ED Disability Diagnostic Tool: An HIT Feasibility Study

ED 残疾诊断工具：HIT 可行性研究

• 批准号: 8470557
• 负责人: Lori Ann Post
• 金额: $ 49.25万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8470557
• 关键词: ED; Disability; Diagnostic; Tool; HIT

6. ABSTRACT Principal Investigator: Lori A. Post, Ph.D. Associate Professor, Yale Dept of Emergency Medicine Title: ED Disability Diagnostic Tool: an HIT Feasibility Study Objective: To improve health patient oriented outcomes in Emergency Departments (ED) by deriving, validating, and comparing the Rasch Disability Diagnostic Tool (RDDT) to existing Measure of Disability (MOD) Research Design: This multi methodological study includes deriving a Rasch scale of disability: I) Using the RDDT to retrospectively score disability indicators, validating the RDDT, selecting a subset of the Rasch scale to be used as a brief measure for an ED randomized clinical trial; II) Prospectively, linking disability assessments to patient oriented outcomes (health care service utilization and mortality). This study will compare diagnoses to determine impact on patient outcomes and costs. Methodology: An expert panel will determine content for the disability diagnostic tool, Rasch scales will be created to score disability in existing hospital records in the retrospective phase. First, we will retrieve all disability assessments performed on ED patients (20-30 per day) since the inception of the electronic data collection system at Yale New Haven Hospital (April 2005). Second, we will score disability in ED records for patients > 65 years and examine patient outcomes, treatments and referrals based on the assessment. Third, we will examine how the assessment impacted ED patient oriented outcomes. The retrospective phase of this study will allow us to track subsequent Yale hospital and ED visits, treatments, and health outcomes. A brief accurate and precise RDDT, developed in the retrospective analysis will be used for the prospective phase to compare with the existing MOD in a randomized clinical trial. 600 patients will be recruited over the course of the study and randomly allocated into the MOD (control) or RDDT (test) arm. Consented study subjects, including ED patients, families, and patient health care providers will be followed for two months. The primary patient outcomes, ED visits, hospital admits, and mortality will be quantified for comparative purposes. We will estimate the number of preventable ED visits and hospitalizations and provide a cost benefit for adopting the RDDT in EDs. Finally, the RDDT will rely on health information technology. The exploratory aim of the study will assess work flow, time and cost savings, efficiency and usability for use in the ED. Potential Impact on Health Outcomes: We expect that a better disability diagnostic tool will lead to lower mortality, a reduction in unnecessary costs, preventable ED visits and hospitalizations, and a better quality of life for patients presenting to Emergency Departments.

6。摘要 首席研究员：Lori A. Post，博士耶鲁大学急诊医学部副教授 标题：ED残疾诊断工具：一项热门可行性研究 目的：通过派生来改善急诊室（ED）的健康结果 验证并比较Rasch残疾诊断工具（RDDT）与现有的残疾度量（MOD） 研究设计：这项多种方法论研究包括得出残疾的rasch量表：i）使用 RDDT回顾性评分残疾指标，验证RDDT，选择Rasch量表的子集 用作ED随机临床试验的简短措施； ii）前瞻性地关联残疾 评估以患者为导向的结果（医疗保健服务的利用和死亡率）。这项研究会 比较诊断以确定对患者预后和成本的影响。 方法：专家小组将确定残疾诊断工具的内容，Rasch量表将是 创建是为了在回顾阶段中在现有医院记录中评分残疾。首先，我们将检索所有 自电子数据成立以来，对ED患者进行的残疾评估（每天20-30） 耶鲁纽黑文医院的收集系统（2005年4月）。其次，我们将在ED记录中为残疾分数 患者> 65岁，并根据评估检查患者的结果，治疗和转诊。第三， 我们将研究评估如何影响ED患者的结果。回顾阶段 研究将使我们能够跟踪随后的耶鲁医院和急诊就诊，治疗和健康结果。简短 回顾性分析中开发的准确，准确的RDDT将用于前瞻性阶段 在随机临床试验中与现有MOD进行比较。在整个过程中将招募600名患者 该研究并随机分配给MOD（对照）或RDDT（测试）组。同意的研究主题， 包括ED患者，家庭和患者医疗保健提供者在内，将遵循两个月。主要 出于比较目的，将量化患者的结果，急诊就诊，医院录取和死亡率。我们将 估计可预防的ED访问和住院的数量，并为通过 RDDT在Eds中。最后，RDDT将依靠健康信息技术。研究的探索目的 将评估在ED中使用的工作流，节省时间和成本，效率和可用性。 对健康结果的潜在影响：我们希望更好的残疾诊断工具会导致降低 死亡率，降低不必要的成本，可预防的ED访问和住院以及更好的质量 出现在急诊室的患者的生活。