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 每年约有62,000名美国人患头颈癌（HNC）。癌症治疗可以 导致口服结构正常功能的无数变化。这些与治疗有关的口服 病态可能会在患者的寿命中持续存在，使HNC生存处于迅速状态 口腔健康状况恶化。除了HNC幸存者可能经历的其他口腔护理障碍之外，许多 这些患者是没有保险的，无法负担牙科就诊以维持其口服状况的监视。 无法尽早识别这些口服病毒可能会导致昂贵，效率较低的治疗方法 生活质量差。为了应对这一短缺，德里克·史密斯（Derek Smith）（PI）提出了职业发展 项目将提高我们对护理和发展统计基础设施的障碍的理解 需要实施一种新颖的口腔护理模型。拟议的护理模型将整合医学 专业人士及其支持人员进入口腔健康团队，通过为他们提供筛查工具 允许他们确定口腔疾病高风险的患者。史密斯博士拥有独特的资格购买 这项研究于2008年完成了他在印第安纳大学的牙医培训，并在生物统计学博士学位上 范德比尔特大学（Vanderbilt University）于2017年。他参加了许多研究项目和初步研究， 在临床牙科方面拥有丰富的经验，使他成为该奖项的杰出候选人。史密斯博士 目前是生物统计学和口腔上颌面外科系的研究助理教授 在范德比尔特（Vanderbilt 制定该研究计划。拟议的职业发展计划涉及参加AT 大学牙科公共卫生奖学金计划和指导以患者为中心的研究。 该开发计划由Mendored研究建议完成。史密斯博士的护理模式 拟议的需要一个验证的筛查工具，医疗专业人员可以使用该工具来识别患者 口腔发病的风险和数据驱动的决策规则，该规则可帮助提供者决定何时转介口口相关 专业人士有必要。在本提案的目标1中，我们将对范德比尔特负责人进行验证 颈部症状调查的口服分量表与患者报告的结局与临床的结果相关联 考试。该工具确定有效性后，在AIM 2中，将通过组合开发筛选工具 来自VHNS和其他精心验证的患者的项目报告的结果指标，包括口腔 健康影响概况。最后，对于AIM 3访谈，将与HNC幸存者进行更好的 了解HNC人群中口腔护理的非财务障碍。该项目完成后我们 团队将拥有在范德比尔特实施综合护理模型的必要工具，这将改善 口腔健康监视并促进我们未来的研究工作。