Telemedicine For Anterior Eye Diseases

项目总结： 眼部远程医疗可以为数百万无法获得服务的美国人提供眼部护理。 这项K23提案表明了玛丽亚·A·伍德沃德博士对研究的承诺，该研究针对国家 和全球公共卫生保健需求，以及她对追求调查员独立性的承诺。 虽然在美国，大部分的视力损害都是由眼后部疾病引起的，但 国家眼科研究所(NEI)的战略计划指出，前部眼部疾病导致大部分就诊 眼科护理专业人员在全国范围内，并导致全球数百万人失明。NEI计划还强调了 非常需要进行研究，以确定远程医疗程序的安全性、可靠性和可行性 通过试点研究“和”确定哪些眼科应用程序适合远程医疗，同时仍 保持面对面检查的准确性、敏感性和特异度。 研究项目已经建立了用于远程评估糖尿病视网膜病变的眼底照相，没有试点 项目的重点是外眼和前眼。 伍德沃德博士的职业公共卫生目标是将负担得起的和可获得的眼部护理扩展到 服务不足的社区，以便在其过程中更早地发现眼睛状况。她的职业研究目标是 测试适合远程医疗的眼科技术的应用。近期的项目目标 是双重的。首先，申请人寻求开发严格和准确的方法来检测关键的外部 和前部眼部疾病使用外部摄影。申请者将进行外部测试的先导研究 已知的前部眼病受试者的摄影规程。其次，申请人寻求确认一个 视力调查问卷，将加强全面的远程医疗评估，以确定眼睛健康和 无论是否存在前部眼部疾病。申请者将管理多个预先验证的愿景 问卷(例如，国家眼科研究所视觉功能问卷)，并将答案与 临床检查结果。 伍德沃德博士的研究得到了培训目标的支持，这些目标将为她提供 发展成为一个独立的调查者。申请者将利用加州大学的巨大资源 密歇根州和包括保罗·李博士和大卫·马什博士在内的研究导师的支持下，完成了三项 具体培训目标：1)研究方法方面的专门知识，2)远程医疗方案方面的卓越表现 发展，以及3)完善的眼科成像知识。伍德沃德博士制定了一项针对目标的计划 课程安排、个性化指导和定向自学，以确保实现这些目标。在这个过程中， 她将从罗伯特·伍德·约翰逊大学获得健康和保健研究硕士学位 基金会临床学者计划。

Project Summary: Ocular telemedicine can deliver eye care to millions of Americans who do not have access to services. This K23 proposal demonstrates Dr. Maria A. Woodward's commitment to research that addresses a national and global public health care need and her commitment to the pursuit of investigator independence. Although posterior eye diseases cause the majority of visual impairment in the United States, the National Eye Institute's (NEI) strategic plan states that anterior eye diseases result in the majority of visits to eye care professionals nationally and cause blindness in millions globally. The NEI plan also emphasizes the significant need for research that can "establish the safety, reliability and feasibility of telemedicine procedures through pilot studies" and "determine which ophthalmic applications are amenable to telemedicine, while still preserving the accuracy, sensitivity and specificity achieved with in-person examinations." Although funded research projects have established fundus photography for remote assessment of diabetic retinopathy, no pilot projects have focused on the external and anterior eye. Dr. Woodward's career public health goal is to extend affordable and accessible eye care to underserved communities in order to detect eye conditions earlier in their course. Her career research goal is to test applications of ophthalmic technology that are amenable to telemedicine. The immediate project goals are two-fold. First, the applicant seeks to develop rigorous and accurate methods for detecting key external and anterior eye diseases using external photography. The applicant will conduct pilot studies testing external photography protocols on subjects with known anterior eye diseases. Second, the applicant seeks to validate a vision questionnaire that will augment comprehensive telemedicine assessments to determine eye health and whether or not anterior eye diseases are present. The applicant will administer multiple pre-validated vision questionnaires (e.g., the National Eye Institute Visual Function Questionnaire) and correlate answers with clinical examination findings. Dr. Woodward's research is supported by training goals that will provide the foundation for her to develop into an independent investigator. The applicant will utilize the immense resources at the University of Michigan and the support of research mentors, including Drs. Paul Lee and David Musch, to accomplish three specific training aims: 1) expertise in research methodology, 2) excellence in telemedicine programmatic development, and 3) refined knowledge of ophthalmic imaging. Dr. Woodward has set forth a plan for targeted coursework, individualized mentorship, and directed self-study to assure achieving these aims. In the process, she will obtain a master's degree in health and health care research from the Robert Wood Johnson Foundation Clinical Scholars Program.