Improving Child Psychiatrists' Clinical Decision-Making

描述（由申请人提供）：该k奖旨在培养专业知识，使其成为儿童和青少年精神病学家（CAPs）临床决策研究的独立调查员。这一领域至关重要，因为cap之间在诊断方面存在差异，导致适当治疗的延误和不适当治疗的不同影响。这些问题被发现发生在多种情况下，并被诊断为注意缺陷多动障碍（ADHD）和青少年双相情感障碍（JBD）。令人惊讶的是，很少有研究来理解和改善cap的行为，然而，在医学的其他领域，工具已经被用来描述和改善临床医生的行为。判断和决策（JDM）研究描述了临床医生如何评估和衡量症状，得出诊断和治疗。研究人员已经创造了有效的工具来改进这些过程。候选人的长期目标是将JDM方法应用于一系列儿童精神病理学。对于这个奖项，她将专注于ADHD和JBD的诊断，并借鉴她在儿童疾病诊断和治疗方面的研究经验。她将完成k奖的三个目标：1)培训成为精神病学JDM的独立研究者，以描述和改进CAP的临床实践；ii)应用JDM来描述CAPs如何对患有JBD、ADHD和共病的儿童做出诊断决策，iii)利用这些结果来帮助开发和试点以人为中心的诊断决策辅助（DDA），以提高诊断准确性，为R01做准备，该R01将研究其在对照研究中的应用。后续研究将JDM应用于其他诊断和治疗问题。

DESCRIPTION (provided by applicant): This K-Award is designed to develop expertise for becoming an independent investigator in the study of clinical decision-making of child and adolescent psychiatrists (CAPs). This area is critical because of the demonstrated variability between CAPs regarding diagnosis leading to delays in appropriate treatment and diverse effects from inappropriate treatment. These problems have been found to occur in multiple settings with a range of diagnoses such as Attention Deficit Hyperactivity Disorder (ADHD) and Juvenile Bipolar Disorder (JBD). Surprisingly little research has been done to understand and improve CAPs' behavior, yet tools have been used in other areas of medicine to characterize and improve clinician behavior. Judgment and decision-making (JDM) studies have described how clinicians evaluate and weigh symptoms, arrive at a diagnosis and treatment. Investigators have created effective tools to improve these processes. The candidate's long-term goal is to apply JDM methods to a range of childhood psychopathology. For this award she will focus on the diagnosis of ADHD and JBD drawing on her experience in research on the diagnosis and treatment of childhood disorders. She will accomplish the goals of the K-award with 3 aims: i) To train to be an independent investigator in JDM in psychiatry in order to describe and improve the clinical practices of CAP; ii) To apply JDM to describe how CAPs make diagnostic decisions with children with JBD, ADHD, and comorbid disorders, iii) To use these results to help develop and pilot a human-centered diagnostic decision aid (DDA) to improve diagnostic accuracy in preparation for an R01 which will study its use in controlled studies. Subsequent research will apply JDM to other diagnostic and treatment issues.