Shared Decision Making in ADHD

亚历山大菲克斯，医学博士，微软安全工程师是一个城市初级保健儿科医生谁研究卫生信息技术 (HIT)改善儿童健康状况。Fiks博士的研究发现，尽管临床医生关注的HIT 干预措施是有效的，可以通过促进信息交流， 临床医生和家庭，以澄清治疗的偏好和目标，一个过程称为共同决定 制作（SDM）。虽然Fiks博士的长期职业目标是成为一名独立的调查专家， 大规模实施SDM使用HIT多种儿科条件，这种职业发展 该奖项将重点关注注意力缺陷/多动症（ADHD）。多动症是一种理想的原型状态 对于SDM：家庭在多种循证治疗之间进行选择;个人/文化价值观影响 他们的选择;治疗差异存在;到目前为止，几乎没有做过什么工作来解开这些影响， 支持决策。在这个奖项。Fiks博士将（1）评估患病率，决定因素， SDM在初级保健中对ADHD儿童全国代表性样本的影响，（2）制定一个 工具来衡量家庭的喜好和目标的ADHD治疗，（3）评估的可行性， 可接受性，并探讨ADHD的结果，HIT为基础的SDM试点干预在初级保健。的 该建议假设是使用一种工具来捕获家庭的ADHD治疗偏好， 基于HIT的系统内的目标将促进SDM，并改善对 治疗这项研究，利用儿科实践为基础的研究网络，将补充正式的 课程作业，研讨会/会议参与，以及熟练的指导，以培训Fiks博士实现他的职业生涯 目标.菲克斯博士的具体教育目标是（1）发展专家技能，以评估的有效性 支持HIT的SDM，包括纵向/聚类数据研究和临床试验的实施，（2） 发展健康测量和仪器开发方面的先进技能，以及（3）提高他的 了解鼓励SDM的方法，包括使用决策辅助工具和HIT。5年奖 将为Fiks博士提供启动R 01级SDM治疗ADHD试验所需的培训和试点数据。 相关性（见说明）： 由医学研究所优先考虑，共同决策（SDM）承诺将家庭匹配到 可接受的治疗和改善儿童健康结果。通过捕获、传输和处理健康 信息，计算机系统可以大规模地支持SDM。本研究旨在探讨这些 系统，以促进SDM多动症，一个条件损害超过400万儿童在这个国家。

Alexander Fiks, MD, MSCE is an urban primary care pediatrician who studies health information technology (HIT) to improve child health outcomes. Dr. Fiks's research has found that although clinician-focused HIT interventions are effective, their impact could be increased by facilitating information exchange between clinicians and families in order to clarify treatment preferences and goals, a process called shared decision making (SDM). Although Dr. Fiks's long-term career goal is to become an independent investigator expert in the large-scale implementation of SDM using HIT for multiple pediatric conditions, this career development award will focus on Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is an ideal prototype condition for SDM: families choose between multiple evidence-based treatments; personal/cultural values influence their selection; treatment disparities exist; and little work has so far been done to untangle these effects to support decision making. During this award. Dr. Fiks will (1) assess the prevalence, determinants, and impact of SDM in primary care for a nationally representative sample of children with ADHD, (2) develop an instrument to measure families' preferences and goals for ADHD treatment, and (3) assess the feasibility and acceptability, and explore the outcomes of an ADHD, HIT-based SDM pilot intervention in primary care. The hypothesis of this proposal is that use of an instrument to capture families' ADHD treatment preferences and goals within an HIT-based system will facilitate SDM and improve adherence to and outcomes from treatment. This research, utilizing a pediatric practice-based research network, will complement formal coursework, workshop/conference participation, and skilled mentorship to train Dr. Fiks to achieve his career goals. Dr. Fiks's specific educational aims are to (1) develop expert skills to evaluate the effectiveness of HIT-enabled SDM including the study of longitudinal/clustered data and the conduct of clinical trials, (2) develop advanced skills in health measurement and instrument development, and (3) advance his knowledge of approaches to encourage SDM including the use of decision aids and HIT. This 5 year award will provide Dr. Fiks with the training and pilot data needed to launch an R01-level trial of SDM for ADHD. RELEVANCE (See Instructions): Prioritized by the Institute of Medicine, shared decision making (SDM) promises to match families to acceptable treatments and improve child health outcomes. By capturing, transferring, and processing health information, computer systems can support SDM on a large-scale. This grant explores the role of these systems to facilitate SDM for ADHD, a condition impairing more than 4 million children in this country.