SCH: Improving Patient Health and Equity through the Digital Transformation of Diabetes Care Delivery

SCH：通过糖尿病护理服务的数字化转型改善患者健康和公平

• 批准号: 2205084
• 负责人: Ramesh Johari
• 金额: $ 120万
• 依托单位: Stanford University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=2205084&HistoricalAwards=false
• 关键词: SCH; Improving; Patient; Health; Equity

This Smart and Connected Health (SCH) award will contribute to the advancement of the national health and welfare by developing the scientific foundation of using digital technology to improve the quality and reduce the cost of diabetes management. Increased adoption of remote activity trackers, continuous glucose monitors, other types of sensors, and telehealth (precipitated by the COVID-19 pandemic) have transformed diabetes care. The typical standard of care for diabetes revolves around a few “finger poke” glucose measurements per day and a few in-clinic visits with the care team per year, with many missed opportunities to detect and remedy deteriorating glucose management. The digitization of diabetes care holds the potential for as-needed measurement, monitoring, and personalized patient care. In a best case scenario, these technological advances promise to narrow gaps in health care access, by providing limited care resources to those most in need. Achieving this outcome requires novel scientific progress to leverage sensor data to better understand patients; to develop algorithmic techniques to allocate care resources efficiently to patients; and to help both providers and patients develop and implement care decisions together. This award specifically develops algorithms, platforms, and decision support tools to address these challenges in the context of care of type 1 diabetes in pediatric populations, by connecting engineers, computer scientists, and statisticians with clinicians in an interdisciplinary effort. A key component of the project involves deployment at two sites (Lucile Packard Children’s Hospital at Stanford, and Children’s Mercy Hospital at Kansas City) to capture the real-world constraints the theory must tackle and to validate the real-world efficacy of the scientific innovations developed.The research objectives are to: (1) develop methods to identify patient types from sensor data, informing the health care team's understanding of differentiated needs and behaviors across the patient population; (2) develop methods to allocate scarce provider resources to those patients most in need of care; and (3) design interpretable treatment planning recommendations to facilitate interactions between providers and patients, including both provider-facing and patient-facing “dashboards” that visualize progress and disease management, and guide discussion of interventions. These thrusts both leverage and advance the state of the art in time-series modeling and machine learning; behavioral psychology; and data-driven operations research. Data and real-world understanding from the clinical context serve to define the problems the theory must tackle and as a benchmark to validate the models and methods developed. The models developed will be deployed and evaluated in clinics caring for pediatric patients with type 1 diabetes.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

这项智能和联系的健康奖（SCH）奖将通过开发使用数字技术来提高质量并降低糖尿病管理成本的科学基础，从而有助于国家健康和福利的发展。远程活动跟踪器的采用，连续的葡萄糖监测器，其他类型的传感器以及远程医疗（由COVID-19大流行促进）的采用已改变了糖尿病护理。糖尿病的典型护理标准每天围绕一些“手指戳”葡萄糖测量以及每年的临床访问，每年进行几次临床访问，并有许多未能检测和记住的机会检测到葡萄糖管理的机会。糖尿病护理的数字化具有急需的测量，监测和个性化患者护理的潜力。在最佳情况下，这些技术进步有望通过为最需要的人提供有限的护理资源来缩小医疗保健方面的差距。实现这一结果需要新的科学进步来利用传感器数据来更好地了解患者；开发算法技术以有效地分配护理资源为患者；并帮助提供者和患者共同制定和实施护理决策。该奖项专门开发了算法，平台和决策支持工具，以通过将工程师，计算机科学家和统计学家与跨学科的努力联系起来，在儿科人群中1型糖尿病的情况下应对这些挑战。该项目的一个关键组成部分涉及在两个站点（斯坦福大学的Lucile Packard儿童医院和堪萨斯城的儿童慈悲医院）捕获现实世界的限制，该理论必须解决现实世界的限制，并验证开发的科学创新的现实效率。 人口; （2）开发向最需要护理的患者分配稀缺提供者资源的方法； （3）设计可解释的治疗计划建议，以促进提供者与患者之间的相互作用，包括面向提供者和面向患者的“仪表板”，可视化进度和疾病管理，并指导对干预措施的讨论。这些推力在时间序列建模和机器学习方面既利用又推进艺术的状态；行为心理学；和数据驱动的操作研究。来自临床环境的数据和现实世界的理解有助于定义理论必须解决的问题，并作为验证开发的模型和方法的基准。开发的模型将在针对1型糖尿病的小儿患者的诊所中进行部署和评估。该奖项反映了NSF的法定任务，并使用基金会的知识分子优点和更广泛的影响评估标准，通过评估被认为是宝贵的支持。

