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Principal Investigator: April Jorge
Organization: MASSACHUSETTS GENERAL HOSPITAL
Fiscal Year: 2024
Award: $174,960
Funding agency: National Institute of Arthritis and Musculoskeletal and Skin Diseases
Candidate: April Jorge, MD is an Instructor in Medicine at Harvard Medical School (HMS) and an Assistant in
Medicine in the Rheumatology Unit at Massachusetts General Hospital (MGH). After graduating from the
University of Maryland magna cum laude, she received her MD from Georgetown University, and she
completed her internal medicine residency at Northwestern University. She completed her rheumatology
fellowship at MGH, during which she also completed the Harvard Catalyst Clinical and Translational Research
Academy and began working with Hyon Choi, MD, DrPH. Dr. Jorge's prior work has resulted in 15 peer-
reviewed original papers, with 13 as the first author or co-first author. Her goal is to become an independent
investigator and innovative leader in patient-oriented research of systemic lupus erythematosus (SLE).
Mentorship, Training Activities, and Environment: Dr. Jorge will conduct the proposed project at MGH
under the mentorship of Hyon Choi, MD, DrPH and co-mentorship of Karen Costenbader, MD, MPH and Karen
Sepucha, PhD. Dr. Choi is a world-renowned, NIH-funded physician scientist in advanced clinical epidemiology
of rheumatic conditions, ranging from common disorders to rare but serious disorders (e.g., SLE). He has
served as a mentor for several prior K awardees. Dr. Costenbader is a clinical investigator and expert in SLE
who is also an experienced mentor of K awardees. Dr. Sepucha is a leading expert in patient-centered
decision science. Dr. Jorge's research will also benefit from the specific expertise of her key collaborators,
including advanced clinical epidemiology methods, machine learning prediction algorithms, and decision-
analytic modeling. In addition to receiving excellent mentorship, she will acquire new skills through didactics in
advanced clinical epidemiology and pharmacoepidemiology, risk prediction, eliciting patient preferences with a
mixed methods research approach, and decision-analytic modeling.
Research: SLE carries increased risks of multiple comorbidities and double the risk of death compared to the
general population. Current treatment is limited in part by few proven medications and adverse treatment
effects. The central goal of this research is to improve long-term SLE outcomes by integrating personalized
risks of potential harms and benefits with patient preferences to guide the personalized, patient-centered use
of key lupus medications. To achieve this goal, she will risk stratify patients for potential harms of treatment,
i.e., hydroxychloroquine retinopathy and infection with belimumab use versus other immunosuppressants, and
other adverse outcomes, i.e., severe COVID-19 infection (Aim 1). She will elicit patient preferences for SLE
treatment through a discrete choice experiment (Aim 2a) and will integrate patient preferences with
personalized risks through a multi-criteria decision analysis to determine the optimal hydroxychloroquine dose
in SLE care (Aim 2b). Completion of this proposal and training plan will position Dr. Jorge with the vital
experience to become an independent clinical investigator in patient-oriented research of SLE.
