DESCRIPTION (provided by applicant): Candidate: Dr. Sparks is an Instructor of Medicine in the Section of Clinical Sciences (SCS), Division of Rheumatology, Immunology and Allergy at Brigham and Women's Hospital (BWH) where he has 88% of his full-time professional effort committed to his research projects. He has 12% of his time devoted to clinical care at BWH and teaching at Harvard Medical School (HMS). He has received a Master of Medical Sciences degree in patient-oriented research from HMS, and a career development award from the Rheumatology Research Foundation. His dedication to clinical investigation is evident by 9 total and 6 first-author original research publications, presentations at national and international scientific meetings, and service on scientific committees. He has an experienced team of senior mentors and strong institutional support in an environment that fosters training in patient-oriented research. In line with his career development plan for this award, his immediate career goals are to expand his prior findings on increased risk of respiratory mortality for patients with rheumatoid arthritis (RA) using two prospective cohorts that will serve as the foundation for future independent research endeavors linking RA pathogenesis with subsequent respiratory outcomes. With the assistance of his expert mentoring team, led by Dr. Elizabeth Karlson, he will obtain training in advanced statistical methods in outcomes research, pulmonary evaluation and phenotyping, and integration of biomarkers in his studies to complete the aims of this proposal. The research training, mentorship, and results that arise from this project will lay the groundwork so that he can achieve his long-term goal to become an independent scientist in the field of RA epidemiology. Ultimately, he plans to develop interventions that prevent or decrease the respiratory burden of RA patients while informing the pathogenesis of respiratory diseases. Environment: Dr. Sparks has a commitment from his Department and Division at BWH that ensures at least 75% protected time for the research and career development activities detailed in this K23 proposal. He has institutional support from a recruitment package as well as supplemental salary support though his primary mentor's funding. He has access to subjects with RA for recruitment in the Brigham RA Sequential Study (BRASS), an ongoing 13-year longitudinal cohort, as well as >2,500 RA patients seen annually at the BWH Arthritis Center. Since BWH is a leading academic hospital for rheumatic and pulmonary diseases, he will have access to recruit adequate numbers of subjects for this project and future studies. He will obtain training in pulmonary phenotyping at the BWH Pulmonary Physiology Center and RA/Interstitial Lung Disease Clinic. In addition, he has full access to data in the Nurses' Health Study (NHS), through the BWH Channing Division of Network Medicine. The NHS is composed of 121,700 women followed since 19...