Shared Decision-Making for the Promotion of Patient-Centered Imaging in the Emergency Department: Suspected Kidney Stones
促进急诊科以患者为中心的影像学的共同决策:疑似肾结石
基本信息
- 批准号:10457307
- 负责人:
- 金额:$ 14.67万
- 依托单位:
- 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:2018-08-01 至 2024-01-31
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
PROJECT SUMMARY
CANDIDATE: Dr. Elizabeth Schoenfeld is an Emergency Medicine Physician at the University of
Massachusetts Medical School – Baystate. She completed a fellowship in Emergency Ultrasound and a
Masters in Clinical and Translational Science, and her goal is to become an independent investigator with
expertise in Shared Decision-Making (SDM), decision aid development, and clinical trials of SDM in the
Emergency Department (ED), with a focus on the diagnosis and management of acute renal colic (kidney
stones) in ED patients. RESEARCH PROJECT: Kidney stones affect 1 in 11 Americans, cause debilitating
pain, and result in over a million ED visits each year. Total charges for the care for kidney stones exceed $10
billion annually. The large majority of patients seen in an ED for a possible kidney stone undergo a CT scan,
despite strong evidence that an ultrasound is safe, effective, less expensive, and does not expose patients to
radiation. Because there are potential risks and benefits to both CT and ultrasound, the decision regarding
which to use is an appropriate one for Shared Decision-Making, the “collaborative process in which patients
and physicians make a health care decision together, taking into account the best available evidence and the
patient’s values and preferences.” Decision aids are tools designed by clinicians, patients, and other
stakeholders to facilitate a conversation aimed to enable Shared Decision-Making. Dr. Schoenfeld proposes to:
(Aim 1) use established stakeholder engagement methods, including interviews and focus groups, to develop,
design, and revise a decision aid to use in the setting of suspected renal colic, and (Aim 2) pilot this decision
aid via a randomized controlled trial of 100 ED patients presenting with signs and symptoms of suspected renal
colic. The overall goals of this project are to educate and empower patients to be involved in medical decisions
that involve radiation exposure, and to safely decrease the radiation burden to this population. Both Aims will
be carried out at Baystate Medical Center, Springfield, MA, which serves a population with a large proportion of
minority and low-income patients (AHRQ priority populations). The data from the pilot will support the
development of a larger randomized controlled trial aimed at increasing SDM in the ED and safely decreasing
CT use. ENVIRONMENT AND MENTORS: Under the experienced mentorship of Drs. Lindenauer, Mazor,
Hess, and Pekow, Dr. Schoenfeld will carry out the proposed research plan in concert with a structured
curriculum focusing on qualitative methods, clinical trials, and patient-oriented research methods. Dr.
Schoenfeld’s proposal brings together the resources of the Baystate Medical Center Emergency Department
(which sees 115,000 patients/year), the Institute for Healthcare Delivery and Population Science (UMMS-
Baystate), the University of Massachusetts Medical School Center for Clinical and Translational Science, and
the Tufts Clinical and Translational Science Institute. In alignment with AHRQ’s mission, Dr. Schoenfeld’s
overall research goals are to make ED care safer, more patient-centered, and more cost-effective.
项目总结:
--
候选人:伊利莎白·舍恩菲尔德博士是加州大学洛杉矶分校的急救医学和内科医生。
马萨诸塞州医学院贝州分校。她已经完成了急救和超声研究的高级研究员学位。
