Ocular fundus photos in the emergency room: a new application for telemedicine?

本申请提出了一项研究项目和培训计划，旨在将Beau B.Bruce医学博士培养成急性神经眼科疾病领域的独立临床医生和科学家。这项提议是布鲁斯博士在急性神经性眼病领域的卓越学术背景和早期科学努力的合乎逻辑的延伸，也是朝着获得他建立成功的独立临床研究事业所需的经验和培训的下一步。他的导师团队将由David W.Wright医学博士(联合导师)、Nancy J.Newman医学博士(联合导师)、Roy W.Beck医学博士(顾问委员会)、Valérie Biousse医学博士(顾问委员会)和Michael Lynn(顾问委员会)组成，他们在各种重叠领域拥有非凡的经验，将提供协同指导和支持。埃默里大学为他的短期和长期职业发展提供了无与伦比的环境。他将通过正式的课程工作和结构化的指导，在五个主要领域接受培训：(1)临床研究基础，(2)多学科、多中心临床试验的实用性，(3)眼底摄影的临床解释，(4)高级相关/纵向数据分析，以及(5)远程医疗。布鲁斯博士的研究方案认识到，在现有的临床框架内，急性神经眼科疾病的诊断和治疗之间存在严重的脱节，并试图探索新兴远程医疗技术的应用，以缩小临床实践和临床研究中的这一差距，同时提高我们对这些紧急疾病的了解。它将通过两个具体目标开始解决这些问题：(1)评估非扩张性眼底照相在急诊科头痛患者中诊断乳头状肿的影响和诊断能力，以及(2)确定头痛患者中预测存在乳头状肿和乳头状肿导致视力不良的危险因素。这些目标的实现可能会为乳头状浮肿的诊断提供一种新的方法，并提高我们对乳头状浮肿的预后能力和病理生理的了解。这项研究计划和培训计划的成功完成将为布鲁斯博士的独立临床研究生涯奠定科学基础，在这一职业生涯中，他寻求提高神经眼科科学知识，促进患者护理，并在急性神经眼科疾病领域执行有前景的治疗方法的临床试验。

This application proposes a research project and training plan to develop Beau B. Bruce, M.D. into an independent clinician-scientist in the area of acute neuro-ophthalmic disease. This proposal is a logical extension of Dr. Bruce's excellent academic background and early scientific efforts in the field of acute neuroophthalmic disorders, and is the next step toward gaining the experience and training that he needs to establish a successful independent clinical research career. His mentorship team will consist of David W. Wright, M.D. (co-mentor), Nancy J. Newman, M.D. (co-mentor), Roy W. Beck, M.D., Ph.D. (advisory committee), Val¿rie Biousse, M.D. (advisory committee), and Michael Lynn, M.S. (advisory committee) who have exceptional experience in a variety of overlapping areas that will provide synergistic guidance and support. Emory University provides an unrivaled environment for his short- and long-term career development. He will receive training through formal course work and structured mentorship in five major areas: (1) fundamentals of clinical research, (2) practicalities of multidisciplinary, multicenter clinical trials, (3) clinical interpretation of fundus photography, (4) advanced correlated/longitudinal data analysis, and (5) telemedicine. Dr. Bruce's research protocol recognizes that there is a critical disconnect between the diagnosis and treatment of acute neuro-ophthalmic diseases within existing clinical frameworks and seeks to explore the application of emerging telemedical technologies to close this gap in clinical practice and clinical research while advancing our knowledge of these emergent diseases. It will begin to address these issues through two specific aims: (1) assessing the impact and diagnostic capability of non-dilated ocular fundus photography on the diagnosis of papilledema among headache patients presenting to the emergency department, and (2) determining risk factors among headache patients predictive for the presence of papilledema and for poor visual outcomes from papilledema. Accomplishing these aims will likely provide a new approach to the diagnosis of papilledema and improve our prognostic capability and pathophysiologic understanding of papilledema. The successful completion of this research proposal and training plan will serve as the scientific foundation for Dr. Bruce's independent clinical research career in which he seeks to advance neuro-ophthalmic scientific knowledge, facilitate patient care, and execute clinical trials of promising therapies in the field of acute neuro-ophthalmic diseases.