Patient Oriented Research and Mentoring Program in Orthopedics

以患者为中心的骨科研究和指导计划

基本信息

批准号：
7772421
负责人：
Elena Losina
金额：
$ 15.97万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-02-01 至 2015-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7772421
关键词：
Accident and Emergency department Address Adult Affect Age-Years Area Arthritis Arthroscopy Articular Range of Motion Award Behavioral Sciences Biometry Bypass Caring Censuses Centers for Disease Control and Prevention (U.S.)Cessation of life Characteristics Clinical Clinical Data Clinical Investigator Clinical Research Clinical Sciences Clinical Trials Design Clinical effectiveness Code Commit Communities Comorbidity Complication Computer Simulation Computer-Assisted Surgery Computers Coupled Critical Pathways Data Databases Debridement Decision Making Degenerative polyarthritis Dependency Development Diagnosis Diagnostic Disease Doctor of Philosophy Drug usage Early Ambulation Education Elderly Enrollment Ensure Epidemic Epidural Anesthesia Etiology Evaluation Event Evidence based practice Excision Expenditure Face Faculty Failure Fostering Foundations Frequencies Funding Future Goals Grant Hand Hand functions Health Health Status Hip Pain Hip region structure Holly Hospitalization Hospitals Incidence Incontinence Individual Infection Interdisciplinary Study International Intervention Irrigation Joint Dislocation Joints Knee Osteoarthritis Lead Life Expectancy Life Tables Ligaments Longitudinal Studies Low income Lower Extremity Magnetic Resonance Imaging Manuscripts Medical Medical Records Medical Students Medicare Mentors Methods Minority Modeling Monitor Morbidity - disease rate Muscle Musculoskeletal Musculoskeletal Diseases National Health and Nutrition Examination Survey National Institute of Arthritis and Musculoskeletal and Skin Diseases Non obese Obesity Observational Study Operative Surgical Procedures Orthopedics Outcome Pain Pain management Participant Patient Recruitments Patient Self-Report Patients Personal Satisfaction Persons Pharmaceutical Preparations Physicians Policies Policy Maker Population Postdoctoral Fellow Postoperative Period Prevalence Prevention Prevention strategy Probability Procedures Process Public Health Publications Quality of life Quality-Adjusted Life Years Randomized Clinical Trials Randomized Controlled Clinical Trials Randomized Controlled Trials Recording of previous events Recovery Registries Rehabilitation therapy Replacement Arthroplasty Reporting Research Research Design Research Methodology Research Personnel Research Priority Research Project Grants Research Support Research Training Risk Risk Factors Role Rotator Cuff Rural Sampling Scientist Services Severity of illness Simulate Socioeconomic Status Source Staging Structure Students Surgeon Surveys Symptoms Techniques Technology Tendon structure Testing Time Total Hip Replacement Traineeship Training Training Programs Treatment Cost Treatment outcome Universities Visit Withdrawal Woman Work Writing aged arm base bone career clinical care cohort cost cost effectiveness design diagnostic accuracy disability effective therapy evidence base experience falls follow-up frailty functional disability functional outcomes functional status health economics high risk improved injury prevention innovation instrument interest knee replacement arthroplasty life time cost medical schools men minimally invasive models and simulation mortality multidisciplinary new technology next generation novel novel diagnostics patient expectation patient oriented research population based preference professor programs prospective randomized trial research study residence response rheumatologist sham surgery shared decision making simulation sobriety standard of care success systematic review time use tool treatment strategy willingness years of life lost

