NIAMS MULTIDISCIPLINARY CLINICAL RESEARCH CENTER

这项建议是对NIAMS多学科临床研究中心RFA AR-00-0012的回应，是逐步淘汰多功能关节炎中心计划和向临床研究中心过渡的分水岭。在20多年来建立的严格的积极临床前研究计划和研究人员发起的临床科学计划的基础上，我们提交了3项建议，其目标是改善患者的结果，为所有项目提供咨询和实践支持的生物统计学和方法学关怀，以及加强互动和对新研究机会的响应的行政关怀。项目1的研究目标是了解全膝关节置换术的外科医生和医院容量之间的关系，并阐明容量影响结果的机制。了解这些机制将使我们能够提高这一主要程序的效力。它使用了强大的索赔分析统计工具。项目2剖析了功能性识字对结果的影响，并测试了一种新的干预措施，以克服有识字问题的系统性风湿病受试者的健康劣势。它在关节炎和肌肉骨骼疾病方面开辟了新的天地，并已开发出新的方法来进行研究。它在关节炎和肌肉骨骼疾病方面开辟了新的天地，并已开发出新的方法来进行研究。项目3试图改善SLE患者的预后，减少动脉粥样硬化加速的发生率。系统性红斑狼疮患者有极高的动脉粥样硬化加速风险。系统性红斑狼疮患者有极高的动脉粥样硬化加速风险，这一点早在20多年前就已为人所知。它的预防尚不清楚，该项目是一项概念验证研究，使用心脏风险概况作为替代终点。

This proposal is in response to RFA AR-00-0012, NIAMS Multi- disciplinary Clinical Research Center and is a watershed for the phasing out of the Multipurpose Arthritis Center program and a transition to a Clinical Research Center. Building on a rigorous active preclinical research program and investigator initiated clinical sciences program built over 20 years, we submit 3 proposals whose goals is to improve patient outcomes, a Biometry and Methodology Care to provide consultation and practical support to all projects and Administrative care to enhance interactions and responsiveness to new research opportunities. The research goals of project 1 are to understand the relationships between surgeon-and hospital-volume of total knee arthroplasty and to elucidate the mechanisms by which volume affects outcomes. To know these mechanisms will allow us to improve the effectiveness of this major procedure. It uses powerful statistical tools of claim analysis. Project 2 dissects the effects of functional literacy on outcome and tests a novel intervention to overcome the health disadvantages for subjects with systemic rheumatic diseases who have literacy problems. It breaks new ground in arthritis and musculoskeletal diseases and new methods have been developed to permit its study. It breaks new ground in arthritis and musculoskeletal diseases and new methods have been developed to permit its study. Project 3 attempts to improve SLE patients outcomes and reduce the incidence of accelerated atherosclerosis. That patients with SLE have an exceedingly high risk of accelerated atherosclerosis. That patients with SLE have an exceedingly high risk of accelerated atherosclerosis has been known for over 20 years. It's prevention is unknown the project is a proof of concept study using a cardiac risk profile as a surrogate endpoint.