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

本申请提出了一个研究项目和培训计划，以发展博B。医学博士布鲁斯成为急性神经眼科疾病领域的独立临床科学家。该提案是布鲁斯博士优秀学术背景和早期在急性神经眼科疾病领域的科学努力的逻辑延伸，也是他获得成功的独立临床研究生涯所需的经验和培训的下一步。他的导师团队将由大卫W。Wright，医学博士（共同导师），Nancy J.纽曼，医学博士（co-mentor），Roy W.贝克，医学博士，博士（咨询委员会），瓦尔里·比乌斯，医学博士（咨询委员会）和迈克尔林恩，M.S.（咨询委员会），他们在各种重叠领域具有特殊经验，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导师在五个主要领域接受培训：（1）临床研究的基础知识，（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）先进的相关/纵向数据分析，和（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，并寻求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，同时推进我们对这些紧急疾病的认识。它将开始通过两个具体目标来解决这些问题：（1）评估非散瞳眼底照相对急诊科头痛患者诊断视乳头水肿的影响和诊断能力，以及（2）确定头痛患者中预测视乳头水肿存在和视乳头水肿导致视力不良结局的风险因素。实现这些目标将可能提供一种新的方法来诊断视乳头水肿，提高我们的预后能力和视乳头水肿的病理生理学的理解。本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，他将在此期间寻求推进神经眼科科学知识，促进患者护理，并在急性神经眼科疾病领域执行有前途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.