拥有临床医学硕士学位和翻译硕士学位的硕士,她的目标是成为一名独立的医学调查员。
在世界各地分享国家决策中心(SDM)的专业知识,帮助国家SDM中心的开发、研究和临床试验。
急诊科(ED),重点是急性肾绞痛(肾脏)的早期诊断和治疗。
结石)在急症患者中的作用。研究项目:肾脏结石会影响11名美国人中的1%,从而导致身体虚弱。
每年,疼痛、疼痛和疾病导致急诊室就诊超过100万人次。肾结石的急诊室总费用超过10美元。
每年数十亿美元。大多数患者都在急诊室接受了一次CT扫描,以确定是否可能患有肾结石。
尽管有强有力的证据表明,普通超声波检查是安全、有效、更便宜的,但它并不一定会使患者暴露在危险之中。
辐射。因为存在潜在的风险和好处,无论是CT检查还是超声检查,都是关于辐射的最高决定。
对于共享的医疗决策来说,使用它是非常合适的一种方式,而在这种情况下,使用这种方式是一种非常合适的方式,因为在这种方式下,患者需要接受治疗。
医生们应该共同做出最好的医疗保健决定,同时考虑到现有的最佳证据和证据。
患者的价值观和个人喜好。决策辅助工具是由临床医生、患者和其他人共同设计的工具。
利益相关者希望为旨在实现共同决策的对话提供更多便利。舒恩菲尔德博士建议采取以下措施:
(目标1)使用既定的利益相关者参与方法,包括访谈和重点关注小组,以便更好地发展,
设计、制定和修改一项新的决定,以帮助飞行员在疑似肾绞痛、腹痛和腹痛(AIM 2)的试点项目中使用药物。
援助是通过对约100名急诊患者进行随机和对照试验进行的,患者出现了疑似肾脏疾病的症状和体征。
绞痛。这个项目的总体目标是帮助教育患者,并使他们能够更多地参与医疗保健决策。
这将涉及到更多的辐射暴露,以安全地减少对这一年轻人口的辐射负担。这两个目标都将是。
将在马萨诸塞州斯普林菲尔德的贝州医疗保健中心开展,该中心将以非常大的比例提供医疗服务。
少数族裔患者和低收入家庭患者(AHRQ)优先考虑人群。来自中国试点项目的最新数据将继续支持这一计划。
一项更大规模的随机对照临床试验的开发计划,旨在提高美国疾病控制和预防中心的SDM水平,并确保其安全地下降。
CT的使用、环境评估和指导:在Mazor,Lindenauer博士的指导下,我们经验丰富。
Hess,和Pekow,Schoenfeld博士,将在演唱会上以一种结构化的方式,执行他们提出的研究计划。
课程重点放在定性研究方法、临床研究方法和以患者为中心的研究方法上。
舍恩菲尔德的这项提议将海湾州立大学医疗保健中心和急诊部的资源整合在一起。
(预计每年约有11.5万名美国患者),由美国国家医疗保健与分娩研究所和美国人口与科学研究所(UMMS--)联合推出
美国马萨诸塞州州立大学医学院医学研究中心负责临床医学和医学翻译的研究。
塔夫茨临床研究所和美国翻译科学研究院的研究与AHRQ的使命保持一致,而舍恩菲尔德博士的使命也是如此。
总体而言,我们的研究和目标可能会使EED的医疗保健更安全,更以患者为中心,更具成本效益。
项目成果
期刊论文数量(10)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Does Shared Decision Making Actually Occur in the Emergency Department? Looking at It from the Patients' Perspective.
- DOI:10.1111/acem.13850
- 发表时间:2019-12
- 期刊:
- 影响因子:0
- 作者:Schoenfeld EM;Probst MA;Quigley DD;St Marie P;Nayyar N;Sabbagh SH;Beckford T;Kanzaria HK
- 通讯作者:Kanzaria HK
Executive summary of the 2021 SAEM consensus conference: From bedside to policy: Advancing social emergency medicine and population health through research, collaboration, and education.
- DOI:10.1111/acem.14451
- 发表时间:2022-03
- 期刊:
- 影响因子:0
- 作者:Schoenfeld EM;Lin MP;Samuels-Kalow ME
- 通讯作者:Samuels-Kalow ME
A Scoping Review of Current Social Emergency Medicine Research.
- DOI:10.5811/westjem.2021.4.51518
- 发表时间:2021-10-27
- 期刊:
- 影响因子:0
- 作者:Shah R;Della Porta A;Leung S;Samuels-Kalow M;Schoenfeld EM;Richardson LD;Lin MP
- 通讯作者:Lin MP
The terminology of social emergency medicine: Measuring social determinants of health, social risk, and social need.
- DOI:10.1002/emp2.12191
- 发表时间:2020-10
- 期刊:
- 影响因子:2.3
- 作者:Samuels-Kalow ME;Ciccolo GE;Lin MP;Schoenfeld EM;Camargo CA Jr
- 通讯作者:Camargo CA Jr
Shared Decision Making in Patients With Suspected Uncomplicated Ureterolithiasis: A Decision Aid Development Study.
- DOI:10.1111/acem.13917
- 发表时间:2020-07
- 期刊:
- 影响因子:0
- 作者:Schoenfeld EM;Houghton C;Patel PM;Merwin LW;Poronsky KP;Caroll AL;Sánchez Santana C;Breslin M;Scales CD;Lindenauer PK;Mazor KM;Hess EP
- 通讯作者:Hess EP
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Elizabeth Mae Schoenfeld其他文献
Elizabeth Mae Schoenfeld的其他文献
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{{ truncateString('Elizabeth Mae Schoenfeld', 18)}}的其他基金
Conversations can save lives: TALKing About Buprenorphine & methadone for Opioid Use Treatment Initiation (TALK ABOUT)
对话可以拯救生命:谈论丁丙诺啡
- 批准号:
10807173 - 财政年份:2023
- 资助金额:
$ 14.67万 - 项目类别:
Shared Decision-Making for the Promotion of Patient-Centered Imaging in the Emergency Department: Suspected Kidney Stones
促进急诊科以患者为中心的影像学的共同决策:疑似肾结石
- 批准号:
10219360 - 财政年份:2018
- 资助金额:
$ 14.67万 - 项目类别:
Physician Perspectives Regarding the Use of Shared Decision-Making in the Emergency Department
医生对急诊科使用共享决策的看法
- 批准号:
9015931 - 财政年份:2015
- 资助金额:
$ 14.67万 - 项目类别:
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