Lung Transplant for COPD: Outcomes/Technology Assessment

肺移植治疗慢性阻塞性肺病：结果/技术评估

• 批准号: 7020453
• 负责人: ROGER D YUSEN
• 金额: $ 26.74万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-01 至 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7020453
• 关键词: behavioral /social science research tag; chronic obstructive pulmonary disease; clinical research; health care service planning; health care service utilization; health services research tag; human subject; lung transplantation; outcomes research; patient oriented research; quality of life

DESCRIPTION (provided by applicant): The broad goal of this proposal is to perform a technology assessment of lung transplantation (LTx) LTx for patients with COPD in the new donor lung allocation system. We will compare post-LTx quality of life to pre- LTx quality of life of patients within the new system. In addition, we will compare the quality of life outcomes in the new system to the outcomes in the old system. To perform this technology assessment, we propose two specific aims: Specific Aim 1: Assess the effectiveness of LTx, for patients with COPD, in the new donor lung allocation system. A. For patients that undergo LTx, evaluate the change in utilities (quality of life), comparing 6 months post- LTx utilities to pre-LTx utilities. B. Assuming LTx will be effective, evaluate the duration of improvement in utilities (quality of life), by comparing post-LTx utilities to pre-LTx utilities. C. Compare the utilities of transplanted patients with the utilities of patients not transplanted, after adjusting for baseline differences (severity of illness, age, gender, race, etc). Specific Aim 2: Compare the effects of LTx on the quality of life of patients with COPD in the new donor lung allocation system and the old donor lung allocation system. Compare the new and the old system utilities and utility changes, after controlling for baseline differences (severity of illness, age, type of LTx, gender, race, etc), in patients in the two systems. To generate hypotheses for potential revision of the new allocation system, we propose a third aim: Specific Aim 3: Determine preoperative predictors of post-LTx outcomes in the new donor lung allocation system, for patients with COPD. Perform multivariable linear regression to develop a model that uses detailed baseline data as explanatory variables and the change in utilities from pre-LTx to post-LTx change as the outcome variable. We will also model post-LTx utility scores (not change scores) as the outcome variable. Given the huge stakes for the patients, the providers, and the healthcare system, it is imperative that we assess the effectiveness of LTx and the impact of new organ allocation methods. This study will attempt to determine the survival and quality of life effects of LTx on patients with COPD in the new donor lung allocation system.

描述（由申请人提供）：该提案的广泛目标是针对新的供体肺分配系统中的COPD患者对肺移植（LTX）LTX进行技术评估。我们将将LTX后生活质量与新系统中患者的生活质量进行比较。此外，我们将将新系统的生活质量与旧系统的结果进行比较。为了进行此技术评估，我们提出了两个具体目标：特定目标1：在新的供体肺分配系统中，针对COPD患者评估LTX的有效性。答：对于经历LTX的患者，评估公用事业（生活质量）的变化，比较了LTX公用事业与LTX公用事业的6个月。 B.假设LTX将是有效的，可以通过将LTX后实用程序与LTX前实用程序进行比较，评估公用事业改善（生活质量）的持续时间。 C.在调整基线差异（疾病，年龄，性别，种族等）后，将移植患者的实用性与未移植的患者的实用程序进行比较。具体目标2：比较LTX对新供体肺分配系统和旧供体肺分配系统中COPD患者生活质量的影响。在控制两个系统的患者中，比较了新的和旧系统实用程序和公用事业的变化，在控制基线差异（疾病，年龄，LTX，性别，性别，种族等）之后。为了产生对新分配系统进行潜在修订的假设，我们提出了第三个目的：特定目标3：确定新供体肺部分配系统中LTX后结果的术前预测因素，针对COPD患者。执行多变量线性回归以开发一个模型，该模型将详细的基线数据用作解释变量，以及用作结果变量从前LTX变为LTX变化的实用程序的变化。我们还将建模LTX后实用程序分数（不更改得分）作为结果变量。考虑到患者，提供者和医疗保健系统的巨大股份，我们必须评估LTX的有效性以及新的器官分配方法的影响。这项研究将试图确定LTX对新供体肺分配系统中COPD患者的生存和质量效果。