WReN's Response to Emerging Public Health Threats

简介(申请人提供)：背景：以实践为基础的研究网络[PBRN]是加强家庭医学学科和将研究成果转化为日常医疗实践的基本研究实验室。威斯康星州研究网络[WREN]是公认的和成功的，但目前处于静止状态的PBRN。目前的停滞是在领导层换届和身份混乱之际出现的。第一类项目的目标：将WREN重组为一个自给自足的PBRN，其关键组成部分如下：(1)由来自两所医学院的知名研究团队进行科学监督，(2)利用信息技术加强电子通信和数据收集，(3)利用已建立的临床数据仓库和拟议的临床医生登记册，针对重点人群招募更多的医生，以及(4)扩大与非常成功的公共卫生监测网络的现有接口，从而为WREN创建持续的公共卫生监测职能。第一类项目的方法。威斯康星大学和威斯康星医学院的研究团队将在年度会议上与Wren临床医生在研究项目的所有阶段合作，以提高学科相关研究的质量、完成情况和翻译。威斯康星州家庭医生学会将在他们的网站上支持一个门户网站，用于Wren通信和数据输入。来自本网站和华盛顿大学家庭医学部临床数据仓库的年度电子注册表的数据将用于识别潜在的新WREN实践。第二类项目的目标：评估PBRN与公共卫生监测网络互动的可行性和益处，评估PBRN在检测和应对新出现的公共卫生威胁(如生物恐怖主义行为)方面的作用。第二类项目的方法：所有Wren临床医生都将参加威斯康星州流感监测计划。将在两年的研究期间对每个参与者对监测方案的遵从性进行评估，以便对Wren和非Wren监测临床医生进行比较。将根据账单记录/图表审查和公共卫生记录审查进行回溯性评估，以评估参与公共卫生监督是否与改善患者直接护理和与公共卫生机构的沟通有关。将比较老年患者(65岁及以上)的流感疫苗接种率、流感误诊率、与公共卫生机构的自我报告水平以及提交威斯康星州“急性和传染性疾病病例报告表”的数量与遵守监测方案的比率。结果：主要结果是增强了WREN的功能和效率，采用了“自上而下”和“自下而上”的初级保健研究方法，增加了研究结果的公布，并提交了拨款申请。将确定PBRN在检测和应对新出现的公共卫生威胁方面的作用和可行性。

DESCRIPTION (provided by applicant): Background: Practice-based research networks [PBRNs] serve as the essential research laboratories for enhancing the discipline of family medicine and the translation of research findings into everyday medical practice. The Wisconsin Research Network [WReN] is a well recognized and successful, yet presently quiescent, PBRN. This current stagnation comes at a time of leadership transition and identity confusion. Objectives of Category I Project: To reorganize WReN as a self-sustaining PBRN with the following key components: (1) scientific oversight by well-established research teams from two medical schools, (2) information technology to enhance electronic communication and data collection, (3) use of an established clinical data warehouse and a proposed clinician registry to target recruitment of additional practices with priority populations, and (4) expand an existing interface with a highly-successful public health surveillance network, thus creating an ongoing public health monitoring function for WReN. Methods for Category I Project. An annual WReN convocation will be created at which research teams from the University of Wisconsin and the Medical College of Wisconsin will work with WReN clinicians at all stages of research projects to enhance the quality, completion and translation of discipline relevant research. The Wisconsin Academy of Family Physicians will support a portal on their web site for WReN communication and data entry. Data from an annual electronic registration form at this site and the UW Department of Family Medicine's Clinical Data Warehouse will be used to identify potential new WReN practices. Objective of Category II Project: To assess the feasibility and benefits of PBRN interaction with public health surveillance network, to evaluate the PBRN role in detection of, and response to, emerging public health threats, such as acts of bioterrorism. Methods for Category II Project: All WReN clinicians will enroll in the Wisconsin Influenza Surveillance Program. Compliance with the surveillance protocol will be evaluated for each participant over a two-year study period allowing comparison of WReN and non-WReN surveillance clinicians. Retrospective evaluations, based upon billing record/chart review and public health record review, will be conducted to assess whether participation in public health surveillance is associated with improved direct patient care and communication with public health agencies. The rates of influenza immunization in elderly patients (aged 65 and above), rates of erroneous influenza diagnosis, self-reported level of contact with public health agencies, and volume of filing Wisconsin "Acute & Communicable Disease Case Report" forms will be compared to rates of compliance to surveillance protocol. Outcomes: The primary outcomes are enhanced function and efficiency of WReN, with "top-down" and "bottom-up" approaches to primary care research, increased publication of research findings, and submission of grant applications. The role and feasibility of PBRNs in detecting and responding to emerging public health threats will be defined.