Terms: <Academy><Adverse effects><Award><Azathioprine><Azothioprine><Benlysta><Biological><COVID-19 infection><COVID-19 virus infection><COVID19 infection><Cardiovascular><Cardiovascular Body System><Cardiovascular Organ System><Cardiovascular system><Career Development Awards><Career Development Awards and Programs><Career Development Programs K-Series><Caring><Clinical><Clinical Investigator><Clinical Research><Clinical Study><Decision Analysis><Decision Making><Disease><Disorder><Doctor of Philosophy><Dose><Drugs><Electronic Health Record><Environment><Epidemiologic Methods><Epidemiological Methods><Epidemiological Techniques><Equilibrium><Event><FDA approved><Fellowship><Flare><Foundations><Funding><General Hospitals><General Population><General Public><Goals><Guidelines><Harm Minimization><Harm Reduction><Heart Vascular><Heterogeneity><Hospital Admission><Hospitalization><Hydroxychlorochin><Hydroxychloroquine><Immunosuppressants><Immunosuppressive Agents><Immunosuppressive drug><Immunosuppressive treatment><Immuran><Imuran><Imurel><Infection><Internal Medicine><Investigators><K-Awards><K-Series Research Career Programs><Life><Lupus><Lupus Erythematosus Disseminatus><Machine Learning><Maryland><Massachusetts><Medication><Medicine><Mentors><Mentorship><Methodology><Methods Epidemiology><Methotrexate><Methotrexate Methylaminopterin><Methotrexatum><Metotrexato><Modeling><Morbidity><Morbidity - disease rate><Mycophenolate><NIH><National Institutes of Health><Ophthalmology><Oral><Organ><Outcome><Oxychlorochin><Oxychloroquine><Paper><Patient Compliance><Patient Preferences><Patient Recruitments><Patients><Peer Review><Ph.D.><PhD><Pharmaceutical Epidemiology><Pharmaceutical Preparations><Pharmacoepidemiology><Physicians><Position><Positioning Attribute><Predicting Risk><Premature Mortality><Recommendation><Research><Research Career Program><Research Methodology><Research Methods><Research Personnel><Researchers><Residencies><Retinal Diseases><Retinal Disorder><Rheumatology><Risk><Risk Factors><SARS-CoV-2 infection><SARS-CoV2 infection><SLE><Science><Scientist><Severe acute respiratory syndrome coronavirus 2 infection><Severity of illness><Sight><Subgroup><Systemic Lupus Erythematosus><Systemic Lupus Erythematous><Systemic Lupus Erythmatosus><Training><Training Activity><Translational Research><Translational Science><Treatment outcome><Uncertainty><United States National Institutes of Health><Universities><Vision><Work><adjudication><adjudicative process and procedure><adverse consequence><adverse outcome><balance><balance function><belimumab><biologic><care outcomes><catalyst><circulatory system><clinical decision-making><clinical epidemiology><co-morbid><co-morbidity><cohort><comorbidity><computer based prediction><conventional dosage><conventional dosing><coronavirus disease 2019 infection><damage to kidney><data access><data-driven model><death risk><disease severity><disseminated lupus erythematosus><dosage><doubt><drug epidemiology><drug/agent><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><experience><experiment><experimental research><experimental study><experiments><forecasting risk><health care outcomes><healthcare outcomes><immune suppressive agent><immune suppressor><immunosuppressive substance><immunosuppressor><improved><improved outcome><infected with COVID-19><infected with COVID19><infected with SARS-CoV-2><infected with SARS-CoV2><infected with coronavirus disease 2019><infected with severe acute respiratory syndrome coronavirus 2><infection risk><innovate><innovation><innovative><instructor><kidney damage><life-threatening COVID><life-threatening COVID-19><life-threatening SARS-CoV-2><life-threatening coronavirus disease><life-threatening coronavirus disease 2019><life-threatening severe acute respiratory syndrome coronavirus 2><machine based learning><machine learning prediction algorithm><medical college><medical schools><mortality><mortality risk><novel><participant recruitment><patient adherence><patient centered><patient cooperation><patient oriented><patient oriented research><patient oriented study><patient stratification><personalization of treatment><personalized medicine><personalized therapy><personalized treatment><pharmacoepidemiologic><pharmacoepidemiological><predict risk><predict risks><predicted risk><predicted risks><predicting risks><predictive modeling><predictive risk><predicts risk><preference><renal damage><research and methods><retina disease><retina disorder><retinopathy><risk prediction><risk predictions><risk stratification><school of medicine><serious COVID><serious COVID-19><serious SARS-CoV-2><serious coronavirus disease><serious coronavirus disease 2019><serious severe acute respiratory syndrome coronavirus 2><severe COVID><severe COVID-19><severe COVID19><severe SARS-CoV-2><severe coronavirus disease><severe coronavirus disease 19><severe coronavirus disease 2019><severe severe acute respiratory syndrome coronavirus 2><skills><stratified patient><stratify risk><systemic lupus erythematosis><therapy adverse effect><traditional dosage><traditional dosing><training module><translation research><translational investigation><treatment adverse effect><trend><visual function>