The Northwest Tribal Vision Project

本申请提出了一个培训计划，以发展史蒂芬L。Mansberger，医学博士，M.P.H.成 专门从事眼科流行病学和生物统计学的独立临床医生/科学家。Mansberger博士是一名经过委员会认证的眼科医生，接受过青光眼专科培训。他有先前的研究经验，涉及青光眼筛查，视盘病理与视功能之间的关系，以及眼血流。Devers眼科研究所、俄勒冈州健康科学大学和西北波特兰地区印第安人健康委员会在研究和教育方面拥有丰富的经验，特别适合作为培训地点。该培训计划将包括生物统计学和流行病学，多学科会议和指导研究的高级课程。将进行指导性研究 在由医学博士托马斯贝克尔组成的指导委员会的指导下，哲学博士、OHSU公共卫生和预防医学系临时主席Chris约翰逊博士，Discovery In Sight/Devers眼科研究所诊断研究主任和Francine Romero博士，M.P.H.西北部落健康研究中心项目首席研究员。乔治Cioffi，医学博士，安妮湖医学博士科尔曼，博士，和Dongseok Choi博士将作为委员会成员担任该项目的顾问。大多数流行病学研究都使用专家人员，如眼科医生或验光师，作为患病率调查的一部分来诊断眼病。然而，评估视野、视网膜和视神经的新方法使得非MD、非OD辅助专业人员（如眼科技术人员）可以进行基线检查，并将结果异常的参与者转诊给专家人员进行明确检查。这种分阶段的方案允许人们接受检查， 速度快，费用低。研究项目的具体目标是：1）确定非MD，非OD辅助专业人员（如眼科技术人员）执行较新的测试方法，与专家检查员相比具有良好的诊断精度和可行性; 2）获得关于视力障碍、失明、和眼病的研究。然后，该项目将导致对AI/AN中视力障碍的患病率和原因进行更大，更全面的调查。

This application proposes a training plan to develop Steven L. Mansberger, M.D., M.P.H. into an independent clinician/scientist specializing in ophthalmic epidemiology and biostatistics. Dr. Mansberger is a board certified ophthalmologist with subspecialty training in glaucoma. He has prior research experience involving screening for glaucoma, the relationship between optic disc pathology and visual function, and ocular blood flow. Devers Eye Institute, Oregon Health Science University, and the Northwest Portland Area Indian Health Board have extensive experience with research and education and are especially well suited as training sites. This training program will consist of advanced coursework in biostatistics and epidemiology, multi-disciplinary conferences, and mentored research. Mentored research will be conducted under the direction of a mentorship committee composed of Thomas Becker, M.D., Ph.D., Interim Chairman of the Department of Public Health and Preventive Medicine at OHSU, Chris Johnson, Ph.D., Director of Diagnostic Research at Discoveries In Sight/Devers Eye Institute, and Francine Romero, Ph.D., M.P.H., Principal Investigator of the Northwest Tribal Health Research Center Project. George A. Cioffi, M.D., Anne L. Coleman, M.D., Ph.D., and Dongseok Choi, Ph.D. will serve as consultants on the project as committee members. Most epidemiological studies have used expert personnel, such as ophthalmologists or optometrists, to diagnose eye diseases as part of a prevalence survey. However, newer methods of evaluating the visual field, retina, and optic nerve make it possible for non-MD, non-OD paraprofessionals (such as ophthalmic technicians) to perform a baseline examination and refer participants with abnormal results for a definitive exam by expert personnel. This staged protocol allows persons to be examined rapidly and with reduced expense. The specific aims of the research project are: 1) to determine if non-MD, non-OD paraprofessionals (such as ophthalmic technicians) performing newer methods of testing have good diagnostic precision and feasibility in comparison to an expert examiner; 2) to attain preliminary data regarding the age-specific prevalence of visual impairment, blindness, and ocular disease in a sample of Northwest American Indians and Alaskan Natives (AI/AN) aged 40 years and older. This project will then lead to a larger, more comprehensive survey of the prevalence and causes of visual impairment in AI/AN.