CORE--EVALUATION

评价核心的目标是为协调每个项目的评价工作提供实用的基础设施和专门知识。评估将衡量已开发技术的有效性及其对明确界定的患者群体和医疗保健提供者的影响。为了实现这一目标，评估核心将具体：(1)通过协助实施评估工具和工具，协助项目进行实验室技术评估；(2)为每个项目指派和管理专职工作人员，负责从临床现场收集数据；(3)检查数据的一致性和范围(即质量控制)；(4)将评估数据存档到中央储存库；以及(5)分析收集的数据。这五项任务包括技术评估和临床评估。对于每个项目，评估核心的特定于项目的部分清楚地描述了技术、流程和满意度测量终点。技术措施包括评估信息检索结果、机器学习、最终用户满意度和其他特定于项目的技术指标。主要的流程衡量标准包括最终处置时间：稳定状态的时间；医生用于检查图表的时间；以及医疗文件编码的时间长度。二级流程措施包括初级保健和专科就诊的次数，以及所执行的程序的数量和类型。最后，还在适当的领域对医生和患者的满意度进行了评估。这些措施的总体设计是为了评估所描述的技术在现实世界临床环境中的影响。这些初步措施，以及本计划项目中描述的技术开发，也可能为未来的成本效益评估奠定适当的基础：(1)定义基于适当成像的“事件”护理的特征；(2)记录资源利用情况；(3)收集与呈现症状和“最终处置”相关的患者特定信息；以及(4)以结构化格式存储患者特定信息，以便于回忆。采用了三种不同的设计(自然实验、时间序列和“关/开/关”)。每个项目的实验设计的选择受到其真实世界的临床患者设置和对照组数据可用性的影响。定义并提供功率计算，以确定有意义的评估所需的适当样本量。项目与评估核心之间的互动通过以下方式加强：(1)项目领导、核心主管和绩效指标的定期会议；以及(2)专职评估核心的分配通过以下方式得到加强：(1)项目负责人、核心主管和绩效指标的定期会议；以及(2)在核心教员的直接监督下，向每个项目指派熟悉项目细节的专职评估核心工作人员。

The objective of the Evaluation Core is to provide the practical infrastructure and expertise for the coordinated effort of each Project's evaluation. Evaluation will measure the effectiveness of developed technologies and their impact on well defined patient populations and health care providers. To achieve this goal, the Evaluation Core will specifically: (1) assist the Projects in the laboratory evaluation of technologies by aiding in the implementation of evaluation instruments and tools; (2) assign and managed dedicated staff members to each Project, charged with collecting data from clinical sites; (3) perform data checks for consistency and range (i.e. quality control); (4) archive evaluation data into a central repository; and (5) analyze the collected data. These five tasks are inclusive of both technical and clinical evaluations. For each Project, technical, process, and satisfaction measurement endpoints are clearly described within the Project-specific sections of the Evaluation Core. Technical measures encompass the evaluation of information retrieval results, machine learning, end-user satisfaction, and other Project-specific technical metrics. Primary process measures include time to final disposition: time to stabilization; time spent by physicians for chart review; and the length of time for medical document coding. Secondary process measures include the number of primary care and specialty visits, and the number and types of procedures performed. Finally, physician and patient satisfaction are also evaluated in appropriate domains. The totality of these measures is designed to evaluate the impact of the described technologies in a real-world clinical environment. These initial measures, along with technical development described in this Program Project may also lay the appropriate groundwork for future cost-effectiveness evaluation by: (1) defining characterizations of appropriate imaging based "episodes" of care; (2) recording resource utilization; (3) gathering patient-specific information related to presenting symptoms and "final disposition"; and (4) storing patient-specific information in a structured format to facilitate recall. Three different designs (natural experiment, time series, and "off/on/off") are used. The choice of experimental design for each Project was influenced by its real-world clinical patient settings and the availability of data for a control group. Power calculations are defined and presented to determine the appropriate sample sizes required for meaningful evaluation. Interaction between the Projects and the Evaluation Core is enhanced by: (1) regular meetings of the Project leaders, Core directors, and the PI; and (2) the assignment of dedicated Evaluation Core is enhanced by: (1) regular meetings of the Project leaders; Core directors, and the PI; and (2) the assignment of dedicated Evaluation Core staff to each Project who are familiar with the details of the Project while working under the direct supervision of the Core faculty.