TRACE-CORE

追踪核心

• 批准号: 8146166
• 负责人: CATARINA I. KIEFE
• 金额: $ 147.4万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8146166
• 关键词: 21 year old; Adherence; Adult; African American; Age; Behavior; Cardiac; Case Mixes; Cell Nucleus; Cessation of life; Clinical; Cognitive; Commit; Communities; Consensus; Consent; Coronary; Coronary heart disease; Data; Databases; Education; Elements; Enrollment; Epidemiologist; Ethnic Origin; Event; Future; Health; Health Personnel; Health behavior; Hispanics; Home environment; Hospitalization; Hospitals; Impaired cognition; Individual; Inpatients; Intervention; Interview; Knowledge; Laboratories; Manuscripts; Massachusetts; Measurement; Measures; Mediating; Medical Records; Medical center; Mentors; Methods; Modeling; Morbidity - disease rate; Outcome; Outcomes Research; Outpatients; Patient Discharge; Patient Outcomes Assessments; Patients; Persons; Pharmaceutical Preparations; Preparation; Process; Process Measure; Provider; Quality of Care; Quality of life; Race; Records; Recruitment Activity; Recurrence; Research; Research Infrastructure; Research Personnel; Research Project Grants; Research Proposals; Respondent; Risk; Science; Shortness of Breath; Socioeconomic Status; Staging; Statistical Models; Structure; System; Teaching Hospitals; Testing; Time; Training; Variant; Visit; Vulnerable Populations; abstracting; acute coronary syndrome; base; career; cohort; evidence base; experience; follow-up; health care delivery; health disparity; high risk; improved; indexing; innovation; interest; medication compliance; mortality; novel; novel strategies; professor; prototype; rural area; suburb

DESCRIPTION (provided by applicant): Acute Coronary Syndromes (ACS), the usual reason for hospitalization of patients with coronary heart disease, is common and high-risk. Despite remarkable advances in the management of ACS in recent decades, unrealized health gains remain from underuse of available evidence for post-ACS patients. The proposed Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) will recruit a new longitudinal cohort of post-ACS patients, conduct two research projects using the cohort, and develop the careers of four early stage investigators (ESIs). We have 4 specific aims. 1) We will recruit and follow for 2 years a COHORT of 2,500 individuals, age 21-I-, 18% African-American and 10% Hispanic, at the time of their discharge from an ACS hospitalization at 8 medical centers in Massachusetts and Georgia. We will abstract medical records from the index and subsequent hospitalizations and outpatient records. Patient interviews at the time of discharge and at 2 and 6 weeks, and 3, 12, and 24 months later will include measurements of quality of life (QoL), cognitive impairment, adherence to medications, and health related behaviors. 2) TRANSITIONS PROJECT: We will characterize the 90-day transition process for patients discharged after an ACS. We will engage a national panel to develop an evidence-based Transition Measurement Set reflecting the first 90 days after discharge and going beyond existing systems that focus on the discharge process. We will test hypotheses on the associations between quality of care and outcomes (including rehospitalization and QoL), particularly as they pertain to health disparities. 3) ACTION SCORES PROJECT: We will develop and validate two novel "Action Scores" that predict clinical events/mortality and QoL and which emphasize modifiable aspects of health care delivery and patient behaviors. 4) Using TRACE-CORE as a training laboratory, we will develop the CVD outcomes research careers of the four ESIs. This will include structured mentoring, key involvement of the ESIs astheco-PIs in the research projects, and preparation of new research proposals based on the TRACE-CORE infrastructure and findings. Our team involves prominent CVD outcomes researchers, methodologists, cardiologists, and other clinicians. Our innovative Action Scores should activate patients and providers to improve CVD outcomes; our Transitions Project will fill important knowledge gaps. Future studies will benefit from our data, infrastructure, Action Scores, and transition measures; building on these will also underpin the careers of future CVD outcomes researchers.

描述（由申请人提供）：急性冠状动脉综合征（ACS）是冠心病患者住院治疗的常见原因，是一种常见且高危的疾病。尽管近几十年来ACS的管理取得了显著进展，但由于对ACS后患者现有证据的利用不足，未实现的健康收益仍然存在。拟议的冠状动脉事件转轨、风险和行动结局研究和教育中心（TRACE-CORE）将招募acs后患者的纵向队列，使用该队列开展两个研究项目，并发展四名早期研究者（ESIs）的职业生涯。我们有4个具体目标。1)我们将在马萨诸塞州和佐治亚州的8个医疗中心招募2500名年龄在21- 1岁的患者，其中18%是非裔美国人，10%是西班牙裔美国人，在他们从ACS住院出院时进行为期2年的随访。我们将从索引和随后的住院和门诊记录中提取医疗记录。患者在出院时、2周、6周、3、12和24个月后的访谈将包括生活质量（QoL）、认知障碍、药物依从性和健康相关行为的测量。2)过渡期项目：我们将描述ACS后出院患者90天的过渡期过程。我们将聘请一个全国小组，制定一套以证据为基础的过渡测量集，反映出院后的头90天，超越现有的以出院过程为重点的系统。我们将检验关于护理质量和结果（包括再住院和生活质量）之间关系的假设，特别是当它们与健康差异有关时。3)行动评分项目：我们将开发和验证两个新的“行动评分”，预测临床事件/死亡率和生活质量，并强调卫生保健服务和患者行为的可修改方面。(4)以TRACE-CORE为培训实验室，开展4个esi的心血管疾病成果研究事业。这将包括有组织的指导，在研究项目中关键的参与，以及在TRACE-CORE基础设施和发现的基础上准备新的研究建议。我们的团队包括著名的心血管疾病结局研究人员、方法学家、心脏病学家和其他临床医生。我们创新的行动评分应该激活患者和提供者来改善心血管疾病的预后；我们的转型项目将填补重要的知识空白。未来的研究将受益于我们的数据、基础设施、行动评分和过渡措施；在这些基础上建立也将支持未来心血管疾病结果研究人员的职业生涯。