Midwest Children's Consortium

中西部儿童联合会

• 批准号: 8119742
• 负责人: Yumirle P Turmelle
• 金额: $ 30万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-15 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8119742
• 关键词: Adolescent; Age; Ancillary Study; Arkansas; Award; Biliary Atresia; Biochemical; Biological Markers; Biological Neural Networks; Biopsy; Caring; Child; Childhood; Cholestasis; Cirrhosis; Clinical; Clinical Sciences; Data; Databases; Diagnosis; Diagnostics Research; Disease; Education; Enrollment; Event; Fibrosis; Funding; Goals; Grant; Health Services Research; Hepatic; Hepatology; Icterus; Image; Imaging technology; Immunohistochemistry; In Situ Hybridization; Individual; Infant; Institutes; Intervention; Knowledge; Laboratories; Laboratory Study; Lead; Link; Liver Failure; Liver Fibrosis; Liver diseases; Logistic Regressions; Measures; Medical; Medical Research; Methodology; Methods; Morbidity - disease rate; Neonatal Jaundice; Neural Network Simulation; Outcome; Pathology; Patients; Pediatric Hospitals; Population; Primary Health Care; Principal Investigator; Process; Proteomics; Protocols documentation; Provider; Public Health; Queensland; Radiology Specialty; Receiver Operating Characteristics; Recommendation; Regression Analysis; Research; Resources; Sampling; Science; Serum; Technology; Testing; Training and Education; Translational Research; Universities; Washington; base; clinical care; computerized; digital; fibrogenesis; health care quality; improved; liver imaging; liver transplantation; medical schools; metabolomics; mortality; multidisciplinary; novel; novel diagnostics; pediatrician; practice-based research network; prognostic; programs; sample collection

DESCRIPTION (provided by applicant): The Children's Liver Disease Research and Education Network (ChiLDREN) provides unprecedented opportunities to improve outcomes of pediatric liver diseases worldwide. This proposed Clinical Center submission builds on a strong institutional record in patient enrollment, clinical and bench research, and diagnostic technology at the St. Louis Children's Hospital/Washington University School of Medicine (SLCH/WUSTL) by expanding enrollments to Arkansas Children's Hospital/University of Arkansas for Medical Sciences (ACH/UAMS), interacting with the resources of the Washington University Clinical and Translational Science Award and Queensland Institute for Medical Research, and collaborating with a pediatric primary care network (WU Pediatric/Adolescent Ambulatory Research Consortium). We will apply advanced imaging, pathology, and population analyses to the sophisticated multidisciplinary project required to tackle pediatric liver diseases. Our goals are embodied in the following Specific Aims: Aim I (Clinical Enrollment, Data Accrual, and Specimen (Collection) extends the highly effective SLCH/WUSTL enrollment effort to the active program at ACH/UAMS, generating a large referral base across the central US, that will collect data, sera, pathology samples and sophisticated images from >70 patients annually. We anticipate enhanced contribution to all protocols. Aim 2 (Develop Novel Diagnostic and Prognostic Strategies for ChiLDREN Diseases) tests the hypotheses that identifiable, possibly modifiable mechanisms leading to hepatic fibrosis, and that systematic and rigorous biomarker discovery studies will elucidate these processes, and that competing outcomes and neural network analyses will further define disease course. Aim 3 (Enhance practice quality, and Education) scrutinizes primary care practices and laboratory utilization in an attempt to accelerate identification and referral of infants with cholestasis, focussing on the critical events surrounding presentation, with the goal of defining, then reducing, the factors that hinder timely referral for biliary atresia. Aim 4 (Apply imaging methodologies to ChiLDREN diseases) amalgamates SLCH/WUSTL's advanced liver imaging capabilities to the study of childhood liver diseases, offering these to the Network. These highly matrixed Aims will be built on our enrollment strategies funded by this grant, augmented by existing and anticipated competitive funding, and dedicated WUSTL institutional support. By study conclusion, we intend to generate knowledge that will improve diagnosis, predict outcomes, guide intervention and improve provider practices in ChiLDREN diseases. Relevance: Children with liver disease present major challenges. These diseases are collectively important because of high morbidity, mortality, and public health impact. Management is often ineffective, with cirrhosis, liver failure and liver transplantation as common end-points. Advances in ability to diagnose, and discover causes and determinants of cirrhosis offer hope and potential to impact these outcomes. To achieve this, integration of research and clinical care via a collaborative research consortium is essential.

描述（由申请人提供）： 儿童肝病研究和教育网络（ChiLDREN）提供了前所未有的 改善全球儿科肝病预后的机会。该临床中心 提交建立在患者入组、临床和实验室研究的良好机构记录基础上， 圣路易斯儿童医院/华盛顿大学医学院的诊断技术 (SLCH/WUSTL）通过扩大阿肯色州儿童医院/阿肯色州大学医学科学（ACH/UAMS）的注册人数，与华盛顿大学临床和转化科学奖和昆士兰州医学研究所的资源互动，并与儿科初级保健网络（WU儿科/青少年门诊研究联盟）合作。我们将应用先进的成像，病理学和人口分析，以解决儿科肝病所需的复杂的多学科项目。我们的目标体现在以下具体目标中：目标I（临床入组、数据累积和标本（收集））将高效的SLCH/WUSTL入组工作扩展到ACH/UAMS的活动计划，在美国中部地区建立大型转诊基地，每年从超过70名患者中收集数据、血清、病理学样本和复杂图像。我们期望对所有议定书作出更多的贡献。目标2（开发儿童疾病的新诊断和预后策略）测试以下假设：可识别的、可能可改变的导致肝纤维化的机制，以及系统和严格的生物标志物发现研究将阐明这些过程，以及竞争性结果和神经网络 分析将进一步确定病程。目标3（提高实践质量和教育）审查初级保健实践和实验室利用率，试图加速胆汁淤积婴儿的识别和转诊，重点关注表现周围的关键事件，目的是确定，然后减少，阻碍及时转诊胆道闭锁的因素。目标4（将成像方法应用于儿童肝脏疾病）将SLCH/WUSTL先进的肝脏成像能力与儿童肝脏疾病的研究相结合，并将其提供给网络。这些高度矩阵化的目标将建立在我们的招生策略上，由这笔赠款资助，通过现有和预期的竞争性资金以及专门的WUSTL机构支持来增强。通过研究结论， 我们打算产生知识，将改善诊断，预测结果，指导干预和改善供应商的做法，在儿童疾病。 相关性：患有肝病的儿童面临重大挑战。这些疾病由于发病率、死亡率高和对公共卫生的影响而共同具有重要性。管理往往是无效的，肝硬化，肝功能衰竭和肝移植作为共同的终点。诊断能力的进步，发现肝硬化的原因和决定因素，为影响这些结果提供了希望和潜力。为了实现这一目标，通过合作研究联盟整合研究和临床护理至关重要。