TRACE-CORE

追踪核心

• 批准号: 8312651
• 负责人: CATARINA I. KIEFE
• 金额: $ 145.27万
• 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/8312651
• 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(申请人提供)：急性冠脉综合征(ACS)，冠心病患者住院的常见原因，是常见的和高风险的。尽管近几十年来在急性冠脉综合征的管理方面取得了显著进展，但由于对急性冠脉综合征后患者未充分利用现有证据，仍有未实现的健康收益。拟议的冠状动脉事件结果研究和教育中心(TRACE-CORE)的过渡、风险和行动将招募新的ACS后患者纵向队列，利用该队列进行两个研究项目，并发展四名早期调查人员(ESIS)的职业生涯。我们有四个具体目标。1)我们将招募并跟踪2,500名年龄为21-I-的人，其中18%是非洲裔美国人，10%是西班牙裔，他们从马萨诸塞州和佐治亚州的8个医疗中心的ACS住院出院时。我们将从索引以及随后的住院和门诊记录中提取医疗记录。患者在出院时、2周和6周以及3、12和24个月后进行访谈，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)过渡项目：我们将描述急性冠脉综合征患者出院后90天的过渡过程。我们将聘请一个国家小组制定一套以证据为基础的过渡测量集，反映退役后90天的情况，并超越现有的侧重于退役过程的系统。我们将测试护理质量和结果(包括再住院和生活质量)之间的关系的假设，特别是当它们与健康差距有关的时候。3)行动评分项目：我们将开发和验证两个新的“行动评分”，它们预测临床事件/死亡率和生活质量，并强调医疗保健提供和患者行为的可修改方面。4)利用TRACE-CORE作为培训实验室，发展四个EIS的CVD成果研究事业。这将包括有组织的指导，关键参与研究项目，以及根据跟踪核心基础设施和研究结果准备新的研究提案。我们的团队包括著名的CVD结局研究人员、方法学家、心脏病学家和其他临床医生。我们的创新行动评分应该会激活患者和提供者，以改善心血管疾病的结果；我们的过渡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；建立在这些基础上的研究也将为未来心血管疾病结果研究人员的职业生涯奠定基础。