SEARCH for Diabetes in Youth 2: Hawaii Center

描述（由申请人提供）：该提案建立在一个为期五年的研究项目SEARCH for Diabetes in Youth及其标准化数据收集工作、经验丰富的研究者团队、已建立的病例确定基础设施和种族多样化的人口基础之上。这是来自6个SEARCH临床站点的一个常见的综合应用，它建议继续和扩展SEARCH所做的工作，以解决以下具体研究目标：目标1：前瞻性地确定新诊断（2006-2008）年龄小于20岁的事件病例，以估计青少年糖尿病（DM）发病率的时间趋势；目标2：对2002-2005年已纳入SEARCH的病例进行纵向随访，以便根据临床和生化因素记录新诊断的糖尿病的演变；目标3：完成在检索的头五年开展的分析，扩大护理质量评估的范围，以包括更广泛定义的质量概念和措施；目标4：制定和验证可用于公共卫生监测的青年糖尿病类型的简单和低成本病例定义和分类。

DESCRIPTION (provided by applicant): The proposal builds upon a five year research project, SEARCH for Diabetes in Youth, and its standardized data collection effort, experienced investigator team, established case ascertainment infrastructure, and ethnically diverse population base. This is a common, integrated application from the six SEARCH clinical sites, which proposes to continue and expand the work performed by SEARCH in order to address the following specific research aims: AIM 1: Prospectively ascertain newly diagnosed (2006-2008) incident cases age less than 20 years in order to estimate temporal trends in incidence of diabetes mellitus (DM) in youth; AIM 2: Conduct longitudinal follow-up of incident cases already recruited to SEARCH in 2002-2005 in order to document the evolution of newly diagnosed DM according to clinical and biochemical factors; AIM 3: Complete analyses initiated in the first five years of SEARCH and expand the scope of quality of care assessment to encompass more broadly defined concepts and measures of quality; and AIM 4: Develop and validate simple and low-cost case definitions and classifications of DM types in youth that can be used for public health surveillance. The novelty of this proposal includes its comprehensive nature that brings together major and timely facets of childhood DM research; an epidemiologic study, unique in the United States, of temporal trends in the incidence of DM in youth; a pathophysiologic component addressing the natural history of DM in youth; a study of processes of care and quality of life; and a public health perspective on case classification of DM in youth. This research is critically important to public health as it will provide information about whether and how much DM is increasing among youth of different racial/ethnic groups in the U.S., how DM impacts physical health, including complications, as well as valuable data regarding the quality of care and quality of life of these youth. The SEARCH study in Hawaii is population-based, with the three health insurance plans participating in the study including in their membership nearly 80% of the population of the State. Approximately 80% of the youth enrolled in SEARCH in Hawaii belong to an ethnic minority group, primarily Asian/Pacific Islanders (API). The Hawaii Center had the highest response rate to in person visits in the study and accounts for approximately half of the API cases included in the study nationwide. SEARCH data indicates that the prevalence of Type 2 diabetes among API was 3 times higher compared to non-Hispanic whites. As a study center, Hawaii offers many advantages including a low rate of uninsured residents and low migration, and due to geographic isolation, diabetes care is received almost exclusively within the State.