Enhancing Infrastructure for Clinical and Translational Research to Address the Opioid Epidemic
加强临床和转化研究基础设施以应对阿片类药物流行病
基本信息
- 批准号:10424436
- 负责人:
- 金额:$ 71.65万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-08-06 至 2024-06-30
- 项目状态:已结题
- 来源:
- 关键词:Accident and Emergency departmentAddressAlgorithmsAutomationCaliforniaClinical DataClinical ResearchClinical TrialsClinical Trials DatabaseClinical Trials NetworkClinical assessmentsCodeCountryDataDatabasesEffectivenessElectronic Health RecordEpidemicEvaluationEvolutionFentanylFoundationsFundingHealth Care CostsHealth ResourcesHealth systemHealthcare SystemsHeroinHospitalsIndividualInfrastructureInstitutionInternational Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10)InterventionIntervention TrialInvestmentsKentuckyLaboratoriesModificationMonitorMorbidity - disease rateNational Center for Advancing Translational SciencesNational Institute of Drug AbuseNatural Language ProcessingNon-Prescription DrugsOdds RatioOpiate AddictionOpioidOutcome StudyOverdosePatientsPharmaceutical PreparationsPhenotypePoliciesPredictive ValuePreventionPrevention ResearchProceduresProcessPublic HealthResearchSiteSourceTimeTrainingTranslational ResearchUnited StatesUniversitiesWorkbaseclinical careclinical infrastructurecombatcomorbiditydata dictionarydata infrastructuredata integrationdata modelingdata toolsdemographicsdesigneffective therapyelectronic datafitnesshigh risk populationinnovationinter-institutionalmortalitynatural languageopioid epidemicopioid misuseopioid overdoseopioid use disorderoverdose preventionpoint of careprescription opioidprescription opioid misuseprototyperesponseservice deliverysocialsocial health determinantssynthetic opioidtherapy designtherapy developmenttooltranslational studytreatment research
项目摘要
PROJECT SUMMARY
Up-to-date information about non-fatal overdose emergency department (ED) encounters can provide critical
information about the evolution of the opioid epidemic and response of the healthcare system and is an
essential to planning of clinical trials to address the problems underlying this epidemic. Establishing a platform
that delivers high positive predictive value for opioid-related overdose (OD) using a combination of coded and
natural language terms in electronic health records (EHRs) is an essential step toward the large-scale
surveillance necessary to evaluate the pragmatic effectiveness of numerous systemic and policy-based efforts
and to create the infrastructure for large scale trials to reduce drug-related mortality and morbidity. However, to
date, localized and federal efforts have been largely based on discrete ICD-10 code data or have had time lags
of one-to-three years for more detailed data. Perhaps more Importantly, they have not had the capacity for
planning and feasibility assessment for clinical and translational research at specific sites. We propose
foundational work to create an inter-institutional research database and network focused on patients
presenting to EDs with opioid-related OD. To create this network, we will extend previous work to develop: (1)
an e-phenotype for case identification in the ED based on EHR data, and (2) combine this with a data
dictionary and coded data extraction tools, and natural language processing (NLP) algorithms, to obtain
additional data from EHRs; tools for primary capture of data during clinical care; and tools for integration of
data on social determinants of health. This will allow for a more thorough characterization of individuals
presenting to EDs with opioid-related OD including: demographics, comorbidities, OD agent and source,
intentionality of the OD, ED treatment and discharge disposition. Through refinement and automation, the data
extraction process will be extended to a set of pilot CTSA Accrual to Clinical Trials (ACT) Network sites and
then potentially to other CTSA's nation-wide. This new functionality focuses on providing a platform to
accelerate research. To accomplish this work, our Specific Aims are to: 1) Demonstrate the feasibility of
extending the ACT Network data model and infrastructure to monitor the opioid epidemic using ED data, 2)
Create a prototype opioid overdose monitoring and response network across participating institutions and a
toolkit for other CTSA sites to join the network, and 3) Demonstrate potential usefulness of the network in
monitoring the opioid epidemic and in planning clinical trials. This proposal is innovative as it aims to develop a
feasible and effective near real time means of monitoring opioid-related OD presentation in EDs across the
country to inform point-of-care service delivery, prevention and treatment intervention development and
evaluation. Downstream, the application of project deliverables include dissemination of the replication toolkit
to leverage the platform of the CTSAs and NIDA Clinical Trials Network to build capacity for timely surveillance
of opioid-related OD to facilitate prevention and treatment research and intervention.
