权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Rotator Cuff Tears: Optimizing Diagnosis and Treatment Strategies

肩袖撕裂：优化诊断和治疗策略

基本信息

批准号：
8923770
负责人：
Nitin B Jain
金额：
$ 11.95万
依托单位：
VANDERBILT UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-30 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8923770
关键词：
Accounting Address Age Area Articular Range of Motion Award Biometry Clinical Cohort Studies Comorbidity Consensus Cost Savings Decision Making Detection Diagnosis Diagnostic Disease Elderly Elements Ensure Environment Epidemiology Evaluation Failure Funding Future Goals Health Care Costs Hospitals Image Individual Infiltration International Investigation Knowledge Learning Literature Magnetic Resonance Imaging Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Modality Musculoskeletal Diseases Operative Surgical Procedures Orthopedics Outcome Outpatients Pain Participant Pathology Patients Physical Examination Physical Medicine Physicians Process Productivity Prognostic Factor Qualifying Randomized Clinical Trials Randomized Controlled Trials Recording of previous events Recruitment Activity Research Research Methodology Research Personnel Research Training Rotator Cuff Sample Size Sampling Sensitivity and Specificity Services Shoulder Shoulder Pain Specificity Sports Medicine Surgeon Surveys Symptoms Tendon structure Testing Thick Time Training Ultrasonography Variant Visit Woman Work base clinical Diagnosis clinical decision-making design diagnostic accuracy disability evidence base experience follow-up functional improvement functional outcomes interest medical schools patient oriented research programs prospective radiologist success treatment strategy

项目摘要

DESCRIPTION (provided by applicant): Rotator cuff tears are the most common cause of shoulder disability and pain accounting for 4.5 million physician visits and 75,000 surgeries annually. There is paucity of evidence addressing the diagnostic value of clinical history and physical examination of the shoulder. Consequently, magnetic resonance imaging (MRI) is used frequently to make a diagnosis of rotator cuff tear. Shoulder ultrasound is portable, office-based, and ~ 75% less expensive than MRI for diagnosis of rotator cuff tears. However, the diagnostic accuracy of ultrasound has not been established. This study will assess the sensitivity and specificity of a combination of select symptoms, physical examination findings, and ultrasound as compared to MRI and expert clinical diagnosis as a criterion standard. There is little evidence on the best treatment approach for rotator cuff tears and on factors associated with better outcomes of operative and non-operative treatment. There is no evidence from randomized clinical trials in this area. Current decision-making on non-operative treatment versus surgery is based largely on anecdotal clinical experience. Our study will determine predictors of pain and functional outcomes of non-operative and operative treatment of rotator cuff tears at two year follow-up period. Results from our study will provide evidence to inform clinical decision-making. This work will also lay a framework for a randomized controlled trial of surgery versus non-operative treatment which will be proposed in the final years of this award. The candidate's clinical background in Rehabilitation Medicine, and prior work in musculoskeletal diseases and patient-oriented studies is ideally suited for this mentored patient-oriented research program. His research and clinical environments at Brigham and Women's Hospital and Harvard Medical School offer him stimulating and rich learning opportunities. During the K23 award period, the candidate will obtain advanced training in research methodology, and shoulder disorders and imaging. The candidate will benefit from mentorship of Dr. Jeffrey N. Katz, a leading international expert in musculoskeletal diseases research. The candidate's mentoring team will also include Dr. Elena Losina, a biostatistician and independently funded R01 investigator, with extensive experience in mentoring of junior investigators; Dr. Laurence Higgins, an international clinical expert in shoulder disorders and Chief of Sports Medicine and Shoulder Surgery at Brigham and Women's Hospital, and; Dr. Joel Newman, a radiologist with expertise in shoulder ultrasound. The candidate with his prior training, research productivity, and clinical interests is uniquely situated to deliver the proposed research agenda and benefit from a highly qualified mentoring team.

