A Prognostic System for Selecting Appropriate Level of Amputation

选择适当截肢程度的预后系统

• 批准号: 8839277
• 负责人: JOSEPH M CZERNIECKI
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8839277
• 关键词: Accounting; Amendment; Amputation; Amputees; Anatomy; Caring; Clinical; Communication; Communities; Consent; Decision Making; Development; Distal; Ensure; Failure; Family; Funding; Future; Goals; Grant; Healed; Healthcare; Healthcare Systems; Hospitalization; Hospitals; Individual; Institution; Judgment; Lead; Life; Lower Extremity; Major Depressive Disorder; Measures; Medical; Medical Care Team; Medical center; Minor; Mission; Modeling; Morbidity - disease rate; Multi-Institutional Clinical Trial; Operative Surgical Procedures; Outcome; Patient Care; Patient Education; Patients; Performance; Peripheral Vascular Diseases; Policies; Population; Practice Guidelines; Probability; Prospective Studies; Provider; Quality of Care; Quality of life; Recruitment Activity; Recurrence; Rehabilitation Outcome; Rehabilitation therapy; Reporting; Research; Resources; Risk; Risk Factors; Services; Site; Surgeon; System; Time; Treatment outcome; Uncertainty; United States Department of Veterans Affairs; Validation; Vascular Diseases; Veterans; Work; abstracting; base; care systems; clinical care; clinical decision-making; diabetic; diabetic patient; disability; functional outcomes; healing; loss of function; mortality; multi-site trial; outcome forecast; prognostic; programs; prospective; psychologic; psychosocial; satisfaction; social; sound; success; tool

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.

描述（由申请人提供）： 项目摘要/摘要 我们目前的前瞻性多部位研究已在经股骨 (TF)、经胫骨 (TT) 和经跖骨 (TM) 截肢者中开发出稳健的预后模型，我们称之为 AMPREDICT。 AMPREDICT 旨在通过将结果成功与基线人口统计、身体和心理社会测量相关联，在术前用于治疗决策。拟议研究的最终目标是验证 AMPREDICT，以便将其推荐广泛临床使用，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、康复团队和患者规划最合适的截肢程度； (3) 提供有效比较治疗和康复结果的客观工具； （四）协助临床医生与患者之间的沟通和信息交流； (5) 协助 VA 范围内的政策决策，以确保对每位患者的最佳护理水平做出正确的判断。为了实现这一目标，我们计划通过评估预后模型 AMPREDICT 在不同人群中的准确性（而不是在其开发的人群中）来评估其性能。在建议 AMPREDICT 广泛临床使用之前，这项研究至关重要。本研究的主要目的是评估我们当前的预后模型 (AMPREDICT) 在预测同一机构不同时间段（时间可迁移性）和不同机构（地理可迁移性）的 TT 和 TM 截肢者的身体和心理社会结果方面的性能，以便推荐广泛临床使用。