Developing an oral health screening tool for an integrated model of care to reduce treatment-related oral morbidity in head and neck cancer survivor

开发口腔健康筛查工具，用于综合护理模式，以减少头颈癌幸存者与治疗相关的口腔发病率

• 批准号: 10781183
• 负责人: Derek Kyle Smith
• 金额: $ 2.98万
• 依托单位: ADA SCIENCE AND RESEARCH INSTITUTE LLC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2023-07-03
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10781183
• 关键词: Abscess; Academic Medical Centers; Activities of Daily Living; Address; American; Award; Bayesian Modeling; Biometry; Cancer Burden; Cancer Patient; Cancer Survivor; Caregiver Burden; Caring; Chemotherapy and/or radiation; Childhood; Chronic; Clinic; Clinical; Complement; Counseling; Data; Dental; Dental Care; Dental caries; Dentistry; Dentists; Deterioration; Development; Development Plans; Diagnosis; Disease; Disparity population; Doctor of Philosophy; Early Diagnosis; Early identification; Eating; Education; Educational Technics; Esthetics; Evaluation; Failure; Fatigue; Fellowship Program; Financial Hardship; Foundations; Future; Goals; Guidelines; Head and Neck Cancer; Head and neck structure; Health Personnel; Health Professional; Healthcare; Incidence; Indiana; Infrastructure; Interview; Life; Maintenance; Malignant Neoplasms; Medical; Mental Depression; Mentors; Mentorship; Minority Groups; Modeling; Morbidity - disease rate; Mouth Diseases; Oncology; Oral; Oral Health Impact Profile; Oral Pathology; Oral cavity; Oral health; Outcome Measure; Patient Care; Patient Outcomes Assessments; Patient Participation; Patient Self-Report; Patients; Periodontal Diseases; Population; Procedures; Provider; Public Health; Qualifying; Quality of life; Radiation therapy; Recommendation; Reporting; Research; Research Assistant; Research Project Grants; Research Proposals; Risk; Sampling; Schedule; Screening procedure; Structure; Surveys; Survivors; Symptoms; Taste Perception; Testing; Time; Training; Treatment-Related Cancer; Trismus; Uninsured; United States; Universities; Update; Validation; Validity and Reliability; Visit; Xerostomia; barrier to care; cancer therapy; care providers; care systems; career development; chronic pain; cost; cost effective; effective therapy; experience; follow-up; head and neck cancer patient; health assessment; health care model; high risk; improved; information gathering; innovation; integrated care; member; novel; oral care; oral condition; oral pain; oral surgery specialty; patient oriented; patient subsets; prevent; professor; programs; prosthesis fitting; recruit; research and development; response; screening; success; support tools; survivorship; tool

Summary Approximately 62,000 Americans develop head and neck cancer (HNC) each year. Cancer treatments can result in a myriad of changes to the normal function of the oral structures. These treatment-related oral morbidities can persist for the duration of the patient’s life leaving HNC survivors in a state of rapidly deteriorating oral health. In addition to other barriers to oral care likely experienced by HNC survivors, many of these patients are uninsured and cannot afford dental visits to maintain surveillance of their oral condition. Failure to identify these oral morbidities early can result in expensive, less effective treatments that contribute to poor quality of life. In response to this shortfall, Dr. Derek Smith (PI) is proposing a career development project which will improve our understanding of the barriers to care and develop the statistical infrastructure required to implement a novel oral care model. The proposed model of care would integrate medical professionals and their support staff into the oral health team by providing them with a screening tool that allows them to identify patients that are at high risk for oral disease. Dr. Smith is uniquely qualified to pursue this research completing his training as a dentist at Indiana University in 2008 and his PhD in Biostatistics at Vanderbilt University in 2017. He has participated in numerous research projects and preliminary studies, and has a wealth of experience in clinical dentistry making him an outstanding candidate for this award. Dr. Smith is currently a Research Assistant Professor in the Departments of Biostatistics and Oral Maxillofacial Surgery at Vanderbilt and has been given protected time, infrastructure, and excellent mentorship to aid in the development of this research plan. The proposed career development plan involves participating in the AT Still University dental public health fellowship program and mentoring on the conduct of patient-centered research. This development plan is complemented by the mentored research proposal. The model of care Dr. Smith has proposed requires a well-validated screening tool that medical professionals can use to identify patients at high risk for oral morbidity and a data-driven decision rule that helps providers decide when a referral to oral health professionals is warranted. In Aim 1 of this proposal we will conduct a validation of the Vanderbilt Head and Neck Symptom Survey’s oral subscale by correlating patient reported outcomes with clinician’s findings on exam. Having established validity of the tool, in Aim 2 a screening tool will be developed out of a combination of items from the VHNSS and other well-validated patient reported outcome measures including the Oral Health Impact Profile. Lastly, for Aim 3 interviews will be conducted with HNC survivors to gain a better understanding of non-financial barriers to oral care in the HNC population. At the completion of this project our team will have the tools necessary to implement the integrated care model at Vanderbilt, which will improve oral health surveillance and facilitate our future research efforts. !

概括 每年大约有 62,000 名美国人患上头颈癌 (HNC)。 导致口腔结构的正常功能发生无数变化。 疾病可能会持续终生，使 HNC 幸存者处于快速恶化的状态 除了 HNC 幸存者可能遇到的口腔护理障碍外，许多人还面临着口腔健康恶化的问题。 这些患者没有保险，也无法负担看牙医的费用来维持对其口腔状况的监测。 未能及早识别这些口腔疾病可能会导致昂贵且效果较差的治疗，从而导致治疗效果不佳。 为了应对这种短缺，Derek Smith 博士（PI）提出了职业发展建议。 该项目将提高我们对护理障碍的了解并发展统计基础设施 需要实施一种新颖的口腔护理模式。拟议的护理模式将整合医疗。 专业人士及其支持人员加入口腔健康团队，为他们提供筛查工具， 使他们能够识别患有口腔疾病高风险的患者。史密斯博士具有独特的资格。 这项研究是他于 2008 年在印第安纳大学完成牙医培训并在 2017年获得范德比尔特大学博士学位。参与了众多研究项目和前期研究，并 史密斯博士在临床牙科方面拥有丰富的经验，使其成为该奖项的杰出候选人。 目前是生物统计学和口腔颌面外科系的研究助理教授 在范德比尔特大学，并获得了受保护的时间、基础设施和优秀的指导来帮助 制定本研究计划。拟议的职业发展计划涉及参加 AT Still。 大学牙科公共卫生奖学金计划以及对以患者为中心的研究进行指导。 史密斯博士的护理模式对这一发展计划进行了补充。 提议需要一种经过充分验证的筛查工具，医疗专业人员可以使用该工具来识别高危患者 口腔发病风险和数据驱动的决策规则可帮助提供者决定何时转诊至口腔健康 在本提案的目标 1 中，我们将对 Vanderbilt Head 和 Vanderbilt Head 进行验证。 颈部症状调查的口腔分量表，将患者报告的结果与临床医生的发现相关联 确定该工具的有效性后，目标 2 将通过组合开发筛选工具。 来自 VHNSS 和其他经过充分验证的患者报告的结果测量的项目，包括口腔 最后，针对目标 3，将对 HNC 幸存者进行采访，以获得更好的信息。 了解 HNC 人群口腔护理的非经济障碍。 团队将拥有在范德比尔特实施综合护理模式所需的工具，这将改善 口腔健康监测并促进我们未来的研究工作！