Optimizing Surgical Interventions for Patients with Spinal Metastases: A Mixed-Methods Study

优化脊柱转移瘤患者的手术干预：混合方法研究

• 批准号: 10180899
• 负责人: Andrew Schoenfeld
• 金额: $ 17.82万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-09 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10180899
• 关键词: Address; Aftercare; Age; Cancer Center; Characteristics; Clinical; Clinical Data; Cohort Studies; Collaborations; Cost Effectiveness Analysis; Data; Decision Analysis; Decision Making; Development; Diagnosis; Disease; Ensure; Environment; Epidemiologic Methods; Face; Focus Groups; Fright; General Hospitals; Goals; Health; Hospitals; Individual; Inferior; Institution; Intervention; Investigation; Journals; Learning; Life Expectancy; Literature; Malignant Neoplasms; Massachusetts; Medical; Medical Oncologist; Medicine; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Metastatic Neoplasm to the Spine; Methods; Michigan; Modality; Multicenter Studies; Musculoskeletal; NCI Scholars Program; Neoplasm Metastasis; Neurological status; Neurosurgeon; Nutritional; Oncologist; Oncology; Operative Surgical Procedures; Orthopedic Surgery; Orthopedics; Outcome; Pain; Patient Care; Patient Preferences; Patients; Peer Review; Perioperative; Physicians; Play; Process; Productivity; Prognosis; Prospective Studies; Publishing; Qualitative Research; Quality of life; Quality-Adjusted Life Years; Radiation Oncologist; Registries; Research; Research Methodology; Research Training; Risk; Role; Scientist; Spinal; Spinal Diseases; Spine surgery; Surgeon; Techniques; Testing; Time; Training; Treatment outcome; Tumor Burden; Universities; Vertebral column; Woman; Wood material; Work; base; cancer diagnosis; career development; cohort; comorbidity; cost; cost-effectiveness ratio; experience; functional outcomes; incremental cost-effectiveness; independent ambulation; medical specialties; meetings; mortality; older patient; palliation; patient oriented; preservation; prevent; professor; recruit; research and development; skills; treatment optimization; tumor

Candidate: Dr. Schoenfeld is an Assistant Professor and Associate Orthopaedic Surgeon in the Department of Orthopaedic Surgery at Brigham and Women’s Hospital (BWH). He is a graduate of the Robert Wood Johnson Clinical Scholars Program at the University of Michigan. Dr. Schoenfeld has a successful track record of publishing in peer reviewed journals and presenting original research at national scientific meetings. He has an experienced team of mentors and collaborators combined with strong institutional support in a rich academic environment that has successfully trained other clinician scientists in patient-oriented researchUnder the guidance of his mentoring team, led by Dr. Jeffrey Katz, Dr. Schoenfeld will obtain training in causal inference techniques, qualitative research methods, and decision analysis in order to complete the aims outlined in this proposal. The research training, mentorship, and results that arise from this project will help Dr. Schoenfeld achieve his long-term goal of maturing into an independent clinician scientist in the field of spinal metastatic disease and musculoskeletal medicine. Environment: Dr. Schoenfeld has a commitment from the Department of Orthopaedic Surgery at BWH that ensures at least 60% protected time for the research and career development activities outlined in this proposal. He has access to patients with spinal metastases for recruitment in the focus groups outlined in Aim 2 through collaboration with surgeons and oncologists at BWH, Massachusetts General (MGH) and the Dana Farber Cancer Center (DFCC). Since these three centers are leading academic institutions with a specialty focus in musculoskeletal oncology, he will have access to recruit adequate numbers of subjects for this project as well as future research. He has access to experts in causal inference and decision analysis techniques including Drs. Miguel Hernan and Elena Losina. At HSPH, Dr. Schoenfeld will obtain formal didactic training in causal inference, programming, qualitative research methods, and decision analysis to enhance the research skills necessary to complete this proposal. Research: At present, the literature lacks research that integrates the effects of spinal metastatic disease and its treatment with patient preferences for outcomes. In this K23 proposal, Dr. Schoenfeld will perform a cohort study where causal inference testing is used to adjust for confounding by indication, conduct focus group sessions to help understand patient preferences for treatment in the setting of spinal metastases and perform a decision analysis that will highlight the value of operative and non-operative treatment for specific types of patients. By enhancing appreciation for factors that can inform treatment for an individual with spinal metastases, as well as understanding of the factors that drive decision making for both patients and physicians, this mixed methods proposal has the potential to substantially influence patient care.

