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Principal Investigator: Elizabeth Marie Viglianti
Organization: UNIVERSITY OF MICHIGAN AT ANN ARBOR
Fiscal Year: 2024
Award: $170,894
Funding agency: National Heart Lung and Blood Institute
Project Summary
Candidate’s Long-Term Career Goal: To become an independently funded physician-scientist with a clinical
expertise in persistent critical illness and bioethics with a methodological expertise in longitudinal surveys.
Clinical Problem: Patients with prolonged ICU stays are costly, increasing in prevalence, and resulting in
long-term morbidity. Unfortunately, we have not been able to identify this cohort of patients early and
subsequently have not been able to institute evidence-based processes to prevent its development.
Candidate Background and Achievements: Dr. Viglianti is a Lecturer in Pulmonary and Critical Care
Medicine at the University of Michigan (UM). She received her MD from Duke University, MPH from the
University of North Carolina Chapel Hill, and MSc from UM. To date she has published 23 papers, including 14
original peer-reviewed manuscripts; 7 of which she is first author. She won a minority grant award from the
American Thoracic Society, an F32 and loan repayment award from NHLBI, and an institutional K12.
Regardless of the outcome of this proposal, her department anticipates she will be appointed to an assistant
professor on or before July 1, 2021, with a start-up package including $250,000 of discretionary research fund.
Career Development Plan: Dr. Viglianti proposes to develop new expertise in longitudinal survey
methodology and analysis, and bioethics through formal coursework and mentored research. Her primary
mentor is Dr. Theodore J. Iwashyna at UM, who has mentored 7 clinician-scientists on K awards, including 4 to
R-level funding. She will be co-mentored by Dr. Mick Couper a research professor at the Institute of Social
Research at UM who is an expert in design and implementation of longitudinal surveys.
Aims: Using both prospective and retrospective surveys and secondary data, she will 1) Determine the
accuracy of physicians to prognosticate new late-onset shock and acute hypoxic respiratory failure; 2) Develop
hypotheses about sources of prognostication accuracy and inaccuracy by exploring heuristics, cognitive biases
and bioethical principles and values; 3) Determine the extent to which variation in hospital rates of persistent
critical illness are explained by new late-onset organ failures and palliative care utilization.
Deliverables from Aims: The proposed aims will lead to at least 4 publications and prepare Dr. Viglianti to
write 2 R01 proposals: 1) Develop and validate a new risk-prediction tool; 2) Identification of evidence-based
practices utilized by high performing hospitals in the prevention and management of late-onset organ failures.
Terms: <Achievement><Achievement Attainment><Admission><Admission activity><American><Austria><Automobile Driving><Award><Bed Occupancy><Beds><Bioethics><Biomedical Ethics><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Care Givers><Career Development Awards><Career Development Awards and Programs><Career Development Programs K-Series><Caregivers><Caring><Chest><Circulatory Collapse><Clinical><Clinical stratification><Cognitive><Consult><Critical Care><Critical Illness><Critically Ill><Data><Data Analyses><Data Analysis><Data Set><Decision Making><Development><Development Plans><Distress><Ethics><Event><Evidence based practice><Family><Funding><Goals><Grant><Health Care Systems><Healthcare Systems><Hospital Mortality><Hospitals><Hour><In-house Mortalities><Inhospital Mortality><Institution><Intensive Care Units><Interview><K-Awards><K-Series Research Career Programs><K12><K12 Award><K12 Mechanism><K12 Program><Knowledge><Learned Helplessness><Long-term cohort><Longitudinal Surveys><Longitudinal cohort><Longterm cohort><Lung><Lung Respiratory System><Manuscripts><Medical><Medical center><Medicine><Mental Depression><Mentored Clinical Scientist Development Program><Mentors><Methodology><Michigan><Minority><Morbidity><Morbidity - disease rate><NHLBI><National Heart, Lung, and Blood Institute><North Carolina><Organ failure><Outcome><Palliative Care><Palliative Therapy><Palliative Treatment><Paper><Patient Admission><Patient Care><Patient Care Delivery><Patients><Peer Review><Physicians><Population><Predicting Risk><Prevalence><Prevention><Probability><Process><Prognosis><Prospective cohort><Provider><Publications><Publishing><Research><Research Career Program><Research Resources><Resources><Risk><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Scientific Publication><Scientist><Scotland><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Shock><Societies><Source><Structure><Survey Instrument><Survey Method><Survey Methodology><Surveys><Symptoms><System><Thorace><Thoracic><Thorax><Universities><Validation><Variant><Variation><Veterans Health Administration><Veterans Health Affairs><Work><Writing><acute hypoxemic respiratory failure><acute hypoxic respiratory failure><acute onset hypoxemic respiratory failure><bed days><biomarker identification><care for patients><care of patients><career><career development><caring for patients><circulatory shock><cohort><comfort care><conditioned helplessness><consults><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><cost><data interpretation><depression><design><designing><developmental><driving><ethical><evidence base><experience><forecasting risk><heuristics><high risk><identification of biomarkers><identification of new biomarkers><improved><lecturer><marker identification><palliative><patient stratification><patient subclass><patient subcluster><patient subgroups><patient subpopulations><patient subsets><patient subtypes><predict risk><predict risks><predicted risk><predicted risks><predicting risks><predictive risk><predictive tools><predicts risk><prevent><preventing><professor><prognostication><prospective><psychologic><psychological><pulmonary><response><risk prediction><risk prediction algorithm><risk prediction model><risk predictions><risk stratification><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><shocks><social><stratified patient><stratify risk><systematic review><validations>