Multi-modal physician intervention to detect amblyopia

描述（由申请人提供）：尽管数十年的研究表明异常视力的不良神经后果，弱视儿童几乎没有改变。数据显示，大约一半的弱视病例是晚期发现的，这一发现在过去40年中一直保持稳定。在我们的医疗保健系统中，初级保健医生在将弱视的发现转化为实践方面发挥着关键作用。不过，根据我们与母婴健康局/国家教育研究院学前儿童视力普查专家小组的经验， CHB/美国儿科学会（AAP）项目通用学龄前视力筛查显示，初级保健医生很少接受有关弱视和风险因素的培训。 因此，许多人不会积极筛查这些疾病。亚拉巴马大学验光、儿科和继续医学教育系与AAP、MCHB、美国防盲协会、儿科眼病调查组、学龄前儿童视力研究组和亚拉巴马医疗补助机构合作，提出开发一种新颖的、基于互联网的、多模式策略，以提高儿科医生和初级保健医生在办公室环境中对弱视及其危险因素的理解和认识。我们提出了一个随机的，对照的临床试验，以测试我们的干预是否导致改善性能的“干预”医生相比，对照医生（暴露于免疫干预）。我们的设计，沿着干预前后的绩效指标，将评估实践中归因于干预的变化与随着时间的推移从其他来源发生的变化。我们的最终分析将显示干预医生的学龄前患者是否更有可能被识别为斜视或弱视。这项研究在NEI所培养的真正非凡的弱视研究机构和为美国儿童提供的医疗保健之间建立了关键的联系。

DESCRIPTION (provided by applicant): Despite decades of research showing adverse neural consequences of abnormal vision, little has changed for amblyopic children. Data have shown that approximately half the cases of amblyopia are detected late, and this finding has remained stable during the past 40 years. In our health care system, primary care physicians play a pivotal role in translating findings about amblyopia into practice. But, our experience with the Maternal and Child Health Bureau (MCHB) / NEI expert panel on Vision Screening in the Preschool Child and the CHB/American Academy of Pediatrics (AAP) Project Universal Preschool Vision Screening revealed that primary care physicians get very little training about amblyopia and risk factors. Consequently, many do not screen aggressively for these conditions. The University of Alabama Departments of Optometry, Pediatrics and Continuing Medical Education, in collaboration with the AAP, MCHB, Prevent Blindness America, the Pediatric Eye Disease Investigators Group, the Vision in Preschoolers Study Group, and the Alabama Medicaid Agency, propose to develop a novel, internet-based, multi-modal strategy to increase the understanding and recognition of amblyopia and its risk factors by pediatricians and primary care physicians in office based settings. We propose a randomized, controlled clinical trial to test whether our intervention results in improved performance by "intervention" physicians compared to control physicians (exposed to an immunization intervention). Our design, along with pre- and post-intervention performance measures, will evaluate changes in practice attributable to the intervention versus those occurring from other sources over time. Our final analysis will show whether preschool patients of intervention physicians are more likely to be identified with strabismus or amblyopia. This research forges a critical link between the truly phenomenal body of amblyopia research fostered by the NEI and the health care offered to American children.