Novel Assessment of the Role of Surgery in Recurrent Diverticulitis

手术在复发性憩室炎中作用的新评估

基本信息

批准号：
10224821
负责人：
Alexander Tharrington Hawkins
金额：
$ 14.96万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10224821
关键词：
Absenteeism Accounting Acute Address Affect Age Agreement Ambulatory Care American Award Benefits and Risks Benign Cessation of life Chronic Chronic Disease Clinic Clinic Visits Cohort Studies Colectomy Colon and Rectal Surgeon Colorectal Comparative Effectiveness Research Cost of Illness Data Decision Making Development Development Plans Disease Diverticulitis Diverticulosis Economics Education Emergency department visit Environment Equipoise Evidence based practice Excision Funding Future Goals Guidelines Health Services Research Health system Hospitalization Hospitals Incidence Information Systems Instruction Interview K-Series Research Career Programs Knowledge Lead Measurement Measures Medical Care Costs Mentors Mentorship Methodology Morbidity - disease rate Natural History Office Visits Operative Surgical Procedures Outcomes Research Patient Outcomes Assessments Patient-Focused Outcomes Patients Perforation Peritonitis Persons Pharmaceutical Preparations Physicians Population Population Study Procedures Process Public Health Qualitative Methods Quality of life Quality-of-Life Assessment Recommendation Recovery Recurrence Research Risk Role Schools Sigmoid colon Societies Structure Supervision Surgeon Surgical Management Surveys Techniques Time Training United States United States Agency for Healthcare Research and Quality Universities Visit Work arm care outcomes career development cohort comparative effectiveness comparative effectiveness analysis comparative effectiveness study comparative effectiveness trial cost design expectation experience financial toxicity health care service utilization improved indexing innovation instrument longitudinal analysis mortality multidisciplinary novel patient expectation programs prospective shared decision making surgery outcome symposium wound

项目摘要

PROJECT SUMMARY/ABSTRACT Diverticulosis of the sigmoid colon is a significant burden to the US health system. Complications lead to substantial morbidity and mortality. In 2004, diverticular disease was responsible for 313,000 hospitalizations, 1.9 million ambulatory care visits, and 3365 deaths in the United States. Indications for surgical management of chronic or recurrent diverticulitis are poorly understood. A number of studies have revealed that there is minimal mortality benefit to elective surgery for diverticular disease. Because of this, traditional surgical outcomes, such as 30-day survival, wound morbidity and in hospital complications are poor metrics to analyze this problem. This proposal describes a career development plan for a colorectal surgeon that will enable me to use my 75% protected effort to develop expertise in qualitative analysis, patient reported outcomes, comparative effectiveness, and analysis of longitudinal data. The research specific aims are: 1) to investigate alignment between the goals and expectations of patients and surgeons; 2) analyze the effect of surgery on the function and quality of life of patients with recurrent diverticulitis; and 3) assess the effect of surgery on health care utilization, work absenteeism and financial toxicity in recurrent diverticulitis. The career development plan integrates: a) advanced coursework and individualized mentor-directed instruction in qualitative methodology, patient reported outcomes, and surgical comparative effectiveness techniques, b) participation in local/national seminars and conferences to advance expertise in qualitative and quantitative aspects in development of patient reported outcomes, c) a multidisciplinary mentored research experience, and d) a highly supportive research environment. This environment includes the Center for Health Services Research, the Center for Surgical Quality and Outcomes Research, an AHRQ-funded Evidence- based Practice Center, a top-ranked Peabody School of Education, a Masters in Public Health program, and the Vanderbilt University Department of Surgery. Overall, this career development award will advance my ability in qualitative methods, patient reported outcomes and comparative effectiveness research by providing both didactic and experiential education under the supervision of proven mentors. We will generate important data on functional and quality of life outcomes for patients with diverticular disease. Importantly, this award provides critical support to seamlessly transition toward future independently funded studies that use patient reported outcomes to conduct comparative effectiveness studies to better understand the role of surgery in chronic disease states, including both diverticular disease and other disorders.

项目概要/摘要乙状结肠憩室病是美国卫生系统的重大负担。并发症导致导致严重的发病率和死亡率。 2004 年，憩室病导致 313,000 例美国有 190 万人次住院治疗、190 万人次门诊护理以及 3365 人死亡。适应症慢性或复发性憩室炎的手术治疗知之甚少。许多研究表明，择期手术对死亡率的益处微乎其微。憩室病。因此，传统手术的结果，如 30 天生存率、伤口发病率和住院并发症是分析这个问题的糟糕指标。该提案描述了结直肠外科医生的职业发展计划，使我能够使用我 75% 的努力是为了发展定性分析、患者报告结果、比较方面的专业知识有效性和纵向数据分析。研究的具体目标是：1）调查对齐患者和外科医生的目标和期望之间的关系； 2）分析手术对功能的影响复发性憩室炎患者的生活质量； 3）评估手术对医疗保健的影响复发性憩室炎的利用、缺勤和经济毒性。职业发展计划包括：a) 高级课程和个性化导师指导定性方法、患者报告结果和手术比较效果的指导 b) 参加地方/国家研讨会和会议，以提高质量和技术方面的专业知识患者报告结果发展的定量方面，c) 多学科指导研究经验，以及 d) 高度支持的研究环境。该环境包括健康中心服务研究、手术质量和结果研究中心、AHRQ 资助的证据- 位于实践中心、一流的皮博迪教育学院、公共卫生硕士项目，以及范德比尔特大学外科系。患者报告说，总的来说，这个职业发展奖将提高我在定性方法方面的能力通过提供教学和体验式教育来进行成果和比较有效性研究久经考验的导师的监督。我们将生成有关功能和生活质量结果的重要数据对于憩室病患者。重要的是，该奖项为无缝过渡提供了关键支持未来的独立资助研究利用患者报告的结果进行比较有效性研究，以更好地了解手术在慢性疾病状态中的作用，包括憩室病和其他疾病。