Multi-modal physician intervention to detect amblyopia

多模式医师干预检测弱视

• 批准号: 7097258
• 负责人: WENDY L MARSH-TOOTLE
• 金额: $ 31.86万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-22 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7097258
• 关键词: Internet; Medicare /Medicaid; amblyopia; clinical research; clinical trials; computer assisted diagnosis; disease /disorder proneness /risk; early diagnosis; education evaluation /planning; educational resource design /development; eye coordination disorder; eye disorder diagnosis; focus groups; health care personnel education; health care personnel performance; health services research tag; human subject; information dissemination; interactive multimedia; outcomes research; patient care personnel relations; patient oriented research; pediatrics; preschool child (1-5); primary care physician; vision tests

DESCRIPTION (provided by applicant): Despite decades of research showing adverse neural consequences of abnormal vision, little has changed for amblyopic children. Data have shown that approximately half the cases of amblyopia are detected late, and this finding has remained stable during the past 40 years. In our health care system, primary care physicians play a pivotal role in translating findings about amblyopia into practice. But, our experience with the Maternal and Child Health Bureau (MCHB) / NEI expert panel on Vision Screening in the Preschool Child and the CHB/American Academy of Pediatrics (AAP) Project Universal Preschool Vision Screening revealed that primary care physicians get very little training about amblyopia and risk factors. Consequently, many do not screen aggressively for these conditions. The University of Alabama Departments of Optometry, Pediatrics and Continuing Medical Education, in collaboration with the AAP, MCHB, Prevent Blindness America, the Pediatric Eye Disease Investigators Group, the Vision in Preschoolers Study Group, and the Alabama Medicaid Agency, propose to develop a novel, internet-based, multi-modal strategy to increase the understanding and recognition of amblyopia and its risk factors by pediatricians and primary care physicians in office based settings. We propose a randomized, controlled clinical trial to test whether our intervention results in improved performance by "intervention" physicians compared to control physicians (exposed to an immunization intervention). Our design, along with pre- and post-intervention performance measures, will evaluate changes in practice attributable to the intervention versus those occurring from other sources over time. Our final analysis will show whether preschool patients of intervention physicians are more likely to be identified with strabismus or amblyopia. This research forges a critical link between the truly phenomenal body of amblyopia research fostered by the NEI and the health care offered to American children.

描述（由申请人提供）：尽管有数十年的研究表现出异常视力的不良神经后果，但弱视儿童的变化很小。数据表明，较晚检测到弱视病例的一半，在过去的40年中，这一发现一直保持稳定。在我们的医疗保健系统中，初级保健医师在将有关弱视的发现转化为实践中起着关键作用。但是，我们在幼儿园儿童和CHB /美国儿科学会（AAP）项目环球学龄前视觉筛查的孕妇和儿童健康局（MCHB） / NEI专家小组中关于弱视和危险因素。 因此，许多人在这些条件下不积极筛选。阿拉巴马大学验光，儿科和持续医学教育系与AAP，MCHB，预防美国盲人，小儿眼病研究人员小组，学龄前儿童研究小组的愿景和阿拉巴马州医疗补助机构的合作，建议开发一个新颖的，基于互联网的，基于互联网的多模式策略，以提高儿科医生和初级保健医生在基于办公室环境中对弱视及其风险因素的理解和认识。我们提出了一项随机，对照临床试验，以测试与对照医生相比（暴露于免疫干预措施）相比，我们的干预措施是否通过“干预”医师改善了绩效。我们的设计以及干预前和干预后的绩效指标将评估归因于干预措施的实践变化，而随着时间的流逝，其他来源发生的变化。我们的最终分析将表明，干预医师的学龄前患者是否更有可能患有斜视或弱视。这项研究建立了在NEI培养的弱视研究和为美国儿童提供的医疗保健的真正惊人的弱视研究机构之间的关键联系。