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: 7564797
• 负责人: ROGER D YUSEN
• 金额: $ 25.83万
• 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/7564797
• 关键词: Address; Age; Cessation of life; Chronic Obstructive Airway Disease; Data; Death Rate; Disease Outcome; Effectiveness; Failure; Gender; Goals; Health; Healthcare Systems; Lead; Linear Regressions; Lung; Lung Transplantation; Lung diseases; Measurement; Measures; Methods; Modeling; Outcome; Patients; Probability; Provider; Quality of life; Race; Research Personnel; Resources; Risk; Severity of illness; Staging; System; Technology Assessment; Time; Transplant Recipients; Transplantation; United Network for Organ Sharing; Waiting Lists; base; organ allocation; programs; research study

LUNG TRANSPLANT FOR COPD: OUTCOMES/TECHNOLOGY ASSESSMENT 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.

COPD的肺移植：结果/技术评估 该提案的广泛目标是对肺移植技术评估（LTX）LTX 在新的供体肺分配系统中患有COPD的患者。我们将比较LTX后的生活质量与 新系统中患者的LTX生活质量。此外，我们将比较生活成果的质量 在旧系统中结果的新系统中。 为了进行此技术评估，我们提出了两个具体的目标： 特定目标1：评估新供体肺中COPD患者LTX的有效性 分配系统。 答：对于经历LTX的患者，评估公用事业的变化（生活质量），比较了6个月后 LTX实用程序至LTX实用程序。 B.假设LTX有效，请评估公用事业改善的持续时间（生活质量）， 将LTX后实用程序与LTX实用程序进行比较。 C.在调整后，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 对于基线差异（疾病，年龄，性别，种族等）。 具体目标2：比较LTX对新的COPD患者生活质量的影响 供体肺分配系统和旧的供体肺分配系统。 在控制基线差异之后，比较了新的和旧的系统实用程序和实用程序更改 （两种系统中患者的疾病，年龄，LTX，性别，种族等）的严重程度。 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标： 特定目的3：确定新供体肺中LTX后结果的术前预测指标 分配系统，适用于COPD患者。 执行多变量线性回归以开发使用详细基线数据作为解释性的模型 变量和公用事业从前LTX变为LTX后的变化，因为结果变量。我们也会 模型LTX实用程序得分（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，我们必须必须 评估LTX的有效性和新器官分配方法的影响。这项研究将尝试 确定LTX对新供体肺中COPD患者的生存和质量影响 分配系统。