Washington Heights Initiative Community-based Comparative Effectiveness Research

描述(由申请人提供)：该项目的总体目标是推进旨在改善高血压护理提供和人口结果的比较有效性研究，方法是在现有的以机构为重点的数据基础设施的基础上建立强大的以社区为重点的数据基础设施，以支持有效解决看似棘手的公共卫生问题所需的各种创新研究。这将通过华盛顿高地/信息学社区比较有效性研究基础设施(WICER)来完成。WICER包含一个研究数据仓库，它将患者级别的数据(包括来自多个设施、环境和护理地点的临床数据)与个人级别的自我报告信息整合在一起，并将链接的数据映射到支持前瞻性比较有效性研究的变量。它还将提供工具，支持研究人员访问这一基础设施，进行回顾性分析，并招募患者进行研究。然后，我们将展示这一基础设施如何支持三项关于高血压的比较有效性研究。这三项研究将涉及高血压患者的诊断、治疗和管理。我们的项目将增强现有的数据基础设施，通过最先进的科学工具加强访问，并实现数据和为其做出贡献的医疗保健组织的更大程度的集成。这将使我们能够进行拟议的和随后的比较有效性研究，以产生证据，为高血压的有效诊断和治疗提供依据，并最终为更广泛的相关社区健康问题提供信息。 公共卫生相关性：这项研究有可能改善治疗高血压和其他临床疾病的证据基础，用于治疗医疗服务不足、少数民族、低收入、移民患者群体。目前，为这一人群提供护理的证据基础不强，导致卫生保健和结果方面的差异。通过与这一特定人群合作而获得的见解将推广到其他此类社区和人群。

DESCRIPTION (provided by applicant): The overall goal of this project is to advance comparative effectiveness research designed to improve hypertension care delivery and population outcomes by building on an existing institution-focused data infrastructure to create a robust community-focused data infrastructure that will support the kinds of innovative studies needed to effectively tackle seemingly intractable public health problems. This will be done through the Washington Heights/Inwood Informatics Infrastructure for Community-Centered Comparative Effectiveness Research (WICER). WICER contains a research data warehouse that integrates patient-level data, including clinical data from multiple facilities, settings and sites of care, with person-level self-reported information and will map the linked data to variables that support prospective comparative effectiveness research studies. It also will provide tools to support researchers in accessing this infrastructure to perform retrospective analyses and recruit patients for research studies. We will then demonstrate how this infrastructure can support three comparative effectiveness studies on hypertension. These three studies will relate to the diagnosis, treatment and management of hypertension in patients. Our project will augment an existing data infrastructure, enhance access through state of the science tools, and achieve greater integration of both the data and the health care organizations that contribute to it. This in turn will enable us to conduct both the proposed and subsequent comparative effectiveness studies generating evidence to inform effective diagnosis and treatment of hypertension, and ultimately a wider range of related community health problems. PUBLIC HEALTH RELEVANCE: This research has the potential to improve the evidence base for treatment hypertension and other clinical conditions for a medically underserved, minority, low income, immigrant patient population. Currently, the evidence base for care delivery is not strong for this population, resulting in disparities in health care and outcomes. Insights gained through working with this specific population will then be generalizable to other such communities and populations.