Shared Decision Making in ADHD

Alexander Fiks医学博士是一名研究卫生信息技术的城市初级保健儿科医生 (HIT)以改善儿童健康结果。菲克斯博士的研究发现，尽管临床医生关注的是Hit 干预措施是有效的，其影响可以通过促进 临床医生和家庭，以明确治疗偏好和目标，这一过程称为共同决定 制作(SDM)。尽管菲克斯博士的长期职业目标是成为一名独立调查专家 大规模实施SDM使用HIT针对多个儿科病情，这一职业发展 该奖项将集中于注意力缺陷/多动障碍(ADHD)。ADHD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/文化价值观的影响 他们的选择；治疗差异存在；到目前为止，还没有做什么工作来理清这些影响 支持决策。在这个奖项中。菲克斯博士将(1)评估患病率、决定因素和 SDM在初级保健中对具有全国代表性的ADHD儿童样本的影响，(2)制定 衡量家庭对ADHD治疗的偏好和目标的工具，以及(3)评估可行性和 可接受性，并探索ADHD，以HIT为基础的初级保健SDM试点干预的结果。这个 这一建议的假设是，使用一种工具来获取家庭的ADHD治疗偏好和 基于HIT的系统中的目标将促进可持续发展管理，并提高对以下目标的遵守和成果 治疗。这项研究利用以儿科实践为基础的研究网络，将补充正式 课程作业、研讨会/会议参与和熟练的指导，以培训菲克斯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 支持HIT的SDM，包括纵向/集群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高级技能，以及(3)推进HIS 了解鼓励可持续发展管理的方法，包括使用决策辅助工具和HIT。这个5年奖 将为Fiks博士提供启动SDM治疗ADHD的R01级试验所需的培训和试验数据。 相关性(请参阅说明)： 由医学研究所优先考虑的共享决策(SDM)承诺将家庭与 可接受的治疗和改善儿童健康结果。通过捕获、传输和处理运行状况 信息方面，计算机系统可以大规模支持SDM。这笔赠款探索了这些 促进对ADHD进行SDM的系统，这种疾病在这个国家损害了400多万儿童。

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.