Dr. Meghan Reading Turchioe, an instructor in the Department of Population Health Sciences at Weill Cornell Medicine (WCM), has been awarded the K99/R00 grant from the National Institutes of Health (NIH) for her study on atrial fibrillation (AFib) symptom management.
AFib is the most common cardiac arrhythmia that disproportionately affects adults over age 65. Patients with this chronic condition are burdened with symptoms that do not improve with medication alone and are at risk for blood clots, stroke, heart failure, and other heart diseases.
Radiofrequency ablation is often a therapeutic option for AFib patients. The procedure involves threading thin wires through a vein to reach the heart’s electrical system. Heat is then sent through the wires to damage the tissues causing abnormal heartbeats. However, there is limited evidence that quantifies symptom improvement following treatment. “Ablations carry non-trivial risks, especially for an older adult population, so the decision to undergo ablation should ideally be made based on a thoughtful evaluation of risks, benefits, and patient goals of care, values, and preferences,” said Dr. Turchioe.
To gain post-procedure insight that will support a shared decision-making process, Dr. Turchioe will: (1) mine AFib patient electronic health records using natural language processing methods to generate evidence about which symptoms improve following ablation, and for which patients, and (2) create an interactive, visualization-based decision aid to communicate evidence about symptom improvement and facilitate shared decision-making around ablations. According to Dr. Turchioe, the overall goal is to help patients and providers select the most appropriate therapy for symptom management in AFib.
The K99/R00 award, also known as the Pathway to Independence Award, is a five-year program designed to launch junior investigators into autonomous positions. “In the K99 phase, I will pursue my research questions in a mentored capacity while also completing training in natural language processing, human-computer interaction, symptom science, and implementation science,” explained Dr. Turchioe. “In the R00 phase, I will transition into a more independent role, applying my training and leveraging the mentorship I have received to continue the research aims.”
Dr. Turchioe’s inquiry into AFib symptom management stems from her Ph.D. work, during which she received a fellowship award from the National Institute of Nursing Research (NINR) at the NIH. The K award, also from the NINR, is a culmination of her research evolution and represents a significant milestone in her career. “It is a launchpad for all of the research questions and ideas I have wanted to pursue but did not have the resources or time to do so. With this award, I will have the chance to pursue these interests while still benefitting from the mentorship and support of my colleagues,” shared Dr. Turchioe.
Dr. Turchioe is also appreciative of the dedicated training opportunities the award provides. “Most of my informatics experience thus far has focused on mobile health interventions, which involves collecting and returning digital health data directly to patients,” she said. “Natural language processing and working with electronic health records are areas in which I have significantly less experience but am eager and excited to learn, as I see them as complementary to many of the research methods I currently use.”
Mentorship is a critical component of the K99/R00 program, and Dr. Turchioe is extremely grateful to her mentors at WCM, including Drs. Jyotishman Pathak, Ruth Masterson Creber, Jessica Ancker, Monika Safford, and David Slotwiner, and mentor at Columbia University School of Nursing, Dr. Suzanne Bakken. “They each bring extensive knowledge about topics ranging from natural language processing and human-computer interaction to cardiovascular physiology, epidemiology, and symptom science,” she related. Coming from a multidisciplinary background with experience as a cardiac nurse and graduate and doctoral studies in public health and biomedical informatics, respectively, Dr. Turchioe finds commonalities with her mentors and looks forward to learning and incorporating their wide-ranging perspectives into her program of research.
The experience has also inspired Dr. Turchioe to become a mentor herself. Since joining WCM, she has mentored and taught students in the department’s Master of Science program, the City Tech-WCM Big Data Training Program, and the CUNY Graduate School of Public Health & Health Policy. “I often find myself directly sharing new insights that I have gleaned from my mentors with my mentees,” she pointed out. “The students come from a variety of personal and professional backgrounds and I find that I learn just as much from the students as they do from me.”
Emphasizing the strength of the department’s scientific environment and the quality of the faculty mentors, Dr. Turchioe believes that these two factors were instrumental in the award being funded. “I am so grateful for the support of my mentorship team and the department in general.”