use in patients with community acquired pneumonia. This will be
accomplished through three specific aims: 1) To develop and validate a machine learning prediction tool for
in-hospital disease progression, 2) To develop and test an individualized treatment rule (ITR) for steroid use,
and 3) To conduct a single center feasibility clinical trial comparing ITR and biomarker guided corticosteroid
use and dosing to usual care in patients with community acquired pneumonia. We hypothesize that: 1) a
combination of demographics, physiological parameters, clinical and laboratory data will be accurate in
predicting risk of in-hospital disease progression and identifying steroid-responsive patients in whom benefit
from adjunct corticosteroid treatment outweighs potential harm, and 2) ITR and biomarker-guided
corticosteroid use, and dosing will be feasible. This career development award will provide important
preliminary data for future larger clinical trials focused on optimizing corticosteroid use in pneumonia while
training a junior investigator in the essential skills needed to become an independent researcher.
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positive patient><Career Development Awards><Career Development Awards and Programs><Career Development Programs K-Series><Cause of Death><Characteristics><Clinic><Clinical><Clinical Trials><Clinical Trials Design><Complication><Corticoids><Corticosteroids><Coupled><Critical Care><Critical Illness><Critically Ill><Da Nang Lung><Data><Data Science><Demographic Analyses><Demographic Analysis><Deterioration><Disease Progression><Dose><Electronic Health Record><Future><Goals><Grant><Guidelines><Hospital Admission><Hospitalization><Hospitals><Hypoxemia><Individual><Inflammation><Inflammatory Response><Investigation><Investigators><K-Awards><K-Series Research Career Programs><Knowledge><Laboratories><Methodology><O element><O2 element><Outcome><Outcomes Research><Oxygen><Pathologic><Patient Selection><Patient outcome><Patient-Centered Outcomes><Patient-Focused Outcomes><Patients><Personalized medical approach><Physiologic><Physiological><Pneumonia><Population><Population 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respiratory syndrome coronavirus 2 pneumonia><severe acute respiratory syndrome coronavirus 2 positive patient><severe acute respiratory syndrome coronavirus 2 related pneumonia><skills><statistical and machine learning><success><tailored approach><tailored medical treatment><tailored therapy><tailored treatment><treatment as usual><trial comparing><unique treatment><usual care><wet lung>