Assessing and Predicting Outcomes in Children with Minor Injury

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DESCRIPTION (provided by applicant): This investigator is a pediatric emergency medicine (PEM) clinician whose long-term objective is to become an independent clinical investigator in this field, with expertise in the assessment of patient-oriented outcomes after pediatric emergency department (FED) care. These short-term outcomes include health- related quality of life (HRQOL) and family impact, as well as clinical markers of interest. This work is a critical prerequisite to evaluating the effectiveness of the care given to children in the FED, most of which is not currently evidence-based. The overall goals of this project are to describe the short-term outcomes in children after FED care for minor injury, to develop a quantitative outcomes measure for these children after FED discharge, and create a predictive tool to identify children at risk for poor outcomes. Under the mentorship of well-established investigators in injury, PEM, epidemiology, and pediatric health status measurement, the candidate proposes a tailored career development program that combines mentor-guided clinical research and an independent study tutorial with didactic courses and seminars. The plan will provide necessary training in the theory and research skills specific to my short term goals: 1) to increase knowledge and methodological skills in injury research as well as in the use, development, and validation of HRQOL and health status measures in children, 2) effectively communicate my research ideas and findings, 3) effectively manage my research career, and 4) establish and maintain a network of colleagues in my field. The research planned in this proposal would first describe (for the first time), then develop a way to measure (a quantitative outcome scale), how children and their families do in the first 2 weeks after care in the FED for minor injury. Most importantly, we could use the measure to test if our current ways of treating them are effective, and how new treatments would compare. This research would also provide a predictive tool that would allow FED clinicians to identify children with minor injury, at the time of their FED care, who are at risk for poor patient and family outcomes, allowing them to tailor treatment and follow-up care plans to try to improve the child's course after discharge. Important steps towards the identification and testing of needed changes in current care for children with minor injuries will be made. The ability to make comparisons of the responses to care of minor injury, and identify care issues specific to particular subgroups (cultural, ethnic, and socioeconomic) of the FED population will be greatly facilitated, thus enhancing the ED care of children.