Patient Oriented Research and Mentoring Program in Orthopedics

以患者为中心的骨科研究和指导计划

• 批准号: 8019104
• 负责人: Elena Losina
• 金额: $ 16.41万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-02-01 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8019104
• 关键词: Address; Age-Years; Arthroscopy; Articular Range of Motion; Award; Clinical; Clinical Investigator; Clinical Research; Clinical Sciences; Commit; Coupled; Debridement; Decision Making; Dependency; Diagnosis; Diagnostic; Disease; Early Ambulation; Elderly; Epidural Anesthesia; Etiology; Evaluation; Evidence based practice; Excision; Faculty; Fostering; Frequencies; Goals; Hospitalization; Incidence; Interdisciplinary Study; Intervention; Irrigation; Joints; Knee; Knee Osteoarthritis; Lead; Ligaments; Mentors; Muscle; Musculoskeletal; Musculoskeletal Diseases; Observational Study; Operative Surgical Procedures; Orthopedics; Outcome; Pain; Pain management; Participant; Patients; Persons; Postoperative Period; Principal Investigator; Procedures; Process; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recording of previous events; Recovery; Rehabilitation therapy; Research; Research Methodology; Research Personnel; Research Training; Role; Scientist; Source; Structure; Symptoms; Tendon structure; Time; Traineeship; Training; Training Programs; Withdrawal; Work; base; bone; career; clinical care; cost effective; design; diagnostic accuracy; disability; effective therapy; evidence base; functional disability; functional outcomes; instrument; knee replacement arthroplasty; next generation; novel diagnostics; patient expectation; patient oriented research; programs; randomized trial; research study; sham surgery; shared decision making; standard of care; tool; treatment strategy

DESCRIPTION (provided by applicant): Musculoskeletal (MSK) disorders represent a broad group of conditions with diverse etiologies that result in pain and functional impairment of bones, joints, tendons, ligaments and/or muscles. These disorders are the leading cause of work disability and the most frequent source of dependency in the elderly. In the US, over 3 million hospitalizations for MSK problems occur annually, primarily for orthopaedic surgical interventions. Rigorously designed patient oriented research studies create the basis for evidence-based practice and serve as powerful tools to bridge patient expectations, clinical care and shared decision making. Presently, the evidence base in musculoskeletal and orthopedic clinical science has large gaps. I have dedicated much of my effort in the last decade to addressing these research needs. Through the K24 Mid Career Investigator Award, I hope to continue this work through patient oriented research and, importantly, to engage the next generation of clinical scientists in rigorous studies of MSK and orthopaedic problems. The Mid-career Award in patient oriented research (K24) will enable me to dedicate a substantial portion of my time to pursue a robust program in patient oriented research in orthopedics and to mentor young clinical scientists committed to orthopaedic and musculoskeletal patient oriented research. This Award will support my mentoring and research program with the following aims: I) To develop a research training program that will prepare young clinical investigators for rigorous evaluation of frequently utilized and/or recently developed orthopaedic interventions in patients with MSK disorders. II) To further develop a comprehensive patient oriented research program in MSK disorders and orthopaedics. The overarching goals of my mentoring program include: 1) providing training in patient oriented research in orthopedics, including design and conduct of randomized clinical trials, observational studies and developing new diagnostic criteria in patients with MSK disorders; 2) increasing the number of researchers focused on patient oriented research with rigorous training in the study of MSK disorders; 3) fostering new multidisciplinary collaborations; and 4) facilitating the transition from traineeship to faculty. While the goals of the program span multiple clinical problems, I highlight two research studies in this proposal: Study 1: To conduct a randomized controlled clinical trial to determine optimal timing for withdrawal of epidural anesthesia in patients undergoing total knee replacement. Study 2: To determine the diagnostic value of clinical history for the diagnosis of symptomatic meniscal tears in the presence of knee osteoarthritis (OA). Each of these studies, coupled with a comprehensive structured mentoring program, will help to address important unanswered questions in the management of patients with MSK disorders. The program will also help the next generation of clinical scientists to develop, evaluate and implement efficient and effective treatment strategies in patients with MSK conditions.

描述（由申请方提供）：肌肉骨骼（MSK）疾病代表一组广泛的疾病，具有不同的病因，导致疼痛和骨骼、关节、肌腱、韧带和/或肌肉的功能障碍。这些疾病是导致老年人丧失工作能力的主要原因，也是老年人最常见的依赖来源。在美国，每年有超过300万人因MSK问题住院，主要是整形外科干预。严格设计的以患者为导向的研究为循证实践奠定了基础，并作为沟通患者期望、临床护理和共同决策的有力工具。目前，在肌肉骨骼和骨科临床科学的证据基础有很大的差距。在过去的十年里，我致力于解决这些研究需求。通过K24中期职业研究者奖，我希望通过以患者为导向的研究继续这项工作，重要的是，让下一代临床科学家参与MSK和骨科问题的严格研究。 在以患者为导向的研究（K24）的职业生涯中期奖将使我能够奉献我的时间的很大一部分，以追求在骨科以患者为导向的研究强大的程序，并指导年轻的临床科学家致力于骨科和肌肉骨骼以患者为导向的研究。该奖项将支持我的指导和研究计划，其目标如下：I）制定一项研究培训计划，为年轻的临床研究人员准备对MSK疾病患者中经常使用和/或最近开发的骨科干预措施进行严格评估。II）进一步发展一个全面的以病人为导向的研究计划，在MSK疾病和骨科。 我的指导计划的总体目标包括：1）提供骨科患者导向研究的培训，包括随机临床试验的设计和实施，观察性研究和开发MSK疾病患者的新诊断标准; 2）增加专注于患者导向研究的研究人员数量，并在MSK疾病研究中进行严格的培训; 3）促进新的多学科合作;（4）促进从实习生到教师的过渡。 虽然该计划的目标跨越多个临床问题，我强调两个研究在这个建议：研究1：进行随机对照临床试验，以确定最佳时机退出硬膜外麻醉的患者进行全膝关节置换术。研究2：确定临床病史对诊断膝关节骨关节炎（OA）患者的症状性膝关节撕裂的诊断价值。这些研究中的每一项，再加上一个全面的结构化的指导计划，将有助于解决重要的悬而未决的问题，在管理MSK疾病的患者。该计划还将帮助下一代临床科学家开发，评估和实施MSK患者的有效治疗策略。