SEARCH for Diabetes in Youth Registry Study, Phase 4: Washington Center

青少年登记研究中的糖尿病搜索，第 4 阶段：华盛顿中心

• 批准号: 9127727
• 负责人: Catherine Pihoker
• 金额: $ 37.74万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-30 至 2020-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9127727
• 关键词: SEARCH; Diabetes; Youth; Registry; Study

 DESCRIPTION (provided by applicant): The SEARCH for Diabetes in Youth Study documented a 31% increase in the prevalence of type 2 diabetes (T2D) between 2001 and 2009, as well as an increase of 21 % in the prevalence of type 1 diabetes (T1D). Increases occurred across most but not all major subgroups of age, sex and race/ethnicity. Further, we documented an annual increase in the incidence of T1D among non-Hispanic White (NHW) youth of approximately 2.7% per year. In contrast, studies from Europe suggest that incidence of T1D may be stabilizing. Thus, compelling questions remain regarding long term trends in incidence and prevalence for both T1 and T2 in youth, particularly among various racial and ethnic population subgroups. Ongoing, efficient surveillance of diabetes diagnosed in youth is essential to inform health care systems and generate testable hypotheses related to the natural history of diabetes in youth. SEARCH is uniquely positioned to address these critical questions through continued surveillance of childhood diabetes employing our well-established infrastructure for surveillance, and its highly experienced, collaborative and multi-disciplinary investigative team. Therefore, in response to RFA-DP-15-002, Component A, we propose the continuation of the SEARCH for Diabetes in Youth Registry Study (SEARCH Phase 4) during which we will continue to ascertain newly diagnosed incident diabetes cases throughout the study period and one additional prevalent cohort (index year 2017) for youth age < 20 years across our five well-established geographically dispersed Study Centers. Our approach is informed by our substantial accrued experience that allows us to conduct surveillance work in a highly efficient manner. We frame our surveillance as an innovative three-tiered approach, starting with the most broad based and cost efficient approach at the highest tier (tier 1) and becoming the most focused in tier 3, with each tier optimizing use of electronic health records (EHRs). Specific Aims are: Aim 1: TIER 1 SURVEILLANCE (Prevalence)- To ascertain cases of prevalent diabetes in calendar year 2017 among youth age < 20 years at diagnosis; Aim 2: TIER 2 SURVEILLANCE (Incidence)- To continue to ascertain newly diagnosed (2015-2020) incident diabetes cases in youth age < 20 years; Aim 3: TIER 3 SURVEILLANCE (Clinical Characteristics) - To confirm classification of diabetes type using biochemical markers, to describe selected clinical characteristics at diagnosis, and to maintain an infrastructure that facilitates the development of more detailed ancillary studies by storing biological samples and preserving contact with potential study participants; Aim 4: OPERATIONAL EFFICIENCY: To optimize efficiency of the SEARCH Surveillance activities through targeted development and validation projects designed to utilize relevant electronic health data to operationalize each of the three tiers of surveillance. Thus, the well-established and highly productive SEARCH team is uniquely positioned to provide critical information on the prevalence, incidence and early clinical course of diabetes in youth.

 描述（由适用提供）：在青年研究中寻找糖尿病的疾病记录了2001年至2009年之间2型糖尿病（T2D）的患病率增加了31％，并且1型糖尿病患病率增加了21％（T1D）。在大多数但不是全部的年龄，性别和种族/种族的主要亚组中，都会增加。此外，我们记录了每年约2.7％的非西班牙裔白人（NHW）青年中T1D事件的年增加。相反，欧洲的研究表明，T1D的事件可能正在稳定。关于T1和T2在各种种族和民族人口亚组中，T1和T2的长期趋势和患病率的长期趋势和患病率的长期趋势仍然令人信服。在青年中诊断出的糖尿病的持续，有效的监测对于为医疗保健系统提供信息至关重要，并产生与青年糖尿病自然史有关的可检验的假设。搜索是通过持续监视儿童糖尿病来解决这些关键问题的独特位置，该糖尿病是利用我们公认的基础设施进行监视的，以及其经验丰富，合作和多学科的调查团队。因此，为了响应RFA-DP-15-002，组件A，我们提出了在青年登记研究（搜索阶段）中搜索糖尿病的继续，我们将在此期间继续确定整个研究期间的新诊断出的糖尿病病例，并在整个五年级的年龄<20岁时，在整个五个年龄<20岁时），整个五年级的年龄<20岁）。我们的大量获得的经验为我们的方法提供了信息，该经验使我们能够以高效的方式进行监视工作。我们将监视作为一种创新的三层方法，从最高层（第1层）的最广泛和最具成本效益的方法开始，并成为第3层中最专注的，每层优化电子健康记录（EHRS）。具体目的是：目标1：第1层监测（患病率） - 确定2017年日历年度诊断年龄<20岁的2017年日历年中普遍存在的糖尿病病例；目标2：第2层监视（发病率） - 继续确定新诊断的新诊断（2015-2020）年轻人<20岁的糖尿病病例；目标3：第3层监视（临床特征） - 使用生化标记确认糖尿病类型的分类，描述诊断时选定的临床特征，并维持基础设施，以促进通过存储生物学样本并保存与潜在研究参与者的接触，从而促进更详细的辅助研究的发展；目标4：操作效率：通过有针对性的开发和验证项目来优化搜索监视活动的效率，旨在利用相关的电子健康数据来操作监视的三个层次。这是，建立良好且高效的搜索团队的位置是为了提供有关青年糖尿病的患病率，发病率和早期临床过程的关键信息。