Harnessing Observational Data through Causal Inference to Reduce Hospital Readmissions for Survivors of Pneumonia with Respiratory Failure

/ABSTRACT Candidate’s Long-Term Career Goals: By pursuing the training plan outlined in this F32 proposal, Dr. Andrew Davis will learn key skills in clinical epidemiology, causal inference, and informatics while writing a K23 award and ultimately becoming an independent health services researcher investigating evidenced-based interventions to improve outcomes for survivors of pneumonia and respiratory failure. Clinical Problem to be Addressed: Community acquired pneumonia (CAP) with hypoxemia remains a major driver of hospitalizations, readmissions and new post-discharge morbidity. Current CAP guidelines are limited and make no recommendations on best practices to support the safe discharge of patient’s home. Candidate Background: Dr. Davis is a postdoctoral fellow in Pulmonary and Critical Care Medicine at Johns Hopkins University. He received his MD from the University of Pennsylvania (2019) after completing an Intramural Research Training Award fellowship at the NIH (2013-2015). He has coauthored 9 peer-reviewed publications and presented 6 oral and 8 poster presentations at national conferences. His department is strongly committed to his scientific career and has awarded him a 1-year fellowship on a T32 training grant. Career Development Plan: In order to achieve his goals, he proposes to develop expertise in biostatistics, clinical epidemiology, and bioinformatics through completing the research aims outlined in this proposal under the close guidance of his mentorship team, as well as through pursuing formal coursework leading to a Master of Health Science (MHS) degree from the Johns Hopkins Bloomberg School of Public Health. Mentors: His primary mentor is Dr. Theodore J. Iwashyna at the Johns Hopkins School of Medicine, who has supervised 15 K-level or equivalent career development awards of whom 10 have so far transitioned to PI of R- level awards or equivalents. He will be co-mentored in bioinformatics by Dr. Khyzer Aziz, assistant professor of pediatrics and Chief Medical Information Officer at the Johns Hopkins Children’ Center, and in biostatistics by Dr. Akihiko Nishimura, assistant professor of biostatistics at the Bloomberg School of Public Health. Aims: He will use the Johns Hopkins Precision Medicine Analytics Platform (PMAP) comprising observational data from 2.4 million patients and 23 million healthcare encounters in both research aims. First, he will perform a target trial emulation evaluating the effect of scheduling early primary care follow-up at discharge following admission for hypoxemic CAP. Then he will develop the informatics infrastructure needed to investigate optimal discharge diuretic regimens for survivors of CAP with comorbid heart failure in his future K23 award proposal. Deliverables from Aims: His proposed aims will lead to 3-4 publications over 2 years with semiannual presentations at national conferences. This proposal constitutes the foundation for a future K23 application to develop evidence-based guidelines to improve outcomes for survivors of pneumonia and respiratory failure by supporting their safe discharge home following hospital admission. Project Number: 1F32HL182325-01 | Fiscal Year: 2025 | NIH Institute/Center: National Heart Lung and Blood Institute (NHLBI) | Principal Investigator: Andrew Davis | Institution: JOHNS HOPKINS UNIVERSITY, BALTIMORE, MD | Award Amount: $101,360 | Activity Code: F32 | Study Section: Special Emphasis Panel[ZRG1 F16-D (20)] View on NIH RePORTER: https://reporter.nih.gov/project-details/1F32HL18232501