ED Disability Diagnostic Tool: An HIT Feasibility Study

ED 残疾诊断工具：HIT 可行性研究

• 批准号: 8470557
• 负责人: Lori Ann Post
• 金额: $ 49.25万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8470557
• 关键词: ED; Disability; Diagnostic; Tool; HIT

6. ABSTRACT Principal Investigator: Lori A. Post, Ph.D. Associate Professor, Yale Dept of Emergency Medicine Title: ED Disability Diagnostic Tool: an HIT Feasibility Study Objective: To improve health patient oriented outcomes in Emergency Departments (ED) by deriving, validating, and comparing the Rasch Disability Diagnostic Tool (RDDT) to existing Measure of Disability (MOD) Research Design: This multi methodological study includes deriving a Rasch scale of disability: I) Using the RDDT to retrospectively score disability indicators, validating the RDDT, selecting a subset of the Rasch scale to be used as a brief measure for an ED randomized clinical trial; II) Prospectively, linking disability assessments to patient oriented outcomes (health care service utilization and mortality). This study will compare diagnoses to determine impact on patient outcomes and costs. Methodology: An expert panel will determine content for the disability diagnostic tool, Rasch scales will be created to score disability in existing hospital records in the retrospective phase. First, we will retrieve all disability assessments performed on ED patients (20-30 per day) since the inception of the electronic data collection system at Yale New Haven Hospital (April 2005). Second, we will score disability in ED records for patients > 65 years and examine patient outcomes, treatments and referrals based on the assessment. Third, we will examine how the assessment impacted ED patient oriented outcomes. The retrospective phase of this study will allow us to track subsequent Yale hospital and ED visits, treatments, and health outcomes. A brief accurate and precise RDDT, developed in the retrospective analysis will be used for the prospective phase to compare with the existing MOD in a randomized clinical trial. 600 patients will be recruited over the course of the study and randomly allocated into the MOD (control) or RDDT (test) arm. Consented study subjects, including ED patients, families, and patient health care providers will be followed for two months. The primary patient outcomes, ED visits, hospital admits, and mortality will be quantified for comparative purposes. We will estimate the number of preventable ED visits and hospitalizations and provide a cost benefit for adopting the RDDT in EDs. Finally, the RDDT will rely on health information technology. The exploratory aim of the study will assess work flow, time and cost savings, efficiency and usability for use in the ED. Potential Impact on Health Outcomes: We expect that a better disability diagnostic tool will lead to lower mortality, a reduction in unnecessary costs, preventable ED visits and hospitalizations, and a better quality of life for patients presenting to Emergency Departments.

6. 摘要 首席研究员：Lori A. Post 博士耶鲁大学急诊医学系副教授 标题： ED 残疾诊断工具：HIT 可行性研究 目标：通过得出以下结论，改善急诊科 (ED) 以患者为导向的结果： 验证 Rasch 残疾诊断工具 (RDDT) 并将其与现有残疾测量 (MOD) 进行比较 研究设计：这项多方法研究包括推导拉希残疾量表：I) 使用 RDDT 对残疾指标进行回顾性评分，验证 RDDT，选择 Rasch 量表的子集 用作 ED 随机临床试验的简要衡量标准； II) 前瞻性地将残疾联系起来 对以患者为中心的结果进行评估（医疗保健服务利用率和死亡率）。这项研究将 比较诊断以确定对患者结果和费用的影响。 方法：专家小组将确定残疾诊断工具的内容，拉希量表将 创建用于在回顾阶段对现有医院记录中的残疾进行评分。首先，我们将检索所有 自电子数据开始使用以来，对急诊科患者进行残疾评估（每天 20-30 次） 耶鲁纽黑文医院的收集系统（2005 年 4 月）。其次，我们将在 ED 记录中对残疾进行评分 年龄 > 65 岁的患者，并根据评估检查患者的结果、治疗和转诊。第三， 我们将研究评估如何影响以急诊患者为导向的结果。本次回顾阶段 研究将使我们能够跟踪随后的耶鲁医院和急诊室就诊、治疗和健康结果。简介 在回顾性分析中开发的准确且精确的 RDDT 将用于前瞻性阶段 与随机临床试验中现有的 MOD 进行比较。整个过程中将招募600名患者 研究并随机分配到 MOD（对照）组或 RDDT（测试）组。同意的研究科目， 包括 ED 患者、家属和患者医疗保健提供者在内的患者将接受为期两个月的跟踪。初级 出于比较目的，将对患者治疗结果、急诊就诊、入院和死亡率进行量化。我们将 估计可预防的急诊就诊和住院次数，并提供采用该方法的成本效益 ED 中的 RDDT。最后，RDDT 将依赖于卫生信息技术。研究的探索性目的 将评估急诊科的工作流程、时间和成本节省、效率和可用性。 对健康结果的潜在影响：我们预计更好的残疾诊断工具将导致更低的 死亡率、减少不必要的费用、可预防的急诊就诊和住院治疗以及更好的治疗质量 急诊室患者的生活。