候选人：Schoenfeld博士是部门的助理教授兼骨科医生 Brigham和妇女医院（BWH）的骨科手术。他是罗伯特·伍德·约翰逊（Robert Wood Johnson）的毕业生 密歇根大学的临床学者计划。 Schoenfeld博士成功地记录了 在同行评审中发布期刊并在国家科学会议上介绍了原始研究。他有 一支经验丰富的导师和合作者团队，结合了丰富的机构支持 在以患者为导向的研究中成功培训了其他临床科学家的学术环境 由Jeffrey Katz博士领导的他的心理团队的指导，Schoenfeld博士将获得因果关系的培训 推理技术，定性研究方法和决策分析以完成目标 在此提案中概述了。该项目的研究培训，指导和结果将有助于博士。 Schoenfeld实现了他的长期目标，即成为脊柱领域的独立临床科学家 转移性疾病和肌肉骨骼医学。 环境：Schoenfeld博士在BWH的骨科手术系有承诺 确保至少有60％的研究时间为研究和职业发展活动概述 提议。他可以接触具有脊柱转移的患者，以招募AIM中概述的焦点小组 2通过与马萨诸塞州BWH的外科医生和肿瘤学家合作（MGH）和DANA Farber癌症中心（DFCC）。由于这三个中心是领导专业的学术机构 专注于肌肉骨骼肿瘤学，他将有能力为该项目招募足够的主题 以及未来的研究。他可以访问因果推理和决策分析技术的专家 包括Drs。 Miguel Hernan和Elena Losina。在HSPH，Schoenfeld博士将获得正式的教学培训 因果推断，编程，定性研究方法和决策分析以增强研究 完成此建议所需的技能。 研究：目前，文献缺乏整合脊柱转移的影响的研究 疾病及其对患者偏好的治疗。在此K23提案中，Schoenfeld博士将 进行一项队列研究，其中因果推理测试用于调整通过指示，进行的混淆 焦点小组会议，以帮助了解脊柱转移的患者偏好 并执行决策分析，该分析将突出操作和非手术治疗的价值 特定类型的患者。通过加强对可以为个人治疗的因素的欣赏 脊柱转移以及了解推动患者和患者决策做出决策的因素 医师，这种混合方法提案有可能极大地影响患者护理。

项目成果

Prospective comparison of the accuracy of the New England Spinal Metastasis Score (NESMS) to legacy scoring systems in prognosticating outcomes following treatment of spinal metastases.

• DOI: 10.1016/j.spinee.2021.03.007
• 发表时间: 2022-01
• 期刊: The spine journal : official journal of the North American Spine Society
• 作者: Schoenfeld AJ;Ferrone ML;Blucher JA;Agaronnik N;Nguyen L;Tobert DG;Balboni TA;Schwab JH;Shin JH;Sciubba DM;Harris MB
• 通讯作者: Harris MB

Prognosticating outcomes and survival for patients with lumbar spinal metastases: Results of a bayesian regression analysis.

腰椎转移瘤患者的预后和生存：贝叶斯回归分析的结果。

• DOI: 10.1016/j.clineuro.2019.04.009
• 发表时间: 2019
• 期刊: Clinical neurology and neurosurgery
• 影响因子: 1.9
• 作者: Schoenfeld,AndrewJ;Ferrone,MarcoL;Schwab,JosephH;Blucher,JustinA;Barton,LaurenB;Harris,MitchelB;Kang,JamesD
• 通讯作者: Kang,JamesD

Evaluating ambulatory function as an outcome following treatment for spinal metastases: a systematic review.

• DOI: 10.1016/j.spinee.2021.05.001
• 发表时间: 2021-09
• 期刊: The spine journal : official journal of the North American Spine Society
• 作者: Nguyen L;Agaronnik N;Ferrone ML;Katz JN;Schoenfeld AJ
• 通讯作者: Schoenfeld AJ

Non-operative management of spinal metastases: A prognostic model for failure.

脊柱转移瘤的非手术治疗：失败的预后模型。

• DOI: 10.1016/j.clineuro.2019.105574
• 发表时间: 2020
• 期刊: Clinical neurology and neurosurgery
• 影响因子: 1.9
• 作者: Schoenfeld,AndrewJ;Schwab,JosephH;Ferrone,MarcoL;Blucher,JustinA;Balboni,TracyA;Barton,LaurenB;Chi,JohnH;Kang,JamesD;Losina,Elena;Katz,JeffreyN
• 通讯作者: Katz,JeffreyN

A Natural History of Patients Treated Operatively and Nonoperatively for Spinal Metastases Over 2 Years Following Treatment: Survival and Functional Outcomes.

• DOI: 10.1097/brs.0000000000004322
• 发表时间: 2022-04-01
• 期刊: Spine
• 影响因子: 3
• 作者: Xiong GX;Fisher MWA;Schwab JH;Simpson AK;Nguyen L;Tobert DG;Balboni TA;Shin JH;Ferrone ML;Schoenfeld AJ
• 通讯作者: Schoenfeld AJ