项目摘要

DESCRIPTION (provided by applicant): Musculoskeletal (MSK) disorders represent a broad group of conditions with diverse etiologies that result in pain and functional impairment of bones, joints, tendons, ligaments and/or muscles. These disorders are the leading cause of work disability and the most frequent source of dependency in the elderly. In the US, over 3 million hospitalizations for MSK problems occur annually, primarily for orthopaedic surgical interventions. Rigorously designed patient oriented research studies create the basis for evidence-based practice and serve as powerful tools to bridge patient expectations, clinical care and shared decision making. Presently, the evidence base in musculoskeletal and orthopedic clinical science has large gaps. I have dedicated much of my effort in the last decade to addressing these research needs. Through the K24 Mid Career Investigator Award, I hope to continue this work through patient oriented research and, importantly, to engage the next generation of clinical scientists in rigorous studies of MSK and orthopaedic problems. The Mid-career Award in patient oriented research (K24) will enable me to dedicate a substantial portion of my time to pursue a robust program in patient oriented research in orthopedics and to mentor young clinical scientists committed to orthopaedic and musculoskeletal patient oriented research. This Award will support my mentoring and research program with the following aims: I) To develop a research training program that will prepare young clinical investigators for rigorous evaluation of frequently utilized and/or recently developed orthopaedic interventions in patients with MSK disorders. II) To further develop a comprehensive patient oriented research program in MSK disorders and orthopaedics. The overarching goals of my mentoring program include: 1) providing training in patient oriented research in orthopedics, including design and conduct of randomized clinical trials, observational studies and developing new diagnostic criteria in patients with MSK disorders; 2) increasing the number of researchers focused on patient oriented research with rigorous training in the study of MSK disorders; 3) fostering new multidisciplinary collaborations; and 4) facilitating the transition from traineeship to faculty. While the goals of the program span multiple clinical problems, I highlight two research studies in this proposal: Study 1: To conduct a randomized controlled clinical trial to determine optimal timing for withdrawal of epidural anesthesia in patients undergoing total knee replacement. Study 2: To determine the diagnostic value of clinical history for the diagnosis of symptomatic meniscal tears in the presence of knee osteoarthritis (OA). Each of these studies, coupled with a comprehensive structured mentoring program, will help to address important unanswered questions in the management of patients with MSK disorders. The program will also help the next generation of clinical scientists to develop, evaluate and implement efficient and effective treatment strategies in patients with MSK conditions.

描述（由申请人提供）：肌肉骨骼（MSK）疾病代表了一组广泛的病因，具有多种病因，从而导致骨骼，关节，肌腱，韧带和/或肌肉的疼痛和功能障碍。这些疾病是造成工作障碍的主要原因，也是老年人中最常见的依赖根源。在美国，每年有超过300万个用于MSK问题的住院治疗，主要用于骨科手术干预措施。严格设计的以患者为导向的研究为循证实践创造了基础，并用作弥合患者期望，临床护理和共同决策的强大工具。目前，肌肉骨骼和骨科临床科学的证据基础具有较大的差距。在过去的十年中，我已经付出了很多努力来满足这些研究需求。通过K24职业生涯调查员奖，我希望通过以患者为导向的研究继续这项工作，重要的是，让下一代临床科学家参与严格的MSK和骨科问题。以患者为导向研究的中期奖（K24）将使我能够大部分时间在骨科研究以患者为导向的患者研究中进行健壮的计划，并指导致力于骨科和肌肉骨骼骨骼患者研究的年轻临床科学家。该奖项将支持我的指导和研究计划，以以下目的：i）制定研究培训计划，该计划将使年轻的临床研究人员对MSK疾病患者的经常使用和/或最近开发的骨科干预进行严格评估。 ii）进一步开发了一项全面的以患者为导向的研究计划，领域是MSK疾病和骨科。我的指导计划的总体目标包括：1）在骨科研究的患者研究中提供培训，包括设计和进行随机临床试验的设计和行为，观察性研究并制定了MSK疾病患者的新诊断标准； 2）在MSK疾病研究中，通过严格的培训增加了研究人员的数量； 3）促进新的多学科合作； 4）促进从实习生到教师的过渡。尽管该计划的目标涵盖了多个临床问题，但我在此提案中重点介绍了两项研究：研究1：进行随机对照临床试验，以确定在接受总膝关节置换的患者中戒断硬膜外麻醉的最佳时机。研究2：确定在膝关节骨关节炎（OA）存在下诊断临床病史的诊断价值。这些研究中的每一个，再加上全面的结构化指导计划，将有助于解决MSK疾病患者管理中重要的未解决问题。该计划还将帮助下一代临床科学家在MSK疾病患者中开发，评估和实施有效的治疗策略。