Mass Casualty Triage Validation Study

大规模伤亡伤员分类验证研究

• 批准号: 7943442
• 负责人: Joan Marie Culley
• 金额: $ 17.86万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 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 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7943442
• 关键词: Acute; Address; Adult; Age; Area; Benchmarking; Biocompatible Materials; Caring; Categories; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chemicals; Chlorine; Classification; Clinical; Code; Consensus; Data; Data Set; Development; Disasters; Effectiveness; Emergency Situation; Environmental Health; Event; Goals; Health; Health Personnel; Healthcare; Informatics; Information Services; Injury; Intervention; Life; Link; Measurement; Measures; Medical; Medical Research; Modeling; Outcome; Outcome Study; Oxygen; Patients; Physiological; Publishing; RQ2; Randomized; Research; Resources; Respiratory Signs and Symptoms; Severities; Sorting - Cell Movement; Source; South Carolina; Statistical Models; Symptoms; System; Testing; Time; Training; Transportation; Triage; United States; United States National Library of Medicine; chemical incident; decision research; demographics; emergency service responder; hazard; improved; injured; innovation; interest; medical attention; prevent; prospective; public health research; research study; tool; validation studies

DESCRIPTION (provided by applicant): The management of large numbers of injured patients expected during catastrophic events - either from natural, unintended or deliberate incidents (e.g. 'all hazards events') could quickly overwhelm existing healthcare resources jeopardizing the lives of victims and healthcare providers. No consensus currently exists on standardized definitions or data needed for effective mass casualty triage. No outcome studies validate data needed for incidents involving chemical, radiological, or biological material, and none are appropriate for use with victims of all ages. Our broad long-term goal is to validate the accuracy of triage systems that are appropriate for use in chemical events with adult victims. We propose a study using health outcome data from a large chlorine leak to determine whether the data collected in four triage systems accurately predict actual clinical status. Six datasets collected from a chlorine leak that occurred in 2005 include patient demographics, exposure estimates, symptoms, outcome categories, and physiological measurements for more than 900 victims. Research studies published on these data indicate that oxygen saturation was predictive of acute medical outcomes. These data will be used to address the following specific aims: 1) Generate a research dataset useful for further analysis by linking actual data from six chlorine leak datasets to explore measures for completeness and robustness (to test RQ1). 2) Develop a statistical model using medical outcome categories and oxygen saturation levels as measures of medical outcome to compare four adult triage systems (to test RQ1). 3) Evaluate the ability of four adult triage systems to accurately predict medical outcomes using the statistical model (SA2) and research dataset (SA1). 4) Explore the development of a data driven model to triage patients using the research dataset (SA1) to predict medical outcomes for adults (to test RQ2). Research questions that frame the study: 1) What is the association between data collected in the four adult triage systems most frequently used in the U.S. and severity of respiratory signs/symptoms necessitating medical intervention from chlorine leak patient datasets? 2) What additional information in an adult mass casualty triage system sufficiently improves the prediction of an accurate triage classification for initial treatment that involves a chemical incident?

描述（由申请人提供）：在灾难性事件期间（无论是自然事件、非故意事件还是故意事件（例如“所有危害事件”））对预计出现的大量受伤患者进行管理可能会迅速压垮现有的医疗资源，从而危及受害者和医疗服务提供者的生命。目前对于有效的大规模伤亡伤员分类所需的标准化定义或数据尚未达成共识。没有结果研究验证涉及化学、放射性或生物材料的事件所需的数据，并且没有一项研究适合所有年龄段的受害者。我们广泛的长期目标是验证适用于成年受害者化学事件的分类系统的准确性。我们提出一项研究，使用来自大量氯泄漏的健康结果数据，以确定四个分诊系统收集的数据是否准确预测实际的临床状态。从 2005 年发生的氯泄漏事件中收集的六个数据集包括 900 多名受害者的患者人口统计数据、暴露估计、症状、结果类别和生理测量数据。针对这些数据发表的研究表明，氧饱和度可以预测急性医疗结果。这些数据将用于实现以下具体目标：1) 通过链接六个氯泄漏数据集的实际数据来探索完整性和稳健性的措施（以测试 RQ1），生成可用于进一步分析的研究数据集。 2) 使用医疗结果类别和氧饱和度水平作为医疗结果的衡量标准来开发统计模型，以比较四种成人分诊系统（以测试 RQ1）。 3) 使用统计模型 (SA2) 和研究数据集 (SA1) 评估四个成人分诊系统准确预测医疗结果的能力。 4) 探索开发数据驱动模型，使用研究数据集 (SA1) 对患者进行分类，以预测成人的医疗结果（以测试 RQ2）。构成本研究的研究问题：1) 美国最常用的四个成人分诊系统收集的数据与氯泄漏患者数据集中需要医疗干预的呼吸道体征/症状的严重程度之间有何关联？ 2) 成人大规模伤亡伤员分类系统中的哪些附加信息足以改进对涉及化学事故的初步治疗的准确分类分类的预测？