PREDICTION AND OUTCOME MEASUREMENT IN CHILDHOOD CANCER

儿童癌症的预测和结果测量

• 批准号: 3071941
• 负责人: JEFFREY H SILBER
• 金额: $ 6.99万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-09-30 至 1994-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3071941
• 关键词: cancer complication; cancer rehabilitation /care; child physical development; computer assisted medical decision making; drug adverse effect; extended care; health care quality; health care service evaluation; heart failure; human morbidity; human therapy evaluation; infant mortality; mathematical model; metastasis; model design /development; neoplasm /cancer epidemiology; neoplasm /cancer relapse /recurrence; neoplasm /cancer remission /regression; neoplasm /cancer therapy; neuroblastoma; pediatric neoplasm /cancer; pediatrics; prognosis; respiratory insufficiency /failure

Research aimed at solving clinical problems often is limited because those who understand the medical questions lack the quantitative skills necessary to arrive at measurable solutions. In this application, i propose to utilize my doctoral training in health services research as well as my knowledge of pediatric oncology to solve problems related to long-term survivors of childhood cancer. Patient outcome measurement relating to quality of care, economic theory and modeling, statistics and health economics have been studied as part of my PH.D program and will be utilized to improve and refine pediatric oncology therapy. The work described in this proposal involves three sequential steps; (1) Prediction: develop new multivariate models and improve on those of others to predict second cancers, heart failure, pulmonary failure, growth abnormalities, and survival; (2)Outcome Measurement: develop and improve measures which quantify health status (quality of life) in order to supplement survival as a reasonable objective of children with malignancies in which high "cure" rates are now achieved; and 93) Decision Models: with improved prediction and measurement; and utilizing the mathematical tools of economics and operations research, to suggest refined therapeutic regimens which maximize patient utility. I plan to begin an academic career in Pediatric Oncology as an Assistant Professor of Pediatrics in the School of Medicine of the University of Pennsylvania, an ideal situation in which to combine my training in clinical oncology with health services research. The members of the Division of Pediatric Oncology have been pioneers in the study of delayed consequences of childhood cancer therapy and the large patient population provides an excellent resource for the study of multiple variables. Additional patients for specific projects are available from the children's Cancer Study Group, the National Wilms; tumor Study and the Late Effects Study Group, as leaders of these cooperative groups are faculty members. The Leonard Davis Institute of health Economics maintains very close ties with the Children;s Hospital and will provide a superb base of technical support as well as a stimulating group of peers interested in economic and statistical modelling.

旨在解决临床问题的研究往往是有限的，因为 那些理解医学问题的人缺乏量化技能 这是达成可衡量的解决方案所必需的。在此应用程序中，我 建议利用我在卫生服务研究方面的博士培训作为 以及我在儿科肿瘤学方面的知识来解决相关问题 儿童癌症的长期幸存者。患者结局测量 与护理质量、经济理论和建模、统计和 卫生经济学已经作为我博士项目的一部分进行了学习，并将成为 用于改进和完善儿科肿瘤治疗。这项工作 本提案所述包括三个顺序步骤：(1) 预测：开发新的多变量模型并改进 其他人预测第二次癌症，心力衰竭，肺功能衰竭， 生长异常与生存；(2)结局测量：发展和 改进量化健康状况(生活质量)的措施 将补充生存作为儿童的合理目标 现已取得高“治愈率”的恶性肿瘤；以及93) 决策模型：具有改进的预测和测量；以及利用 经济学和运筹学的数学工具，建议 精细化的治疗方案，最大限度地提高患者的效用。 我计划以助理的身份开始在儿科肿瘤学的学术生涯 华盛顿大学医学院儿科学教授 宾夕法尼亚州，一个将我的训练结合在一起的理想环境 临床肿瘤学与卫生服务研究。该委员会的成员 儿科肿瘤科一直是延迟治疗研究的先驱 儿童癌症治疗的后果和庞大的患者群体 为研究多变量提供了极好的资源。 特定项目的其他患者可从 儿童癌症研究小组，国家癌症研究所；肿瘤研究和 后效研究小组，作为这些合作小组的组长 教职员工。伦纳德·戴维斯卫生经济研究所 与儿童保持非常密切的联系；S医院将为儿童提供 雄厚的技术支持基础以及一群令人振奋的同行 对经济和统计模型感兴趣。