A Prognostic System for Selecting Appropriate Level of Amputation

描述（由申请人提供）： 项目摘要/摘要我们目前的前瞻性多中心研究已经在经股（TF）、经胫骨（TT）和经跖骨（TM）截肢者中建立了一个强大的预后模型，我们称之为AMPREDICT。AMPREDICT被开发用于术前通过将结局成功与基线人口统计学、身体和心理社会指标相关联来进行治疗决策。拟议研究的最终目标是验证AMPREDICT，以便推荐其广泛用于临床，用于以下目的：（1）为外科医生、康复团队和患者提供有关患者预后的信息;（2）协助外科医生、康复团队和患者计划最合适的截肢水平;（3）提供客观的工具，以有效地比较治疗和康复的结果;（4）协助临床医生和病人之间的沟通和交换信息;以及（5）协助VA范围内的政策决策，以确保对每个患者的最佳护理水平做出合理判断。为了实现这一目标，我们计划通过评估其在不同人群中的准确性来评估预后模型AMPREDICT的性能。在推荐AMPREDICT广泛用于临床之前，这项研究至关重要。本研究的主要目的是评估我们目前的预后模型（AMPREDICT）在预测TT和TM截肢者在同一机构在不同时间段（时间可移植性）和不同机构（地理可移植性）的身体和心理结局方面的性能，以便推荐广泛的临床使用。

DESCRIPTION (provided by applicant): Project Summary/Abstract Our current prospective multi-site study has led to the development of a robust prognostic model among transfemoral (TF), transtibial (TT), and transmetatarsal (TM) amputees that we call AMPREDICT. AMPREDICT was developed to be used pre-operatively for treatment decision making by correlating outcome success with baseline demographic, physical and psychosocial measures. The ultimate goal of the proposed research is to validate AMPREDICT so that it can be recommended for widespread clinical use for the following purposes: (1) providing surgeons, rehabilitation teams, and patients with information about patient prognosis; (2) assisting surgeons, rehabilitation teams, and patients in planning the most appropriate level of amputation; (3) providing an objective tool for validly comparing treatment and rehabilitation outcomes; (4) assisting in the communication and exchange of information among clinicians and patients; and (5) assisting in VA-wide policy decisions to ensure sound judgment regarding the best level of care for each individual patient. To accomplish this, we plan to assess the performance of the prognostic model AMPREDICT by assessing its accuracy in different populations than the one it has been developed in. This research is critical before AMPREDICT is recommended for widespread clinical use. The primary aim for this study is to assess our current prognostic model's (AMPREDICT) performance for predicting both physical and psychosocial outcomes among TT and TM amputees in the same institution during a different time period (temporal transportability) and in different institutions (geographic transportability) so that it can be recommended for widespread clinical use.