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and Women's Hospital
Grant Title: Outcomes
and Care Practices in Lower Intestinal Bleeding
Grant Number: K08 HS014062
Total Award: $663,200
Project Description: The goal of this project was
to improve and standardize the management of Acute Lower Intestinal Bleeding
(ALIB) by comparing the impact of colonoscopy versus radiographic
interventions for ALIB on rebleeding, morality and resource utilization, and
assessing physicians' practices and factors that influence clinical decision
making. Three complementary studies addressed these aims:
- A State-wide
database will be used to study 7,000 patients with ALIB.
- A prospective
cohort of 300 patients admitted to three hospitals with ALIB will be followed
and detailed data collected on procedural interventions and patient outcomes.
- A nationwide survey will be administered to a random sample of 2,000
Career Goals: Dr. Strate is an Assistant Professor in the School of Medicine at the University of Washington. She received her MD from the University of California, San Francisco and was a Clinical Fellow in the Gastroenterology Division at Brigham and Women's Hospital. She went on to earn her MPH from Harvard School of Public Health in Boston. The K-research enabled Dr. Strate to pursue independent career in health services research in the field of gastroenterology by performing studies to improve and standardize the management of acute lower intestinal bleeding.
Progress to Date: This grant has been completed. Dr. Strate found that motality in ALIB was low. Advanced age, intestinal ischemia and comorbid illness were the strongest predictors of mortality suggesting supportive care of comorbid conditions may improve inpatient mortality more than therapeutic interventions.
Highlights and Specific Accomplishments:
- Post-doctoral Fellow, AHRQ,
Harvard School of Public Health.
- Member, American College of Gastroenterology Research Committee.
- Gastroenterology Clinical
Research Conference, co-organizer of this weekly conference.
Strate LL, Syngal S. Predictors of utilization of early
colonoscopy vs. radiography for severe lower intestinal bleeding. Gastrointest
Endosc 2005. 61(1):46-52.
Strate LL, Saltzman JR, Ookubo R, Mutinga ML, Syngal S.
Validation of a clinical prediction rule for sever acute lower intestinal bleeding.
American Journal of Gastroenterology 2005. 100(8):1821-27.
Strate LL, Syngal S. Early colonoscopy and hospital length of
stay in acute lower intestinal bleeding: A nationwide study. Gastrointest Endosc 2005. 61(5):AB84.
Strate LL, Liu YL, Aldoori WH, et al. Nut, corn and popcorn consumption and the incidence of diverticular disease. Journal of the American Medical Association 2008. 300(8):907-14.
Strate LL, Ayanian JZ, Kotler G, Syngal S. Risk factors for mortality in acute lower intestinal bleeding. Clinical Gastroenterology and Hepatology 2008. 6(9):1004-10.
Strate LL, Lieu, Aldoori WH, et al. Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology 2009. 136(1):155-122.e1.
Strate LL, Liu, Aldoori WH, Giovannucci E. Physical activity decreases the risk of diverticular complications. American Journal of Gastroenterology 2009. 104:1221-230.
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