描述（由申请人提供）：肩袖撕裂是导致肩部残疾和疼痛的最常见原因，每年有450万名医生就诊，7.5万例手术。缺乏关于肩关节临床病史和体格检查的诊断价值的证据。因此，磁共振成像（MRI）经常用于诊断肩袖撕裂。肩部超声是便携式的，在办公室进行，并且在诊断肩袖撕裂时比MRI便宜75%。然而，超声诊断的准确性尚未确定。本研究将评估选择症状、体检结果和超声相结合的敏感性和特异性，并将其与MRI和专家临床诊断作为标准进行比较。关于肩袖撕裂的最佳治疗方法以及手术和非手术治疗效果更好的相关因素的证据很少。在这个领域没有随机临床试验的证据。目前对非手术治疗和手术治疗的决策主要基于轶事临床经验。我们的研究将在两年的随访期间确定非手术和手术治疗肩袖撕裂的疼痛和功能结局的预测因素。我们的研究结果将为临床决策提供依据。这项工作还将为手术与非手术治疗的随机对照试验奠定框架，该试验将在本奖项的最后几年提出。候选人在康复医学方面的临床背景，以及之前在肌肉骨骼疾病和以患者为导向的研究方面的工作非常适合这个以患者为导向的研究项目。他在布里格姆妇女医院和哈佛医学院的研究和临床环境为他提供了激励和丰富的学习机会。在K23奖励期间，候选人将获得研究方法，肩部疾病和影像学方面的高级培训。该候选人将受益于Jeffrey N. Katz博士的指导，他是国际领先的肌肉骨骼疾病研究专家。候选人的指导团队还将包括Elena Losina博士，她是一名生物统计学家和独立资助的R01研究者，在指导初级研究人员方面具有丰富的经验；Laurence Higgins博士是肩部疾病的国际临床专家，也是Brigham and Women's Hospital的运动医学和肩部外科主任；乔尔·纽曼医生，一位擅长肩部超声的放射科医生。具有先前培训，研究生产力和临床兴趣的候选人具有独特的位置，可以提供拟议的研究议程，并受益于高素质的指导团队。

项目成果

期刊论文数量（23）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Treatment choice affects inpatient adverse events and mortality in older aged inpatients with an isolated fracture of the proximal humerus.

DOI：
10.1016/j.jse.2013.09.006
发表时间：
2014-06
期刊：
JOURNAL OF SHOULDER AND ELBOW SURGERY
影响因子：
3
作者：
Neuhaus, Valentin;Bot, Arjan G. J.;Swellengrebel, Christiaan H. J.;Jain, Nitin B.;Warner, Jon J. P.;Ring, David C.
通讯作者：
Ring, David C.

Comparative Effectiveness of Operative Versus Nonoperative Treatment for Rotator Cuff Tears: A Propensity Score Analysis From the ROW Cohort.

手术与非手术治疗肩袖撕裂的疗效比较：来自 ROW 队列的倾向评分分析。

DOI：
10.1177/0363546519873840
发表时间：
2019
期刊：
The American journal of sports medicine
影响因子：
0
作者：
Jain,NitinB;Ayers,GregoryD;Fan,Run;Kuhn,JohnE;Warner,JonJP;Baumgarten,KeithM;Matzkin,Elizabeth;Higgins,LaurenceD
通讯作者：
Higgins,LaurenceD

Outcomes of Ultrasound-guided Glen Humeral Corticosteroid Injections in Adhesive Capsulitis.

超声引导下肱骨皮质类固醇注射治疗粘连性囊炎的结果。

DOI：
10.9734/bjmmr/2015/13478
发表时间：
2014
期刊：
British journal of medicine and medical research
影响因子：
0
作者：
Song,Amos;Katz,JeffreyN;Higgins,LaurenceD;Newman,Joel;Gomoll,Andreas;Jain,NitinB
通讯作者：
Jain,NitinB

Ultrasound of the pectoralis major muscle after reverse shoulder arthroplasty: a case report.

反向肩关节置换术后胸大肌的超声检查：病例报告。