Evaluation and management of Veterans with dizziness

产品说明： Kristal米尔斯Riska完成了听力学双学位课程，并于2011年7月在东卡罗莱纳大学获得听力学临床博士学位（Au.D）和哲学博士学位（Ph.D）。她目前拥有美国言语、语言、听力协会和北卡罗来纳州的临床认证。她有超过5年的研究经验，主要在NIH/NIDCD资助的Sherri M。Jones博士在此期间，她研究了由于基因突变导致内耳缺陷的动物模型的功能结果。她的论文评估了爆炸暴露后军事人员的眼运动和前庭功能。她的主要研究兴趣是前庭疾病的评估和管理。她目前是由听觉和前庭研究增强区计划（REAP）奖在山居VAMC的临时研究职位资助，因为她对建立自己的赠款资金的工作。CDA-1奖将为Riska博士提供发展新的研究技能和指导的机会，以扩大她的研究兴趣，并成为一名独立的VA调查员。这项建议有四位导师：（1）Faith Akin博士，他是VA资助的研究者（两次RR&D Merit Reviews），田纳西州山居VA医学中心前庭实验室主任，东田纳西州立大学（ETSU）听力学和言语病理学副教授，（2）Courtney D.霍尔博士，他是田纳西州山居VA医疗中心的VA资助的研究者（RR&D Merit Review，RR&D Pilot Merit），和ETSU物理治疗副教授，（3）Sherri M. Jones博士，他是NIH/NIDCD资助的前庭研究员，教授和特殊教育系主任。和内布拉斯加大学林肯分校的沟通障碍，和（4）贝丝贝利，博士，一位受资助的研究者（NIH，March of Dimes，DHHS），ETSU家庭医学副教授。Riska提出了一个严格的培训计划，包括课程，与VA研究相关的网络研讨会，以及参加会议以继续专业发展和教育。研究计划将在田纳西州山居的詹姆斯·奎伦VAMC进行。这VAMC是一个研究丰富的环境，并设有一个著名的前庭和平衡研究计划与国家的最先进的设施。该项目的广泛的长期计划目标是通过改善和完善前庭评估和管理的临床路径来解决评估和康复退伍军人头晕的挑战。拟议研究的短期目标如下：1）确定头晕的发生率并描述患有头晕/眩晕的退伍军人的特征; 2）确定临床前庭评估的个体比例和前庭功能障碍的发生率; 3）评价在山居VAMC进行前庭测试的退伍军人中特定前庭终末器官功能障碍的比例。为实现目标1，将使用自然语言处理（NLP）、ICD-9代码和捕获再捕获方法对临床数据进行VA范围内的评价。对于目标2，将采用双管齐下的方法，我们将探索全国VA范围的数据和来自山居VAMC的当地VA数据。首先，将分析所有被确定为目标1的一部分的患者，以确定他们是否接受了临床前庭测试。其次，我们将确定临床评估的退伍军人中前庭功能障碍的发病率。最后，我们将确定特定前庭终末器官功能障碍的比例。

DESCRIPTION: Kristal Mills Riska completed a dual degree program in audiology leading to a clinical doctorate in Audiology (Au.D) and a doctor of philosophy (Ph.D) in July 2011 at East Carolina University. She currently holds clinical certification from the American Speech, Language, Hearing Association and the state of NC. She has over 5 years of research experience working primarily in the NIH/NIDCD funded research laboratory of Sherri M. Jones, Ph.D. During that time, she has studied the functional outcomes of animal models with inner ear deficits due to genetic mutations. Her dissertation evaluated ocular motor and vestibular function in military personnel following blast exposure. Her primary research interests are in assessment and management of vestibular disorders. She currently is funded by the Auditory and Vestibular Research Enhancement Area Program (REAP) award in a temporary research position at the Mountain Home VAMC as she works towards establishing her own grant funding. The CDA-1 award would provide Dr. Riska with the opportunity to develop new research skills and mentoring needed to expand her research interests and to become an independent VA investigator. There are four mentors for this proposal: (1) Faith Akin, Ph.D, who is a VA-funded investigator(two RR&D Merit Reviews),Director of the Vestibular Laboratory at the VA Medical Center, Mountain Home, Tennessee, and Associate Professor in Audiology and Speech Pathology at East Tennessee State University (ETSU), (2) Courtney D. Hall, Ph.D., who is a VA-funded investigator(RR&D Merit Review, RR&D Pilot Merit) at the VA Medical Center, Mountain Home, TN., and Associate Professor in Physical Therapy at ETSU, (3) Sherri M. Jones, PhD., who is a NIH/NIDCD funded vestibular researcher, professor and the chair of the Department of Special Education. & Communication Disorders at the University of Nebraska-Lincoln, and (4) Beth Bailey, Ph.D., a funded investigator (NIH, March of Dimes, DHHS), Associate Professor in Family Medicine at ETSU. Dr. Riska has proposed a rigorous training plan including coursework, webinars related to VA research, and travel to conferences for continued professional development and education. The research plan will be conducted at the James Quillen VAMC in Mountain Home, TN. This VAMC is a research rich environment and houses a renowned vestibular and balance research program with state-of the-art facilities. The broad long-term programmatic goals of this project are to address the challenges in evaluating and rehabilitating Veterans with dizziness by improving and refining clinical pathways for vestibular assessment and management. The short term goals of the proposed research are as follows: 1) to determine the incidence of dizziness and to characterize Veterans with dizziness/vertigo; and 2) to determine the proportion of individuals referred for clinical vestibular assessment and the incidence of vestibular dysfunction and 3) to evaluate the proportion of specific vestibular end-organ dysfunction in Veterans referred for vestibular testing at Mountain Home VAMC. To achieve objective 1, a VA-wide evaluation of clinical data will be performed using a natural language processing (NLP), ICD-9 codes and capture recapture methodology. For objective 2, a two-prong approach will be utilized in which we will explore both national VA-wide data and local VA data from Mountain Home VAMC. First, all patients who were identified as part of objective 1 will be analyzed to determine if they underwent clinical vestibular testing. Second, we will determine the incidence of Veterans with vestibular dysfunction among those clinically evaluated. Lastly, we will determine the proportion of specific vestibular end-organ dysfunction.