CORE--EVALUATION

评估核心的目标是为每个项目评估的协调工作提供实用的基础设施和专业知识。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卫生保健提供者的影响。为了实现这一目标，评估核心将具体地：(1)通过协助实施评估工具和工具，协助项目进行技术的实验室评估；(2)为每个项目分配和管理专门的工作人员，负责从临床站点收集数据；(3)对数据进行一致性和范围检查（即质量控制）；(4)将评估数据归档到中央存储库；(5)对收集到的数据进行分析。这五项任务包括技术评估和临床评估。对于每个项目，技术、过程和满意度测量端点在评估核心的项目特定部分中被清楚地描述。技术度量包括对信息检索结果、机器学习、最终用户满意度和其他特定于项目的技术度量的评估。主要工艺措施包括到最终处置的时间：稳定的时间；医生审查病历所花费的时间；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，以及所执行程序的数量和类型。最后，医生和病人的满意度也在适当的领域进行评估。这些措施的总体目的是评估在现实世界的临床环境中所描述的技术的影响。这些初步措施，以及本项目中描述的技术发展，也可以通过以下方式为未来的成本效益评估奠定适当的基础：(1)定义基于护理“发作”的适当成像特征；(2)记录资源利用情况；(3)收集与症状表现和“最终处置”相关的患者特异性信息；(4)以结构化格式存储患者特定信息，以方便召回。使用了三种不同的设计（自然实验、时间序列和“开/关”）。每个项目的实验设计选择受到其真实临床患者环境和对照组数据可用性的影响。功率计算的定义和提出，以确定适当的样本量需要有意义的评估。通过以下方式加强项目与评估核心之间的互动：(1)项目负责人、核心负责人和项目负责人的定期会议；(2)通过以下方式加强专门评估核心的分配：(1)项目负责人的定期会议；核心董事和PI；(2)为每个项目指派专门的评估核心人员，他们在核心教师的直接监督下工作，熟悉项目细节。

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.