QUALITY OF LIFE AND TREATMENT FOR BRAIN TRAUMA

描述(改编自申请者摘要)：与健康有关的素质 生命评估正在迅速成为评估的不可或缺的工具 医学上的结果。通过解决患者术后的健康质量问题 治疗，这些评估极大地加强了治疗的研究 有效性，它们被用于成本和结果关系的研究 (即成本效益分析)，并且它们在以下方面提供了通用标准 用于比较预防、康复和治疗的健康测量 治疗。这个指导研究科学家发展奖是由 让他做好准备帮助领导康复的候选人，因为这有助于 在医学上研究结果的这种综合方法。建议的5- 年度课程计划、研究研讨会和有监督的健康研究 服务、流行病学和健康决策分析提供 具备独立研究人员所需技能的候选人 在康复和脑创伤成本和结果研究领域。一个 与健康相关的生活质量的实验研究，将在 最近由美国国立卫生研究院资助的随机临床试验，题为“硫酸镁 这是一项关于脑损伤后的临床试验。 硫酸盐作为脑创伤后的神经保护剂将招募400名受试者和 正在收集死亡率、癫痫发作频率和神经行为数据。这个 拟议的研究将对试验参与者进行双盲访谈， 伤后6个月获取健康相关生活质量数据。采访 将使用EuroQol确定受试者的当前健康状态 分类系统(EQ-SD)。然后，受试者将评估他们目前的健康状况 使用三种经过验证的技术：标准赌博、时间权衡和 视觉模拟天平。主要的假设是，给定的硫酸镁 在中、重度颅脑损伤后8小时内，提高受试者估值 他们在受伤后6个月的健康状况。这项研究还将评估 通过测试与每种估值方法相关的认知负担 受试者对其当前健康状况的评价的一致性。一致 受试者将判断其他假设的健康状态，以构建 代理权重方案，用于评估对其也有影响的对象 很大的认知负担。最后，候选人计划使用收集到的数据 从损伤严重程度和认知障碍的临床试验到两者 认知障碍与健康相关质量关系的研究 生命判断，并开发出预测受伤严重程度何时将 干扰这些判断。

DESCRIPTION (Adapted from Applicant's Abstract): Health-related quality of life assessment is rapidly becoming an indispensable tool for evaluating outcome in medicine. By addressing the quality of patient health after treatment, these assessments greatly enhance the study of treatment effectiveness, they are used in the study of cost and outcome relationships (i.e., cost-effectiveness analysis), and they offer a universal standard in health measurement for comparison of preventive, rehabilitative, and curative treatments. This Mentored Research Scientist Development Award is proposed by the candidate to prepare him to help lead rehabilitation as it contributes to this integrative approach to the study of outcome in medicine. The proposed 5- year plan of course work, research seminars, and supervised research in health services, epidemiology, and health decision analysis is to provide the candidate with the necessary skills to function as an independent researcher in the area of rehabilitation and brain trauma cost and outcomes research. An experimental study of health-related quality of life, to be conducted within a recently NIH-funded randomized clinical trial, entitled "Magnesium Sulfate After Brain Trauma", is proposed. This randomized clinical trial of magnesium sulfate as a neuroprotectant after brain trauma will enlist 400 subjects and is collecting mortality, seizure frequency, and neurobehavioral data. The proposed study will conduct double-blind interviews with trial participants at 6 months post injury to obtain health-related quality of life data. Interviews will determine subjects' current health status using the EuroQol classification system (EQ-SD). Subjects will then value their current health using three well validated techniques: The Standard Gamble, Time Tradeoff, and Visual Analogue Scale. The primary hypothesis is that magnesium sulfate, given within 8 hours of moderate or severe head injury, improves subject valuation of their current health at 6 months post-injury. The study will also evaluate the cognitive burden associated with each method of valuation by testing each subject's consistency in placing values on their current health. Consistent subjects will judge additional hypothetical health states to construct a surrogate weighting scheme for use with subjects for which valuation is of too great a cognitive burden. Finally, the candidate plans to use data collected from the clinical trial on injury severity and cognitive impairment to both study the relationship between cognitive impairment and health-related quality of life judgments, and to develop ways to predict when injury severity will interfere with these judgments.