Back pain Outcomes using Longitudinal Data- Extension of Research (BOLDER)

描述(由申请人提供)：下腰痛是医学研究所比较有效性研究的优先条件，对于老年人来说仍然是一个特别重要的问题，老年人是AHRQ优先考虑的人群。近三分之一的65岁以上的人患有严重的下腰痛，这是去看医生的最常见原因之一。针对老年人的循证指南很少，他们的因果状况分布与年轻人群不同。关于最常用的诊断测试和治疗的相对有效性，重要的问题仍然没有得到回答。在AHRQ/ARRA拨款1,000万美元的资助下，我们招募了一大批来自三家地理和种族多元化的医疗保健组织的腰痛老年患者：凯撒北加州、亨利·福特健康系统和哈佛先锋/哈佛朝圣者。登记的患者在登记时和定期随访期间完成疼痛、背部相关残疾和健康相关生活质量的经过验证的标准化测量。我们项目的总体目标，使用纵向数据扩展研究(BOLDER)的背痛结果，是为了扩大BOLDER队列基础设施的有用性和提高其能力。使用利益相关者参与流程，我们将增强当前的数据基础设施，以解决与利益相关者相关的问题。利益相关者参与将包括不同地点的卫生系统和支付者利益相关者以及患有背痛的老年患者。具体地说，我们将通过收集从卫生系统内部和之间的不同数据系统收集的较长期Patiet报告结果(PRO)和电子病历数据来扩展我们现有的数据基础设施。我们将利用利益相关者的意见，将我们的额外数据收集集中在对利益相关者最有价值的数据上，并能够解决有关腰痛诊断和治疗干预措施的长期临床有效性的重要问题。

DESCRIPTION (provided by applicant): Low back pain is an Institute of Medicine priority condition for comparative effectiveness research and it remains a particularly important problem for the elderly, an AHRQ priority population. Nearly one-third of the population over age 65 has severe low back pain and it is one of the most common reasons for physician visits. There is a paucity of evidence-based guidelines for the elderly, who have a different distribution of causal conditions than younger populations. Important questions remain unanswered regarding the comparative effectiveness of most commonly used diagnostic tests and treatments. Funded by a $10 million AHRQ/ARRA grant, we have enrolled a large inception cohort of senior patient with low back pain from three geographically and racially diverse HMOs: Kaiser Northern California, Henry Ford Health System and Harvard Vanguard/Harvard Pilgrim. Patients who enroll in the registry complete validated, standardized measures of pain, back-related disability, and health-related quality of life at enrollment and at regular follow-up intervals. The overall gol of our project, the Back pain Outcomes using Longitudinal Data- Extension of Research (BOLDER), is to extend the usefulness and improve the capabilities of the BOLD cohort infrastructure. Using a stakeholder engagement process, we will enhance the current data infrastructure to address stakeholder-relevant questions. Stakeholder engagement will include health system and payer stakeholders at the various sites as well as senior patients with back pain. Specifically, we will extend our existing data infrastructure by collecting longer-term patiet reported outcomes (PRO) and electronic medical record data collected from diverse data systems within and between health systems. We will use stakeholder input to focus our additional data collection on data that will be of greatest value to stakeholders and can address important questions regarding the long-term clinical effectiveness of back pain diagnostic and treatment interventions.