A Patient-Specific Decision Support Tool for Bariatric Surgery

针对减肥手术的患者特定决策支持工具

• 批准号: 7846888
• 负责人: DANIEL P SCHAUER
• 金额: $ 13.37万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-03 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7846888
• 关键词: Adult; Affect; Age; Bariatrics; Benefits and Risks; Body Weight decreased; Body mass index; Cardiovascular system; Characteristics; Clinical; Clinical Trials; Computer software; Conflict (Psychology); Control Groups; Decision Analysis; Decision Making; Decision Modeling; Development; Diabetes Mellitus; Doctor of Philosophy; Doctor of Public Health; Effectiveness; Equilibrium; Foundations; Gender; Generic Drugs; Goals; Health; Health Benefit; Health Care Costs; Hyperlipidemia; Hypertension; Individual; Knowledge; Life Expectancy; Literature; Measures; Medical center; Mentorship; Modeling; Morbid Obesity; Morbidity - disease rate; Natural History; Obesity; Online Systems; Operative Surgical Procedures; Outcome; Outcomes Research; Output; Patients; Perioperative; Pharmaceutical Preparations; Probability; Procedures; Process; Process Measure; Psychosocial Factor; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Research Design; Research Methodology; Research Personnel; Risk; Safety; Science; Self Efficacy; Series; Subgroup; Testing; Time; Training; Uncertainty; Universities; Work; arm; bariatric surgery; base; cardiovascular risk factor; career; career development; clinical care; cost; design; diet and exercise; follow-up; innovation; insight; interest; model design; models and simulation; mortality; patient oriented research; population based; preference; programs; satisfaction; skills; systematic review; tool; usability; user-friendly; web based interface

DESCRIPTION (provided by applicant): Background. Obesity and obesity-associated conditions have been shown to greatly decrease both quality of life and life expectancy. Currently, bariatric surgery is the only proven treatment for sustained weight loss in the morbidly obese patient. However the decision to undergo surgery is a difficult one because of the risks involved in surgery and the uncertain outcome. Objectives. As an outcomes researcher with an interest in decision analysis, the specific objectives of this application are to: a) broaden my skills in the construction of decision analytic models, the decision sciences, and the conduct of patient-oriented research and b) use these skills to develop and test an interactive decision support tool that provides tailored information about the individual patient's surgical risk and the expected benefit of bariatric surgery. My long- term career goal is to develop and test a variety of patient-specific decision support tools for patients with morbid obesity. Training. For my career development, I plan to take additional coursework in the decision sciences, focusing on the design of decision analytic models for simulations. My mentorship team is comprised of leading experts in the fields of decision analysis, obesity and research methodology: Mark H. Eckman, MD, MS, Joel Tsevat, MD, MPH, David D'Alessio, MD, David Fischer, MD, David Arterburn, MD, MPH, Richard Hornung, DrPH, Thomas Inge, MD, PhD, and Meg Zeller, PhD. Research Design. For this proposal, we will first develop a population based decision analytic model that examines two strategies: bariatric surgery versus the natural history of morbid obesity. Using this model we will identify those patients for whom the decision to have bariatric surgery is a "close call". This model will then be the basis for the development of a patient-specific model that will serve as the foundation for our decision support tool. Using a randomized controlled trial, we will assess patients' understanding of the risks and benefits of bariatric surgery, decisional conflict, satisfaction with the decision making process and decision self efficacy when using the decision support tool compared to a control group with access to generic information about bariatric surgery. Relevance. At the completion of this project, we will have developed and tested an interactive web-based decision support tool to be used by morbidly obese patients considering bariatric surgery. This will assist patients in making a more informed decision when weighing the treatment options for morbid obesity.

描述（由申请人提供）： 背景肥胖和肥胖相关的疾病已被证明会大大降低生活质量和预期寿命。目前，减肥手术是唯一被证实的治疗病态肥胖患者持续减肥的方法。然而，决定接受手术是一个困难的，因为手术的风险和不确定的结果。目标.作为对决策分析感兴趣的结果研究人员，此应用程序的具体目标是：a）拓宽我在决策分析模型构建、决策科学方面的技能，和开展以病人为中心的研究，以及B）利用这些技能开发和测试交互式决策支持工具，该工具提供关于个体患者手术风险和减肥预期益处的定制信息手术我的长期职业目标是开发和测试各种针对病态肥胖患者的决策支持工具。训练为了我的职业发展，我计划参加决策科学方面的额外课程，重点是模拟决策分析模型的设计。我的导师团队由决策分析、肥胖和研究方法领域的顶尖专家组成：Eckman（医学博士、理学硕士）、Joel Tsevat（医学博士、公共卫生硕士）、大卫达莱西奥（医学博士）、大卫菲舍尔（医学博士）、大卫阿特伯恩（医学博士、公共卫生硕士）、Richard Hornung（公共卫生博士）、托马斯英奇（医学博士、哲学博士）和Meg Zeller（哲学博士）。研究设计。对于这个建议，我们将首先开发一个基于人群的决策分析模型，该模型检查两种策略：减肥手术与病态肥胖的自然史。使用这个模型，我们将确定那些决定减肥手术是一个“千钧一发”的患者。然后，该模型将成为开发患者特定模型的基础，该模型将作为我们决策支持工具的基础。使用随机对照试验，我们将评估患者对减肥手术的风险和益处的理解，决策冲突，对决策过程的满意度和决策自我效能，当使用决策支持工具时，与对照组相比，可以获得有关减肥手术的通用信息。 本案无关在这个项目完成后，我们将开发和测试一个互动的基于网络的决策支持工具，用于病态肥胖患者考虑减肥手术。这将有助于患者在权衡病态肥胖的治疗方案时做出更明智的决定。