项目概要
有关非致命药物过量急诊室 (ED) 遭遇的最新信息可以提供关键信息
有关阿片类药物流行病演变和医疗保健系统反应的信息,是
对于规划临床试验以解决这一流行病的潜在问题至关重要。建立平台
结合使用编码和
电子健康记录(EHR)中的自然语言术语是迈向大规模
评估众多系统性和政策性努力的务实有效性所必需的监督
并为大规模试验建立基础设施,以降低与毒品相关的死亡率和发病率。然而,为了
截至目前,地方和联邦的努力主要基于离散的 ICD-10 代码数据,或者存在时间滞后
一到三年的更详细数据。也许更重要的是,他们没有能力
特定地点的临床和转化研究的规划和可行性评估。我们建议
创建以患者为中心的机构间研究数据库和网络的基础工作
向急诊室报告阿片类药物相关的 OD。为了创建这个网络,我们将扩展之前的工作来开发:(1)
根据 EHR 数据在 ED 中进行病例识别的电子表型,以及 (2) 将其与数据相结合
字典和编码数据提取工具以及自然语言处理(NLP)算法,以获得
来自电子病历的额外数据;临床护理期间主要采集数据的工具;和集成工具
关于健康问题社会决定因素的数据。这将有助于更全面地描述个体
向急诊室提供与阿片类药物相关的 OD,包括:人口统计、合并症、OD 药物和来源,
OD、ED 治疗和出院处置的意向性。通过精细化和自动化,数据
提取过程将扩展到一组试点 CTSA 临床试验 (ACT) 网络站点和
然后可能会扩展到全国范围内的其他 CTSA。这项新功能的重点是提供一个平台
加速研究。为了完成这项工作,我们的具体目标是: 1) 证明可行性
扩展 ACT 网络数据模型和基础设施,以使用 ED 数据监测阿片类药物流行情况,2)
在参与机构和机构之间创建原型阿片类药物过量监测和响应网络
其他 CTSA 站点加入网络的工具包,以及 3) 展示网络在以下领域的潜在用途:
监测阿片类药物的流行并规划临床试验。该提案具有创新性,旨在开发一种
可行且有效的近实时方法来监测整个急诊室中阿片类药物相关的 OD 表现
国家通报护理点服务的提供、预防和治疗干预措施的制定以及
评估。下游,项目可交付成果的应用包括复制工具包的传播
利用 CTSA 和 NIDA 临床试验网络平台建设及时监测的能力
与阿片类药物相关的 OD,以促进预防和治疗研究和干预。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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{{ truncateString('LESLIE A. LENERT', 18)}}的其他基金
Enhancing Infrastructure for Clinical and Translational Research to Address the Opioid Epidemic
加强临床和转化研究基础设施以应对阿片类药物流行病
- 批准号:
10646250 - 财政年份:2019
- 资助金额:
$ 71.65万 - 项目类别:
Enhancing Infrastructure for Clinical and Translational Research to Address the Opioid Epidemic
加强临床和转化研究基础设施以应对阿片类药物流行病
- 批准号:
10198067 - 财政年份:2019
- 资助金额:
$ 71.65万 - 项目类别:
WWW BASED NORMATIVE PATIENT DECISION SUPPORT
基于 WWW 的规范患者决策支持
- 批准号:
2862645 - 财政年份:1998
- 资助金额:
$ 71.65万 - 项目类别:
WWW BASED NORMATIVE PATIENT DECISION SUPPORT
基于 WWW 的规范患者决策支持
- 批准号:
6055742 - 财政年份:1998
- 资助金额:
$ 71.65万 - 项目类别:
WWW BASED NORMATIVE PATIENT DECISION SUPPORT
基于 WWW 的规范患者决策支持
- 批准号:
6171508 - 财政年份:1998
- 资助金额:
$ 71.65万 - 项目类别:
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