The Northwest Tribal Vision Project

本申请提出了一项培训计划，将Steven L.Mansberger，M.D.，M.P.H.培养成一名 独立的临床医生/科学家，专攻眼科流行病学和生物统计学。曼斯伯格博士是一名经过青光眼专科培训的董事会认证眼科医生。他有青光眼筛查、视盘病理与视功能的关系以及眼血流的研究经验。德弗斯眼科研究所、俄勒冈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。这一培训计划将包括生物统计学和流行病学方面的高级课程、多学科会议和指导性研究。将进行有指导的研究 指导委员会由俄亥俄州立大学公共卫生和预防医学系临时主席Thomas Becker博士、Discovery in Sight/Dever眼科研究所诊断研究主任Chris Johnson博士和西北部落健康研究中心项目首席研究员Francine Romero博士组成。乔治·A·乔菲，医学博士，安妮·L·科尔曼，医学博士和蔡东锡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眼科医生或验光师等专家人员来诊断眼病，作为患病率调查的一部分。然而，评估视野、视网膜和视神经的新方法使非MD、非OD辅助专业人员(如眼科技术人员)能够执行基线检查，并将结果异常的参与者转介给专家人员进行最终检查。这一阶段性协议允许对患者进行检查 速度快，费用低。该研究项目的具体目标是：1)确定与专家检查员相比，非MD、非OD的辅助专业人员(如眼科技术人员)执行新的测试方法是否具有良好的诊断精度和可行性；2)获得关于40岁及以上的西北美洲印第安人和阿拉斯加土著人(AI/AN)样本中特定年龄段视力障碍、失明和眼病患病率的初步数据。然后，该项目将导致对人工智能/AN中视力损害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.