Use and Outcome of Total Joint Replacement in Hispanics

全关节置换术在西班牙裔中的应用和结果

• 批准号: 6512187
• 负责人: AGUSTIN ESCALANTE
• 金额: $ 13.26万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-06 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6512187
• 关键词: Hispanic Americans; Medicare /Medicaid; age difference; culture; depression; functional ability; gender difference; health care service utilization; hip prosthesis; human population study; human subject; interview; longitudinal human study; orthopedics; outcomes research; pain; patient oriented research; person with disability; postoperative state; preoperative state; quality of life; questionnaires; rheumatoid arthritis; social psychology; statistics /biometry

DESCRIPTION (Taken from the applicants abstract): The candidate for this K-24 award has a track record of funding and publications that demonstrate his commitment to a career in patient-oriented research. The award will give him a period of intense focus on the 2 central research themes of his career: (1) Utilization and outcomes of total joint replacement among U.S. Hispanics; and (2) The disablement process in rheumatoid arthritis (RA). The first research project has 3 specific aims: 1) To determine, in the Medicare population, whether recipients of a primary total hip replacement are as likely to be Hispanic, as are age-, sex- and county of residence-matched controls; 2) To determine to what extent preoperative functional status differs between Hispanics and non-Hispanics having a joint replacement in Bexar County, Texas; and 3) To determine how preoperative functional status affects the outcome of joint replacement. The second project will test a biopsychosocial model of the disablement process in a cohort of 770, mostly Mexican American RA patients. Its 4 specific aims are 1) To define the sequence of events in disability due to articular damage; 2) To define the sequence of events due to pain; 3) To define the sequence related to depression; and 4) To determine to what extent the cultural and genetic characteristics of Mexican Americans influence the disablement process in RA. The award will also allow the candidate to build on his record of mentoring, with 5 outstanding junior investigators that have committed to work with him at his institution. Their levels of training range from an Internal Medicine resident pursuing a research pathway for Board Certification, to 2 new Assistant Professors who will collaborate on the candidates research. All 5 of them will participate in a formal clinical research training program developed by the candidate. The research and mentoring activities of this K24 awards will benefit from an outstanding environment that is highly favorable to patient-oriented research. Elements of this environment include: existence of sufficient funding to conduct the research; an established research team with experience studying the predominantly Mexican American population of the region; an NCRR-supported General Clinical Research Center; and an exceptional group of collaborators and consultants with expertise in epidemiology, research methods and biostatistics, all of whom have a record of collaboration with the candidate. With this K24 award, the candidate will extend what is known about the utilization of !joint replacements by Hispanics in the U.S., and will advance understanding of the influence of genetic, clinical and psychosocial factors in the outcome of PA. His mentoring role will also help create a critical mass of investigators focused on arthritis-related disability among the U.S. Hispanic population.

描述（摘自申请人摘要）：该 K-24 奖项的候选人拥有资助和出版物的记录，证明了他的能力 致力于以患者为中心的研究事业。该奖项将给予他一个 强烈关注其职业生涯的 2 个中心研究主题的时期：(1) 美国西班牙裔人群全关节置换术的使用情况和结果；和 (2)类风湿性关节炎(RA)的致残过程。第一项研究 该项目有 3 个具体目标： 1) 确定医疗保险人群中， 初次全髋关节置换术的接受者是否有可能 西班牙裔，以及年龄、性别和居住地县匹配的对照； 2) 至 确定术前功能状态在多大程度上存在差异 在德克萨斯州贝克萨尔县进行关节置换的西班牙裔和非西班牙裔； 3) 确定术前功能状态如何影响手术结果 关节置换术。第二个项目将测试生物心理社会模型 770 名 RA 患者（其中大部分是墨西哥裔美国 RA 患者）的残疾过程。 其 4 个具体目标是 1) 定义因残疾而导致的事件的顺序 关节损伤； 2) 定义因疼痛而发生的事件的顺序； 3) 至 定义与抑郁症相关的序列； 4) 确定到什么程度 墨西哥裔美国人的文化和遗传特征影响着 RA 中的禁用过程。该奖项还将使候选人能够在 他的指导记录，有 5 名杰出的初级研究员 承诺在他的机构与他一起工作。他们的训练水平范围 来自一位正在寻求董事会研究途径的内科住院医师 认证，授予 2 位新助理教授，他们将在 候选人研究。他们5人都将参加正式的临床 候选人制定的研究培训计划。该研究和 本届K24奖的辅导活动将受益于优秀的 非常有利于以患者为中心的研究的环境。的元素 这种环境包括： 存在足够的资金来开展 研究;拥有研究经验的成熟研究团队 该地区主要是墨西哥裔美国人； NCRR 支持的 全科临床研究中心；以及一群杰出的合作者和 具有流行病学、研究方法和生物统计学专业知识的顾问， 所有这些人都有与候选人合作的记录。有了这个K24 奖，候选人将扩展有关 !joint 的使用的已知信息 在美国将被西班牙裔人取代，并将促进人们对 遗传、临床和心理社会因素对 PA 结果的影响。 他的指导作用也将有助于培养足够数量的调查人员 重点关注美国西班牙裔人群中与关节炎相关的残疾。