项目成果

Sequence Modeling with Multiresolution Convolutional Memory

• DOI: 10.48550/arxiv.2305.01638
• 发表时间: 2023-05
• 期刊: ArXiv
• 作者: Jiaxin Shi;Ke Alexander Wang;E. Fox

1129-P: Continuous Glucose Monitoring (CGM) Initiation Shortly after Diagnosis Does Not Worsen Psychosocial States

1129-P：诊断后立即开始连续血糖监测 (CGM) 不会恶化心理状态

• DOI: 10.2337/db23-1129-p
• 发表时间: 2023
• 期刊: Diabetes
• 影响因子: 7.7
• 作者: ADDALA, ANANTA;RITTER, VICTOR;SHAW, BLAKE;PANG, ERICA;CORTES-NAVARRO, ANA L.;BALISTRERI, ILENIA;LOYOLA, ALONDRA;ALAMARIE, SELMA A.;SCHNEIDER-UTAKA, AIKA;BISHOP, FRANZISKA K.
• 通讯作者: BISHOP, FRANZISKA K.

693-P: Diabetes Distress Is Common in Newly Diagnosed Families in the 4T Study and Families Are Receptive to Psychological Services

693-P：4T 研究中新诊断的家庭中糖尿病困扰很常见，家庭愿意接受心理服务

• DOI: 10.2337/db23-693-p
• 发表时间: 2023
• 期刊: Diabetes
• 影响因子: 7.7
• 作者: SCHNEIDER-UTAKA, AIKA;PANG, ERICA;CORTES-NAVARRO, ANA L.;BALISTRERI, ILENIA;LOYOLA, ALONDRA;ARRIZON-RUIZ, NORA;ALAMARIE, SELMA A.;RITTER, VICTOR;SHAW, BLAKE;BISHOP, FRANZISKA K.
• 通讯作者: BISHOP, FRANZISKA K.

1146-P: Changes in Parent/Guardian and Youth Patient Reported Outcomes (PROs) after T1D Diagnosis for Families in the 4T Study 1

1146-P：4T 研究 1 中家庭 T1D 诊断后家长/监护人和青少年患者报告结果 (PRO) 的变化

• DOI: 10.2337/db23-1146-p
• 发表时间: 2023
• 期刊: Diabetes
• 影响因子: 7.7
• 作者: ALAMARIE, SELMA A.;PANG, ERICA;CORTES-NAVARRO, ANA L.;ARRIZON-RUIZ, NORA;BALISTRERI, ILENIA;LOYOLA, ALONDRA;SCHNEIDER-UTAKA, AIKA;RITTER, VICTOR;SHAW, BLAKE;BISHOP, FRANZISKA K.
• 通讯作者: BISHOP, FRANZISKA K.

Disparities in Hemoglobin A1c Levels in the First Year After Diagnosis Among Youths With Type 1 Diabetes Offered Continuous Glucose Monitoring.

• DOI: 10.1001/jamanetworkopen.2023.8881
• 发表时间: 2023-04-03
• 期刊: JAMA NETWORK OPEN
• 影响因子: 13.8
• 作者: Addala, Ananta;Ding, Victoria;Zaharieva, Dessi P.;Bishop, Franziska K.;Adams, Alyce S.;King, Abby C.;Johari, Ramesh;Scheinker, David;Hood, Korey K.;Desai, Manisha;Maahs, David M.;Prahalad, Priya
• 通讯作者: Prahalad, Priya