Laboratory for Early Psychosis Research (LEAP)

早期精神病研究实验室 (LEAP)

• 批准号: 10376216
• 负责人: MIGUEL HERNAN
• 金额: $ 163.46万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-15 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10376216
• 关键词: Accounting; Address; Administrator; Adverse effects; Advocate; Attention; Binding; Caring; Clinic; Clinical; Clinical Trials; Collaborations; Community Outreach; Comparative Effectiveness Research; Complement; Coordinated Specialty Care; Country; Data; Data Collection; Data Science; Data Set; Databases; Discipline; Disease; Early Intervention; Economics; Education and Outreach; Epidemiology; Event; Faculty; Family; Foundations; Funding; Future; Goals; Growth; Health Policy; Health system; Hospitalization; Information Systems; Insurance; Knowledge; Laboratories; Learning; Machine Learning; Massachusetts; Measures; Mental Health; Methods; Modernization; Morbidity - disease rate; National Institute of Mental Health; North America; Operations Research; Outcome; Outcome Measure; Patient Care; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Pattern; Policies; Policy Maker; Population; Process; Protocols documentation; Psychoses; Psychotic Disorders; Research; Research Methodology; Research Personnel; Resource Sharing; Resources; Schizoaffective Disorders; Schizophrenia; Science; Scientist; Source; Standardization; Structure; Students; Subgroup; System; Time; Work; base; care outcomes; clinical heterogeneity; data harmonization; data quality; design; early psychosis; faculty community; first episode psychosis; health care delivery; improved; individual patient; interdisciplinary collaboration; knowledge base; machine learning prediction; mortality; statistics; symposium; treatment effect; web site

1. Abstract We propose to create a NIMH P50 ALACRITY Center that develops the collaborations, data systems, and methods necessary to form a state-wide Laboratory for Early Psychosis Research, aka the LEAP Center. While recent trial evidence suggests great promise for coordinated specialty care (CSC) for patients with first episode psychosis (FEP), there remain several gaps in the knowledge base for the care of psychosis in general. Now is an ideal time to address these gaps because of recent policy changes enhancing FEP care financing, practice changes in the field, and methods developed outside of mental health. To create this Center, we will start with interdisciplinary collaborations between CSC clinics in Massachusetts, policy makers/regulators, and stakeholders, and include FEP experts from across the country plus scientific experts from outside of mental health, e.g., in data science, machine learning, epidemiology, and health policy. We also will leverage recent Massachusetts efforts to mandate, standardized, and support data collection on FEP care structures, delivery, and outcomes from all FEP clinics within the state. We also will apply and develop modern methods for clinical prediction and comparative effectiveness research (CER), e.g., machine learning and g-methods, for FEP research. Accordingly, we have three overall Center aims: 1) Collaborations; 2) Data systems; and 3) Prediction and CER methods. The Center will start with three foundational and complementary projects: 1) Using the state All Payer Claims Database (APCD), Project 1 will apply a population-level approach to examine which patients receive care in FEP clinics offering CSC versus elsewhere, as the number of clinics increases, then estimate the treatment effect on unfavorable clinical event rates such as hospitalizations; 2) Project 2 will review the data collected by the state from all of the FEP clinics, assess and improve data collection quality, validate measures, and integrate perspectives; and 3) Project 3 will define clusters of patients using longitudinal outcome data (i.e., begin to unpack the amount of clinical heterogeneity), predict the cluster type for individual patients, and examine the impact of CSC treatment accounting for this clinical heterogeneity. The Administrative Core and Methods Core (Prediction and CER) bind these projects together. The Center will include a group of Scientific Advisors from across North America, Center Faculty from diverse scientific disciplines, including those that historically have had little exposure in mental health research, and Stakeholders, including policy makers, organizational decision makers, and patient and family advocates. All three groups will be deeply involved in the Center from design to dissemination. The overall goal is to create a state-wide learning health system for early psychosis. This effort to create the protocols and apply the methods necessary to convert large amounts of data into useful clinical and policy knowledge will inform other national efforts, e.g., NIMH’s EPINET.

1。摘要 我们建议创建一个NIMH P50 Alacrity中心，以开发协作，数据系统和 形成早期精神病研究的全州实验室所必需的方法，又称跳跃中心。 虽然最近的试验证据表明，针对首次患者的协调专业护理（CSC）的巨大希望 情节精神病（FEP），在知识库中仍然存在几个差距，以照顾精神病 一般的。现在是解决这些差距的理想时机，因为最近的政策变化增强了FEP护理 融资，实践变化以及在心理健康之外开发的方法。创建这个 中心，我们将从马萨诸塞州的CSC诊所之间的跨学科合作开始，政策 制造商/监管机构和利益相关者，包括来自全国各地的FEP专家以及科学专家 从心理健康之外，例如数据科学，机器学习，流行病学和健康政策。我们 还将利用最近的马萨诸塞州努力来授权，标准化和支持FEP的数据收集 该州所有FEP诊所的护理结构，交付和结果。我们还将申请和开发 临床预测和比较有效性研究（CER）的现代方法，例如机器学习 和G-Methods，用于FEP研究。根据，我们有三个总体中心目标：1）合作； 2）数据 系统； 3）预测和CER方法。该中心将以三个基础和完善开始 项目：1）使用州所有付款人索赔数据库（APCD），项目1将应用人群级别 检查哪些患者在FEP诊所提供CSC的患者的方法，而其他地方则是 诊所的增加，然后估计对不利临床事件发生率的治疗效果，例如 住院； 2）项目2将从所有FEP诊所，评估和 提高数据收集质量，验证措施和综合观点； 3）项目3将定义 使用纵向结果数据的患者集群（即开始拆开临床异质性的量）， 预测个别患者的簇类型，并检查CSC治疗的影响 临床异质性。行政核心和方法核心（预测和CER）绑定了这些项目 一起。该中心将包括来自北美各地的一组科学顾问，来自 潜水员的科学学科，包括那些历史上几乎没有心理健康研究的学科， 以及利益相关者，包括政策制定者，组织决策者以及患者和家庭倡导者。 从设计到传播，这三个小组将深入参与中心。总体目标是创建 一种用于早期精神病的全州学习卫生系统。这项创建协议并应用的努力 将大量数据转换为有用的临床和政策知识所需的方法将告知其他 国家努力，例如NIMH的Epnet。