Lung Transplant for COPD: Outcomes/Technology Assessment

肺移植治疗慢性阻塞性肺病：结果/技术评估

• 批准号: 7337292
• 负责人: ROGER D YUSEN
• 金额: $ 22.14万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-01 至 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7337292
• 关键词: Address; Age; Cessation of life; Chronic; Chronic Obstructive Airway Disease; Data; Death Rate; Disease Outcome; Effectiveness; Failure; Gender; Goals; Health; Healthcare Systems; Lead; Linear Regressions; Lung; Lung Transplantation; Lung diseases; Measurement; Measures; Methods; Modeling; Organ; Outcome; Patients; Personal Satisfaction; Probability; Provider; Quality of life; Race; Research Personnel; Resources; Risk; Score; Severity of illness; Staging; System; Technology Assessment; Time; Transplant Recipients; Transplantation; United Network for Organ Sharing; Waiting Lists; base; programs; research study

LUNG TRANSPLANT FOR COPD: OUTCOMES/TECHNOLOGY ASSESSMENT The broad goal of this proposal is to perform a technology assessment of lung transplantation (LTx) LTx for patients with COPD in the new donor lung allocation system. We will compare post-LTx quality of life to pre- LTx quality of life of patients within the new system. In addition, we will compare the quality of life outcomes in the new system to the outcomes in the old system. To perform this technology assessment, we propose two specific aims: Specific Aim 1: Assess the effectiveness of LTx, for patients with COPD, in the new donor lung allocation system. A. For patients that undergo LTx, evaluate the change in utilities (quality of life), comparing 6 months post- LTx utilities to pre-LTx utilities. B. Assuming LTx will be effective, evaluate the duration of improvement in utilities (quality of life), by comparing post-LTx utilities to pre-LTx utilities. C. Compare the utilities of transplanted patients with the utilities of patients not transplanted, after adjusting for baseline differences (severity of illness, age, gender, race, etc). Specific Aim 2: Compare the effects of LTx on the quality of life of patients with COPD in the new donor lung allocation system and the old donor lung allocation system. Compare the new and the old system utilities and utility changes, after controlling for baseline differences (severity of illness, age, type of LTx, gender, race, etc), in patients in the two systems. To generate hypotheses for potential revision of the new allocation system, we propose a third aim: Specific Aim 3: Determine preoperative predictors of post-LTx outcomes in the new donor lung allocation system, for patients with COPD. Perform multivariable linear regression to develop a model that uses detailed baseline data as explanatory variables and the change in utilities from pre-LTx to post-LTx change as the outcome variable. We will also model post-LTx utility scores (not change scores) as the outcome variable. Given the huge stakes for the patients, the providers, and the healthcare system, it is imperative that we assess the effectiveness of LTx and the impact of new organ allocation methods. This study will attempt to determine the survival and quality of life effects of LTx on patients with COPD in the new donor lung allocation system.

慢性阻塞性肺病肺移植：结果/技术评估 该提案的总体目标是对肺移植 (LTx) 进行技术评估 LTx 新的供肺分配系统中的慢性阻塞性肺病患者。我们将比较 LTx 后和 LTx 前的生活质量 LTx 新系统内患者的生活质量。此外，我们将比较生活质量结果 新制度下的结果与旧制度下的结果。 为了进行这项技术评估，我们提出了两个具体目标： 具体目标 1：评估 LTx 在新供肺中对 COPD 患者的有效性 分配制度。 A. 对于接受 LTx 的患者，评估效用（生活质量）的变化，比较 6 个月后的情况 LTx 实用程序到 LTx 之前的实用程序。 B. 假设 LTx 有效，评估公用事业（生活质量）改善的持续时间，方法是 将 LTx 后的实用程序与 LTx 前的实用程序进行比较。 C. 调整后，比较移植患者与未移植患者的效用 基线差异（疾病严重程度、年龄、性别、种族等）。 具体目标2：比较新疗法中LTx对COPD患者生活质量的影响 供肺分配系统和旧供肺分配系统。 在控制基线差异后，比较新旧系统实用程序和实用程序更改 （疾病严重程度、年龄、LTx 类型、性别、种族等），两个系统中的患者。 为了对新分配制度的潜在修订提出假设，我们提出了第三个目标： 具体目标 3：确定新供肺 LTx 后结果的术前预测因素 分配系统，适用于慢性阻塞性肺病患者。 执行多变量线性回归以开发使用详细基线数据作为解释的模型 变量和效用从 LTx 前到 LTx 后的变化作为结果变量变化。我们还将 将 LTx 后效用分数（不是变化分数）建模为结果变量。 考虑到患者、医疗服务提供者和医疗保健系统的巨大利害关系，我们必须 评估 LTx 的有效性以及新器官分配方法的影响。本研究将尝试 确定 LTx 对新供肺中 COPD 患者的生存和生活质量的影响 分配制度。