# Understanding Response Shift in Acute Respiratory Distress Syndrome (ARDS) survivors

> **NIH NIH K01** · JOHNS HOPKINS UNIVERSITY · 2020 · $170,750

## Abstract

Project Summary / Abstract
Acute respiratory distress syndrome (ARDS) is a severe lung injury usually requiring mechanical ventilation in
an intensive care unit (ICU). While the number of ICU patients requiring mechanical ventilation is steadily
increasing, in-hospital mortality is declining, creating a growing population of ARDS survivors. Such survivorship
comes at a high “cost,” with ARDS patients frequently experiencing new or worsening physical, cognitive, and/or
mental health impairments that last for years after ARDS. NHLBI and professional societies identify improving
quality of life for ARDS survivors as a key research priority. Some ARDS survivors may adapt to new
impairments over time and report improving quality of life not explained by improvements in objective measures
of their physical, cognitive, and mental health. This adaptation phenomenon is known as “response shift.” We
hypothesize that ARDS survivors demonstrate widely varying degrees of response shift, and that patients'
baseline characteristics prior to ARDS have important associations with the magnitude of response shift after
ICU discharge. We also investigate how psychosocial factors, including trait anxiety, social support, resilience,
and survivor expectations for functional recovery, impact quality of life during recovery as a first step toward
designing and evaluating new interventions for ARDS survivors.
 This proposal will exploit a unique, pre-existing cohort of very well-characterized ARDS survivors from
the NHLBI ARDS Network Long Term Outcome Study (ALTOS) containing hundreds of data elements per
patient. Using modern data science methods, I will empirically evaluate the association between baseline patient
characteristics and response shift between 6 and 12 months after ARDS [Aim 1], and identify the changes in
specific aspects of physical, cognitive, and mental health, from among ~165 candidate measures, that best
predict changes in quality of life [Aim 2]. To investigate how psychosocial factors impact quality of life, I will
conduct a new, prospective, ICU cohort study of ARDS survivors to collect data for these novel analyses [Aim
3]. The results from these three Aims will generate new knowledge regarding empirically-derived, testable
hypotheses about important determinants of quality of life, and provide essential data for designing future studies
of interventions aimed at improving the quality of life of ARDS survivors.
 This career development award provides training in data science, patient outcomes-oriented clinical
research, and machine learning statistical techniques for the applicant who is a PhD-trained epidemiologist
without these skills. Immediate, short-term, and long-term career goals include: (1) publishing results of the
proposed research, (2) successfully competing for R-level funding to explore whether addressing psychosocial
issues, including setting appropriate patient expectations for recovery, is a potentially modifiable, low-cost
inte...

## Key facts

- **NIH application ID:** 9925813
- **Project number:** 5K01HL141637-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Alison Turnbull
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $170,750
- **Award type:** 5
- **Project period:** 2018-04-12 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9925813

## Citation

> US National Institutes of Health, RePORTER application 9925813, Understanding Response Shift in Acute Respiratory Distress Syndrome (ARDS) survivors (5K01HL141637-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9925813. Licensed CC0.

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