QUALITY OF LIFE AND COST EFFECTIVENESS IN CMV RETINITIS

本申请提出了一项培训计划，以培养John H.Kempen，MD， 公共卫生硕士成为独立的临床科学家、流行病学专家 研究方法，特别是临床试验。截至1998年7月，Dr。 Kempen将成为委员会认证的眼科医生，并拥有专科学位 葡萄膜炎方面的训练。约翰霍普金斯大学的表现格外出色。 适合作为他的训练场地。培训计划将包括 有指导的研究经验、多学科会议和 进修课程，获得流行病学博士学位。受指导的 研究将作为眼科研究的成员进行 艾滋病并发症(SOCA)课题组由初级导师教授主持。 詹姆斯·托纳西亚，SOCA协调中心联席主任，共同导师 希拉·韦斯特教授，资深眼科流行病学家和校长 合作者道格拉斯·贾布斯博士，SOCA主席。Kempen博士将参加 在SOCA协调中心的所有活动中，以及 在生活质量(QOL)和成本方面发挥主导作用- 更昔洛韦-西多福韦的有效性分析(CEA)部分 巨细胞病毒视网膜病变试验(GCCRT)。吴弘达博士和凯文教授 Frick将担任顾问，分别是QOL和CEA方面的专家 为了这个项目。巨细胞病毒(CMV)视网膜炎并发 获得性免疫缺陷综合征(AIDS)与生活质量下降相关 以及高昂的治疗费用。GCCRT是一个IV期多中心 两种非中心线依赖关系的随机临床试验 巨细胞病毒视网膜炎的治疗策略：玻璃体内植入更昔洛韦 放置加口服更昔洛韦与静脉注射西多福韦的比较。作为使用 这些疗法在很大程度上是由改善生活质量、评估的愿望推动的 生活质量结果将在解释试验结果方面发挥主要作用。 因为人们对控制艾滋病的高成本越来越感兴趣 除了治疗，GCCRT还将为CEA前瞻性地生成成本数据。 试验的这些部分的主要目标是确定哪些 治疗提供了更好的生活质量，这是更昂贵的，并描述 更有效的治疗的成本效益。子分析 将评估除治疗策略之外还有哪些因素与此相关 提高了生活质量，提高了成本效益。

This application proposes a training plan to develop John H. Kempen, MD, MPH into an independent clinical scientist, expert in epidemiologic research methods, especially clinical trials. As of July 1998, Dr. Kempen will be a board certified ophthalmologist with subspecialty training in uveitis. The Johns Hopkins University is exceptionally well suited to serve as his training site. The training program will consist of mentored research experience, multi-disciplinary conferences, and advanced course work, leading to a PhD in Epidemiology. Mentored research will be conducted as a member of the Studies of Ocular Complications of AIDS (SOCA) Research Group under primary mentor Prof. James Tonascia, co-director of the SOCA Coordinating Center, co-mentor Prof. Sheila West, a senior ophthalmic epidemiologist, and principal collaborator Dr. Douglas Jabs, SOCA Chair. Dr. Kempen will take part in the full spectrum of SOCA Coordinating Center activities, as well as assuming a leading role on the quality of life (QOL) and cost- effectiveness analysis (CEA) segments of the Ganciclovir-Cidofovir Cytomegalovirus Retinitis Trial (GCCRT). Dr. Albert Wu and Prof. Kevin Frick, experts in QOL and CEA respectively, will serve as consultants for this project. Cytomegalovirus (CMV) retinitis complicating the Acquired Immunodeficiency Syndrome (AIDS) is associated with reduced QOL and high treatment costs. The GCCRT is a phase IV multi-center randomized clinical trial comparing two non-central line dependent treatment strategies for CMV retinitis: intravitreal ganciclovir implant placement plus oral ganciclovir vs. intravenous cidofovir. As use of these regimens is largely driven by a desire to improve QOL, assessment of QOL outcomes will play a major role in interpreting trial results. Because of increasing interest in controlling the high costs of AIDS therapy, the GCCRT also will generate cost data prospectively, for CEA. The primary goals of these sections of the trial are to determine which treatment provides a better QOL, which is more costly, and to describe the cost-effectiveness of the more effective treatment. Subanalyses will assess what factors other than treatment strategy are associated with improved QOL and cost-effectiveness.