# Evaluation of Multi-level factors Associated with post-ERCP Outcomes

> **NIH NIH K23** · UT SOUTHWESTERN MEDICAL CENTER · 2024 · $159,269

## Abstract

Project Summary/Abstract
This K23 proposal will complete Anna Tavakkoli, MD, MSc’s training towards her long-term career goal of
becoming an independent clinician investigator and leader in advanced endoscopy. Dr. Tavakkoli is an advanced
endoscopist in the Division of Digestive and Liver Diseases at the University of Texas Southwestern (UTSW)
with Master’s training in health services research principles. This proposal builds on Dr. Tavakkoli’s prior
experience, leveraging advanced statistical methods, utilizing complex datasets, developing a prospective
patient cohort, and the rich training environment at UTSW to improve our understanding of ERCP outcomes and
costs throughout the United States. The research will be completed under the guidance of her primary mentor,
Amit G. Singal MD, MSc, and co-mentor, B. Joseph Elmunzer MD, MSc, with a planned mentor-the-mentor
strategy and additional input from an advisory board of physician-investigators. The 5-year plan includes formal
coursework, professional development, and mentored research, with defined milestones to ensure productivity
and a successful transition to independence. This mentored research has 3 Specific Aims:
 • AIM 1 Characterize variation in, and identify patient-, provider, and system-level covariates for
 post-ERCP outcomes.
 • AIM 2a Characterize 30-day post-ERCP variations in healthcare utilization, Medicare
 expenditures and drivers of expenditures across US health systems.
 • AIM 2b Enumerate out-of-pocket and indirect costs associated with post-ERCP adverse events.
 • AIM 3 Model the impact of potential intervention strategies to improve post-ERCP pancreatitis.
Inherent to completing these high-level aims, Dr. Tavakkoli will also (1) characterize variation in post-ERCP
outcomes across Medicare beneficiaries; (2) identify key patient-, provider-, and system-level correlates
associated with variation in post-ERCP outcomes; (3) characterize Medicare expenditures as it relates to ERCP;
(4) characterize healthcare utilization, and correlates that contribute to variations in utilization, as it relates to
post-ERCP outcomes; (5) characterize indirect costs associated with post-ERCP adverse events through direct
patient contact; (6) utilizing decision analytic modeling to understand the clinical impact that various intervention
strategies, such as a selective referral approach to high-volume endoscopists, could have on rates of post-ERCP
pancreatitis. This work will build to an R01 proposal focused on: 1) Building a multi-center prospective cohort to
identify granular clinical factors associated with post-ERCP adverse events; 2) Evaluating patient and provider
acceptance of intervention strategies; 3) Cost-effectiveness of intervention strategies from our decision analytic
model. Beyond establishing a foundation for a programmatic line of research to improve endoscopic care for
patients, this proposal will support and accelerate the career development activities of Dr. Tavakkoli, allow...

## Key facts

- **NIH application ID:** 10781939
- **Project number:** 5K23DK132409-02
- **Recipient organization:** UT SOUTHWESTERN MEDICAL CENTER
- **Principal Investigator:** Anna Tavakkoli
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $159,269
- **Award type:** 5
- **Project period:** 2023-02-15 → 2027-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10781939

## Citation

> US National Institutes of Health, RePORTER application 10781939, Evaluation of Multi-level factors Associated with post-ERCP Outcomes (5K23DK132409-02). Retrieved via AI Analytics 2026-06-14 from https://api.ai-analytics.org/grant/nih/10781939. Licensed CC0.

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