TRACE-CORE

追踪核心

• 批准号: 8146166
• 负责人: CATARINA I. KIEFE
• 金额: $ 147.4万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8146166
• 关键词: 21 year old; Adherence; Adult; African American; Age; Behavior; Cardiac; Case Mixes; Cell Nucleus; Cessation of life; Clinical; Cognitive; Commit; Communities; Consensus; Consent; Coronary; Coronary heart disease; Data; Databases; Education; Elements; Enrollment; Epidemiologist; Ethnic Origin; Event; Future; Health; Health Personnel; Health behavior; Hispanics; Home environment; Hospitalization; Hospitals; Impaired cognition; Individual; Inpatients; Intervention; Interview; Knowledge; Laboratories; Manuscripts; Massachusetts; Measurement; Measures; Mediating; Medical Records; Medical center; Mentors; Methods; Modeling; Morbidity - disease rate; Outcome; Outcomes Research; Outpatients; Patient Discharge; Patient Outcomes Assessments; Patients; Persons; Pharmaceutical Preparations; Preparation; Process; Process Measure; Provider; Quality of Care; Quality of life; Race; Records; Recruitment Activity; Recurrence; Research; Research Infrastructure; Research Personnel; Research Project Grants; Research Proposals; Respondent; Risk; Science; Shortness of Breath; Socioeconomic Status; Staging; Statistical Models; Structure; System; Teaching Hospitals; Testing; Time; Training; Variant; Visit; Vulnerable Populations; abstracting; acute coronary syndrome; base; career; cohort; evidence base; experience; follow-up; health care delivery; health disparity; high risk; improved; indexing; innovation; interest; medication compliance; mortality; novel; novel strategies; professor; prototype; rural area; suburb

DESCRIPTION (provided by applicant): Acute Coronary Syndromes (ACS), the usual reason for hospitalization of patients with coronary heart disease, is common and high-risk. Despite remarkable advances in the management of ACS in recent decades, unrealized health gains remain from underuse of available evidence for post-ACS patients. The proposed Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) will recruit a new longitudinal cohort of post-ACS patients, conduct two research projects using the cohort, and develop the careers of four early stage investigators (ESIs). We have 4 specific aims. 1) We will recruit and follow for 2 years a COHORT of 2,500 individuals, age 21-I-, 18% African-American and 10% Hispanic, at the time of their discharge from an ACS hospitalization at 8 medical centers in Massachusetts and Georgia. We will abstract medical records from the index and subsequent hospitalizations and outpatient records. Patient interviews at the time of discharge and at 2 and 6 weeks, and 3, 12, and 24 months later will include measurements of quality of life (QoL), cognitive impairment, adherence to medications, and health related behaviors. 2) TRANSITIONS PROJECT: We will characterize the 90-day transition process for patients discharged after an ACS. We will engage a national panel to develop an evidence-based Transition Measurement Set reflecting the first 90 days after discharge and going beyond existing systems that focus on the discharge process. We will test hypotheses on the associations between quality of care and outcomes (including rehospitalization and QoL), particularly as they pertain to health disparities. 3) ACTION SCORES PROJECT: We will develop and validate two novel "Action Scores" that predict clinical events/mortality and QoL and which emphasize modifiable aspects of health care delivery and patient behaviors. 4) Using TRACE-CORE as a training laboratory, we will develop the CVD outcomes research careers of the four ESIs. This will include structured mentoring, key involvement of the ESIs astheco-PIs in the research projects, and preparation of new research proposals based on the TRACE-CORE infrastructure and findings. Our team involves prominent CVD outcomes researchers, methodologists, cardiologists, and other clinicians. Our innovative Action Scores should activate patients and providers to improve CVD outcomes; our Transitions Project will fill important knowledge gaps. Future studies will benefit from our data, infrastructure, Action Scores, and transition measures; building on these will also underpin the careers of future CVD outcomes researchers.

描述（申请人提供）： 急性冠状动脉综合征（ACS）是冠心病患者住院的常见原因，是一种常见且高危的疾病。尽管近几十年来 ACS 的治疗取得了显着进展，但由于对 ACS 后患者的现有证据利用不足，健康收益仍未实现。拟议的冠状动脉事件结果研究和教育中心（TRACE-CORE）的转变、风险和行动将招募一个新的 ACS 后患者纵向队列，利用该队列开展两个研究项目，并为四个早期阶段的患者发展职业生涯调查员（ESI）。我们有 4 个具体目标。 1) 我们将在马萨诸塞州和佐治亚州 8 个医疗中心的 ACS 住院出院时招募并跟踪 2,500 名患者的队列，年龄为 21-I-，其中 18% 为非裔美国人，10% 为西班牙裔。我们将从索引中提取医疗记录以及随后的住院和门诊记录。出院时、第 2 周和第 6 周以及第 3、12 和 24 个月后的患者访谈将包括生活质量 (QoL)、认知障碍、药物依从性以及健康相关行为的测量。 2) 过渡项目：我们将描述 ACS 出院患者的 90 天过渡过程。我们将聘请一个国家小组来开发一套基于证据的过渡测量集，反映出院后的前 90 天，并超越专注于出院过程的现有系统。我们将测试有关护理质量和结果（包括再住院和生活质量）之间关联的假设，特别是与健康差异有关的假设。 3) 行动评分项目：我们将开发和验证两个新颖的“行动评分”，用于预测临床事件/死亡率和生活质量，并强调医疗保健服务和患者行为的可修改方面。 4）以TRACE-CORE作为培训实验室，我们将发展四个ESI的CVD结果研究事业。这将包括结构化指导、ESI astheco-PI 主要参与研究项目，以及根据 TRACE-CORE 基础设施和研究结果准备新的研究提案。我们的团队包括著名的 CVD 结果研究人员、方法学家、心脏病专家和其他临床医生。我们创新的行动评分应该激励患者和医疗服务提供者改善 CVD 结果；我们的过渡项目将填补重要的知识空白。未来的研究将受益于我们的数据、基础设施、行动分数和过渡措施；在此基础上，还将为未来 CVD 结果研究人员的职业生涯奠定基础。