Summaries of Independent Scientist (K) Awards

Strate, Lisa

Institution: University of Washington School of Medicine
Grant Title: Outcomes and Care Practices in Lower Intestinal Bleeding
Grant Number: K08 HS014062
Duration: 5 years (2004-2009)
Total Award: $663,200

Project Description: The goal of this project is 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 decisionmaking. Three complementary studies will address these aims:

1. A nationwide database will be used to study patients with ALIB.
2. A prospective cohort of patients admitted with ALIB will be followed and detailed  data collected on procedural interventions and patient outcomes.
3. A nationwide survey will be administered to a random sample of 2,000 practicing gastroenterologists.

Career Goals: The research will enable Dr. Strate to pursue an independent career in health services research in the field of gastroenterology by performing studies to improve and standardize the management of ALIB.

Progress to Date: Dr. Strate is an Acting Assistant Professor of Medicine at the University of Washington School of Medicine. She has conducted two analyses regarding care practices in ALIB. She has continued work initiated prior to the award using, the Clinical Outcomes Research Initiative to study the epidemiology of bleeding diverticulosis and angiodysplasia, and endoscopic treatment practices of these lesions. She also recently completed a prospective, multicenter validation study of her previously developed clinical prediction rule for ALIB. One first authored manuscript has been published this year.

Future Plans: Dr. Strate will continue work using administrative data to study care practices and outcomes in ALIB and plans to produce several manuscripts. She plans to begin to investigate predictors of recurrent bleeding episodes and the appropriate timing of surgical interventions for ALIB. She will continue with her clinical duties.

Highlights and Specific Accomplishments:

• Post-doctoral Fellow, Agency for Healthcare Research and Quality (AHRQ), Harvard School of Public Health.
• Acting Assistant Professor of Medicine, University of Washington School of Medicine.
• Staff Physician, Harborview Medical Center, Seattle, Washington.
• Member, American College of Gastroenterology Research Committee.
• Digestive Disease Week in May, 2 oral presentations on ALIB.
• Professional Societies:
  • American Gastroenterology Association.
  • American College of Gastroenterology.
  • American Society for Gastrointestinal Endoscopy.

K-Generated Publications:

• Strate LL, Syngal S. Predictors of utilization of early colonoscopy vs. radiography for severe lower intestinal bleeding. Gastrointestinal Endoscopy 2005;61(1):46-52.
• Strate LL, Saltzman JR, et al. Validation of a clinical prediction rule for sever acute lower intestinal bleeding. American Journal of Gastroenterology 2005;100(8):1821-7.
• Strate LL, Syngal S. Early colonoscopy and hospital length of stay in acute lower intestinal bleeding: A nationwide study. Gastrointestinal Endoscopy 2005;61(5):AB84.
• Strate LL, Syngal S. Predictors of mortality in acute lower intestinal bleeding in a nationally representative sample [abstract] Gastrointestinal Endoscopy 2005;61(5):AB84.

AHRQ Research Portfolios: Care Management; Data Development; Training.
AHRQ Goals: Effectiveness

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