SEARCH for Diabetes in Youth 2: California Center

描述(由申请人提供)：加州中心的这项提案建立在一个为期五年的研究项目--寻找青年糖尿病，其标准化的数据收集工作，经验丰富的调查团队，已建立的病例确定基础设施，以及不同种族的人口基础上。这是六个Search临床中心共同的综合应用，它建议继续和扩大Search开展的工作，以解决以下具体研究目标：目的1：前瞻性确定年龄在20岁以下的新诊断(2006-2009年)糖尿病病例，以估计青年糖尿病发病率的时间趋势；目标2：对2002-2005年已招募进行Search的病例进行纵向跟踪，以根据临床和生化因素记录新诊断糖尿病的演变；目标3：在搜索的头五年中启动的完整分析，并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衡量标准；目标4：制定和验证可用于公共卫生监测的简单和低成本的青年糖尿病病例定义和分类。这一建议的新颖性包括其综合性，汇集了儿童糖尿病研究的主要和及时的方面；一项在美国独一无二的关于青少年糖尿病发病率时间趋势的流行病学研究；一个涉及青少年糖尿病自然病史的病理生理学部分；一项关于护理过程和生活质量的研究；以及关于青少年糖尿病病例分类的公共卫生观点。 加州中心的优势在于其庞大、多样化的人口；大多数患有糖尿病的青少年得到了该地区8名儿科内分泌科医生中的1名的医疗保健；以及可以获得大量的电子健康数据。在不到20岁的77万青年中，超过一半是西班牙裔、非裔美国人或代表南加州的亚太岛民。这项研究对公众健康至关重要。它将提供关于美国不同背景的青年中糖尿病发病率是否以及增加了多少的信息，以及糖尿病如何影响身体健康，包括并发症，以及关于糖尿病青年的护理质量和生活质量的数据。

DESCRIPTION (provided by applicant): This proposal from the California Center builds upon a five year research project, SEARCH for Diabetes in Youth, 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 centers, 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 (2006-2009) incident cases age less than 20 years in order to estimate temporal trends in incidence of diabetes mellitus 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 diabetes 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; AIM 4: Develop and validate simple and low-cost case definitions and classifications of diabetes 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 diabetes research; an epidemiologic study, unique in the United States, of temporal trends in the incidence of diabetes in youth; a pathophysiologic component addressing the natural history of diabetes in youth; a study of processes of care and quality of life; and a public health perspective on case classification of diabetes in youth. The strengths of the California Center are its large, diverse population; that most youth with diabetes receive health care from 1 of the 8 pediatric endocrinologists in the region; and the availability of a vast amount of electronic health data. Of the more than 770,000 youth less than 20 years, over half are Hispanic, African American, or Asian/Pacific Islander, which is representative of southern California. This research is critically important to public health. It will provide information about whether and how much diabetes incidence in the United States in increasing among youth of different backgrounds and how diabetes affects physical health, including complications, as well as data on the quality of care and the quality of life of youth with diabetes.