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）：在灾难性事件期间预期的大量受伤患者的管理 - 来自自然，意外或故意事件（例如“所有危害事件”）可能会迅速迅速不知所措，使现有的医疗保健资源危害受害者和医疗保健提供者的生活。目前在有效的大规模伤亡分类中所需的标准化定义或数据目前尚无共识。没有结果研究验证涉及化学，放射学或生物材料的事件所需的数据，并且不适合与所有年龄段的受害者一起使用。我们的广泛长期目标是验证适合与成年受害者化学事件一起使用的分类系统的准确性。我们提出了一项使用来自大氯泄漏的健康结果数据的研究，以确定在四个分类系统中收集的数据是否准确预测了实际的临床状况。从2005年发生的氯泄漏中收集的六个数据集包括患者人口统计学，暴露估计，症状，结果类别和生理测量值900多名受害者。关于这些数据的研究表明，氧饱和度预测了急性医疗结果。这些数据将用于解决以下特定目的：1）通过将来自六个氯泄漏数据集的实际数据链接到探索措施以确保完整性和鲁棒性（测试RQ1）来生成用于进一步分析的研究数据集。 2）使用医学结果类别和氧饱和度水平作为医学结果的量度来开发统计模型，以比较四个成人分类系统（测试RQ1）。 3）评估四个成人分诊系统使用统计模型（SA2）和研究数据集（SA1）准确预测医疗结果的能力。 4）探索使用研究数据集（SA1）来探索数据驱动模型，以预测成人的医疗结果（测试RQ2）。研究框架研究的研究问题：1）在美国最常使用的四个成人分类系统中收集的数据与呼吸道体征/症状的严重程度是什么相关性，需要从氯泄漏患者数据集中进行医疗干预？ 2）成人质量伤亡分类系统中有哪些其他信息足够改善了涉及化学事件的初始治疗的准确分类分类的预测？