Cost Effectiveness of Spinal Manipulation Therapy for Seniors with Neck Pain

描述（由申请人提供）：该项目的长期目标是使申请人成为一名独立的临床研究科学家，研究颈椎推拿疗法（SMT）治疗颈部和背部疼痛的临床和成本效益。华盛顿特区的布伦特·莱宁格（Brent Leininger）做了三年的脊椎按摩师。他正在参加西北健康科学大学（NWHSU）的一个桥梁奖学金项目，该项目为CAM从业者从事研究工作做好了准备。Leininger博士的主要赞助人是西北健康科学大学的Gert Bronfort博士，他是一位在颈部和背部疼痛的SMT方面建立的临床研究员。在奖学金期间，Leininger博士将参加实践研究培训、正式课程和研究项目。实践研究经验将通过在Bronfort博士的临床研究中心（Wolfe-Harris临床研究中心）的轮岗获得，包括纳入/排除标准的临床应用、SMT在临床研究中的应用、统计分析/解释和科学写作。与卫生经济学家（共同发起人麦克多诺博士、顾问麦克多诺博士）合作。托斯特森（Tosteson）和尼曼（Nyman）在达特茅斯研究所和明尼苏达大学（U of Minnesota）将提供与随机试验进行经济评估相关的实践研究培训和指导。明尼苏达大学临床和成本效益研究的正式课程最终将获得临床研究理学硕士学位，并将补充实际学习经验。通过拟议的研究项目，Leininger博士将成为第一个从社会角度评估SMT对慢性颈部疼痛老年人的经济价值的人。研究对象为其主要赞助者研究（R18HP01425）的参与者。申请人的项目有三个具体目标，这些目标是对父母试验的补充，并将包括评估SMT与监督运动和家庭运动对老年人慢性颈部疼痛的成本效益，使用疼痛、质量调整生命年和残疾结果进行为期一年的随访。通过结构化的三年培训计划，Leininger博士将获得颈部和背部疼痛的SMT临床研究的新技能，以及成本效益数据收集和分析技术。这将由布朗福特博士和共同发起人（布朗福特博士）提供的个性化指导来培养。Evans和McDonough)。NWHSU和明尼苏达大学非常适合申请人的培训，包括CAM重点临床研究中心和NIH附属的CTSA （1UL1RR033183）。

DESCRIPTION (provided by applicant): The long-term objective of this project is to prepare the applicant to become an independent clinical research scientist investigating the clinical and cost effectiveness of spinal manipulation therapy (SMT) for neck and back pain conditions. Brent Leininger, DC, practiced as a chiropractor for three years. He is participating in a bridge fellowship program at Northwestern Health Sciences University (NWHSU), which readies CAM practitioners to pursue research careers. Dr. Leininger's primary sponsor is Dr. Gert Bronfort at Northwestern Health Sciences University, an established clinical researcher in SMT for neck and back pain conditions. During the fellowship period Dr. Leininger will participate in practical research training, formal coursework, and a research project. Practical research experience will be gained through rotations at Dr. Bronfort's clinical research center (Wolfe-Harris Center for Clinical Studies), which will include clinical application of inclusion/exclusion criteria, applicaion of SMT in clinical research, statistical analyses/interpretation, and scientific writing. Collaboration with health economists (co-sponsor Dr. McDonough, consultants Drs. Tosteson and Nyman) at the Dartmouth Institute and the University of Minnesota (U of M) will provide practical research training and mentorship related to the conduct of economic evaluations alongside randomized trials. Formal coursework in clinical and cost effectiveness research at the University of Minnesota will culminate in a Master's of Science degree in Clinical Research and will complement the practical learning experiences. Through the proposed research project, Dr. Leininger will be among the first to assess the economic value of SMT in seniors with chronic neck pain from a societal perspective. Study subjects were those enrolled in his primary sponsor's study (R18HP01425). The applicant's project has three Specific Aims which are complementary to the parent trial and will include an estimation of the cost effectiveness of SMT versus supervised exercise and home exercise for chronic neck pain in seniors using pain, quality-adjusted life years, and disability outcomes over a one-year follow-up period. Through a structured three year training plan, Dr. Leininger will acquire new skills in clinical research of SMT for neck and back pain conditions, as well as cost effectiveness data collection and analytic techniques. This will be fostered by individualized mentorship provided by Dr. Bronfort and co-sponsors (Drs. Evans and McDonough). NWHSU and the University of Minnesota are well suited for the applicant's training and include a CAM focused clinical research center and an NIH affiliated CTSA (1UL1RR033183).