A Prognostic System for Selecting Appropriate Level of Amputation

描述(由申请人提供)： 项目概述/摘要我们目前的前瞻性多点研究已经导致在经股(TF)、经胫骨(TT)和经跖骨(TM)截肢者中开发出一种可靠的预后模型，我们称之为AMPREDICT。AMPREDICT被开发用于手术前的治疗决策，通过将结果成功与基线人口统计、身体和心理社会措施相关联。拟议研究的最终目标是验证AMPREDICT，以便它可以被推荐用于以下目的的广泛临床应用：(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适当的截肢水平；(3)提供用于有效比较治疗和康复结果的客观工具；(4)协助临床医生和患者之间的沟通和信息交换；以及(5)协助退伍军人事务部的政策决策，以确保对每个患者的最佳护理水平做出合理判断。为了实现这一点，我们计划通过评估AMPREDICT预测模型在不同人群中的准确性来评估其性能，而不是它所在的人群。在AMPREDICT推荐广泛临床使用之前，这项研究是至关重要的。这项研究的主要目的是评估我们目前的预后模型(AMPREDICT)在预测同一机构中不同时间段(时间可迁移性)和不同机构(地理可迁移性)中TT和TM截肢者的身体和心理社会结果方面的表现，以便推荐广泛临床使用。

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.