Optimization of Bi-Pap and PEG intervention protocols for Amyotrophic Lateral Sclerosis

肌萎缩侧索硬化症 Bi-Pap 和 PEG 干预方案的优化

• 批准号: 9169075
• 负责人: Cassie S Mitchell
• 金额: $ 7.89万
• 依托单位: GEORGIA INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9169075
• 关键词: Academy; Age of Onset; American; Amyotrophic Lateral Sclerosis; Analysis of Variance; Autopsy; Big Data; Body Weight decreased; Cessation of life; Characteristics; Chi-Square Tests; Clinic; Clinical; Clinical Informatics; Communities; Complex; Computer Simulation; Data Analyses; Data Set; Databases; Decision Modeling; Decision Trees; Deglutition Disorders; Devices; Dietary Intervention; Disease; Disease Progression; Exertion; Fingerprint; Funding; Gastrostomy; Gender; Grant; Guidelines; Heterogeneity; Intervention; Life; Literature; Measures; Medical History; Methods; Modality; Modeling; Neurology; Nutritional Support; Outcome; Patients; Pharmacologic Substance; Positioning Attribute; Probability; Procedures; Protocols documentation; Publications; Publishing; Recording of previous events; Records; Research; Research Personnel; Respiratory physiology; Risk; Sample Size; Symptoms; System; Techniques; Time; Training; Uncertainty; United States National Institutes of Health; Universities; University Hospitals; Vital capacity; Weight; abstracting; base; clinical decision-making; computer based statistical methods; experience; falls; forest; illness length; neuropathology; non-compliance; novel; outcome prediction; pressure; rate of change; respiratory; respiratory airway pressure; success

R03 Proposal- Optimization of Bi-Pap and PEG intervention protocols for Amyotrophic Lateral Sclerosis Abstract/Summary The positive impact of the use of bi-level positive airway pressure (Bi-Pap) as a respiratory intervention and percutaneous endoscopic gastronomy (PEG) as nutritional support intervention in Amyotrophic Lateral Sclerosis (ALS) has been well cited. While a few clinical guidelines regarding the use of Bi-Pap and PEG exist, there remains a level of uncertainty and apparent inconsistency regarding the perceived optimal implementation of the aforementioned interventions, largely due to outcome variance caused by small study sizes and inherent heterogeneity among patients. In this R03 application, we propose secondary analysis of our existing novel 1,587-patient ALS clinical informatics database, which includes over 300 different fields of quantitative and qualitative measures, to optimize Bi-Pap and PEG intervention protocols as function of patient characteristics and quantitative in-clinic measures. As such, the proposed project entails an in-depth analysis of data featuring sample sizes several times larger than previous studies in the published literature. We utilize a combination of traditional approaches (e.g. analysis of variance (ANOVA), chi-squared test, Kaplan-Meier), novel statistical techniques (relational analysis), and big data techniques (hierarchical clustering, Bayesian Networks, Forest Plot) to identify the optimal point in disease progression at which these treatment modalities should be implemented as well as ascertain optimal usage parameters and outcome predictors.

R03提案-肌萎缩侧索硬化症Bi-Pap和PEG干预方案的优化 摘要/总结 使用双水平气道正压通气 (Bi-Pap) 作为呼吸干预措施的积极影响和 经皮内窥镜美食术（PEG）作为肌萎缩侧索肌营养支持干预 硬化症（ALS）已被广泛引用。虽然存在一些关于使用 Bi-Pap 和 PEG 的临床指南， 关于感知的最佳结果仍然存在一定程度的不确定性和明显的不一致 上述干预措施的实施，很大程度上是由于小型研究造成的结果差异 患者的大小和固有的异质性。在此 R03 应用中，我们建议进行二次分析 我们现有的包含 1,587 名患者的 ALS 临床信息学数据库，其中包括 300 多个不同领域 定量和定性测量，根据患者情况优化 Bi-Pap 和 PEG 干预方案 特征和定量临床测量。因此，拟议的项目需要进行深入分析 数据的样本量比已发表文献中的先前研究大几倍。我们利用 传统方法的组合（例如方差分析 (ANOVA)、卡方检验、Kaplan-Meier）， 新颖的统计技术（关系分析）和大数据技术（层次聚类、贝叶斯 网络、森林图）来确定这些治疗方式在疾病进展中的最佳点 应实施并确定最佳使用参数和结果预测因素。