Variations in Hip Morphology: Frequency and Impact on Osteoarthritis Outcomes

髋关节形态的变化：频率及其对骨关节炎结果的影响

• 批准号: 8164065
• 负责人: Amanda E Nelson
• 金额: $ 13.37万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8164065
• 关键词: Accounting; Ache; Adult; Affect; African American; Age; Agreement; Anatomy; Caucasians; Caucasoid Race; Characteristics; Chronic; Clinic; Clinical; Clinical Research; County; Data; Data Analyses; Decision Making; Degenerative polyarthritis; Development; Diagnostic; Disease; Environment; Epidemiologic Methods; Epidemiology; Foundations; Frequencies; Funding; Future; Gait; Gender; Genetic Crossing Over; Goals; Hand; Head; Head and neck structure; Health; Healthcare Systems; High Prevalence; Hip Osteoarthritis; Hip Pain; Hip region structure; Image; Imaging Techniques; Incidence; Individual; Inguinal region; Intervention; Investigation; Joint by Site; Joints; Jordan; Knee; Knee Osteoarthritis; Knowledge; Lateral; Lead; Learning; Measurement; Measures; Mentorship; Methods; Modeling; Morbidity - disease rate; Morphology; Nature; Neck; North Carolina; Obesity; Operative Surgical Procedures; Outcome; Pain; Patients; Policies; Population; Prevalence; Principal Investigator; Process; Protocols documentation; Publications; Questionnaires; Race; Reporting; Research; Research Ethics; Research Methodology; Research Personnel; Research Training; Resources; Risk; Risk Factors; Rotation; Scientist; Series; Shapes; Site; Speed; Statistical Methods; Subgroup; Symptoms; Therapeutic Intervention; Time; Training; United States; Variant; Vertebral column; Weight-Bearing state; Woman; Work; arthropathies; base; career; career development; cohort; cost; design; disability; economic impact; experience; follow-up; functional disability; functional status; hip replacement arthroplasty; imaging modality; improved; indexing; interest; joint injury; novel; planetary Atmosphere; population based; prevent; racial difference; research and development; responsible research conduct; rheumatologist

DESCRIPTION (provided by applicant): The candidate is a rheumatologist with a foundation in clinical research and epidemiologic methods, and a strong interest in novel imaging techniques as applied to osteoarthritis (OA). The candidate's long-term career goal is to become an independently funded, academic clinician-scientist, with a broad research focus on OA, and particular emphasis on advanced imaging and multiple joint involvement in OA. The candidate's short- term career goals are to 1) design a protocol for and gain practical experience with radiographic estimates of hip morphology (including femoroacetabular impingement [FAI], and hip shape by active shape models), 2) obtain specialized didactic training in advanced epidemiologic and statistical methods, 3) learn to collaborate with other large ongoing cohorts, 4) collect data, establish networks, and amass the necessary publication track record needed to compete for independent funding, and 5) obtain additional training in the Responsible Conduct of Research. The proposed research plan, career development activities, mentorship plan, advisory panel, and institutional environment are well suited to assist the applicant in achieving these goals. The rationale for the proposed research is that knowledge of the frequency and clinical impact of alterations in hip shape (including FAI), and the effects of such alterations on the development of OA, is essential to allow informed policy and clinical decisions regarding diagnostic and therapeutic interventions for hip OA. In Aim 1, the PI will assess the prevalence of radiographic findings of FAI in a large population-based cohort, and in Aim 2 will determine associations between these findings and validated clinical outcomes. Aim 3 will allow the PI to determine whether hip morphology (by FAI or active shape modes) predicts incident radiographic or symptomatic hip outcomes. The expected result of this proposal will be an improved knowledge of the prevalence and clinical importance of hip morphology in the development of hip OA. To support the candidate's career development, she will pursue coursework in advanced data analysis methods and research ethics, along with practical training in specialized imaging methods and interpretation. The advisory team, which includes multi-disciplinary collaborators with a wide range of expertise (Renner, Schwartz, DeVellis, and Helmick) as well as internationally-recognized, independently-funded investigators with expertise in OA epidemiology (Jordan) and imaging and shape assessments in OA (Kraus, Lane, and Aspden), will guide Dr. Nelson's research and career development. The research environment will provide a productive, collegial, and collaborative atmosphere in which Dr. Nelson can pursue her research and training goals. PUBLIC HEALTH RELEVANCE: An estimated 27 million adults in the United States have osteoarthritis, a debilitating chronic joint disease that can affect one or more joint sites, most commonly the hands, knees, hips, and/or spine, leading to substantial morbidity. Despite the large burden of this condition, particularly in weight-bearing joints, there are no disease modifying treatments available to treat or prevent joint damage in OA. The goal of this and subsequent research is to assess potential unique risk factors for OA at the hip, which may lead to specific diagnostic and therapeutic interventions, thereby reducing disability from hip OA.

描述（由申请人提供）：候选人是临床研究和流行病学方法基础的风湿病学家，对应用于骨关节炎（OA）的新型成像技术的强烈兴趣。候选人的长期职业目标是成为一名独立资助的学术临床医生 - 科学家，对OA进行了广泛的研究，并特别强调高级成像和多次共同参与OA。候选人的短期职业目标是1）设计协议并获得实用经验的髋部形态估算值（包括股骨类动物障碍[FAI] [FAI] [FAI]和通过主动形状模型进行髋关节形状），2）获得专业的DIDACTIC培训，在先进的流行病学和统计方法中进行高级录像带，需要与其他大型COLESTICTINCTION，3）学会与其他大型COLSITION contraction Colection and Internal Internation Colleghess Introl，4），4），4），4）4），4），4）4），4）4）为了争夺独立资金，5）在负责任的研究中获得额外的培训。拟议的研究计划，职业发展活动，指导计划，咨询小组和机构环境非常适合帮助申请人实现这些目标。拟议研究的理由是，了解髋部形状改变的频率和临床影响（包括FAI）以及这种改变对OA发展的影响对于允许有关髋关节OA的诊断和治疗干预措施的知情政策和临床决策至关重要。在AIM 1中，PI将评估FAI的射线照相发现的流行，而在AIM 2中将确定这些发现与经过验证的临床结果之间的关联。 AIM 3将允许PI确定髋部形态（通过FAI或主动形状模式）是否预测了射线照相或有症状的髋关节结局。该提案的预期结果将是对髋关节形态在髋关节OA发展中的普遍性和临床重要性的提高知识。为了支持候选人的职业发展，她将在高级数据分析方法和研究伦理方面攻读课程，并在专业成像方法和解释中进行实践培训。该咨询团队包括具有广泛专业知识（Renner，Schwartz，Devellis和Helmick）的多学科合作者，以及具有OA流行病学（Jordan）方面专业知识的国际认可，独立资金资助的研究人员，以及OA（Kraus，Lane，Lane，Lane和Aspden）的Imaging和Imaging and Shape评估和形状评估。研究环境将提供一种富有成效的，合作和协作的氛围，纳尔逊博士可以在其中追求她的研究和培训目标。 公共卫生相关性：估计在美国有2700万成年人患有骨关节炎，这是一种使人衰弱的慢性关节疾病，可能影响一个或多个联合部位，最常见的是手，膝盖，臀部和/或脊柱，导致大量发病率。尽管这种情况负担很大，尤其是在承重关节中，但尚无可用治疗方法来治疗或预防OA中关节损害的疾病。此目的和随后的研究的目的是评估髋关节上OA的潜在独特风险因素，这可能会导致特定的诊断和治疗性干预，从而减少了髋关节OA的障碍。