Evaluation and management of Veterans with dizziness

说明： Kristal Mills Riska完成了听力学双学位课程，于2011年7月在东卡罗来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)。她目前持有美国言语、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，主要是在美国国立卫生研究院/美国国家疾病控制与预防中心资助的Sherri M.Jones博士的研究实验室工作。在此期间，她研究了由于基因突变而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。她目前由听觉和前庭研究增强计划(REAP)奖资助，在Mountain Home VAMC担任临时研究职位，努力建立自己的赠款基金。CDA-1奖将为瑞斯卡博士提供发展新的研究技能和指导所需的机会，以扩大她的研究兴趣，并成为一名独立的退伍军人事务部研究员。这项建议有四位导师：(1)Faith Akin博士，他是退伍军人事务部资助的调查员(两次RR&D Merit审查)，田纳西州山之家退伍军人医学中心前庭实验室主任，东田纳西州立大学(ETSU)听力和言语病理学副教授；(2)Courtney D.Hall博士，退伍军人事务部资助调查员(RR&D Merit Review，RR&D Pilot Merit)，ETSU物理治疗副教授，(3)Sherri M.Jones，他是NIH/NIDCD资助的前庭研究人员、教授和特殊教育系主任。(4)贝丝·贝利博士，他是一名资助的研究员(NIH，DIMARCH of Dimes，DHHS)，ETSU家庭医学副教授。Riska博士提出了一项严格的培训计划，包括课程作业、与退伍军人管理局研究相关的网络研讨会，以及参加继续专业发展和教育的会议。该研究计划将在田纳西州芒廷霍姆的James Quillen VAMC进行。这个VAMC是一个研究丰富的环境，拥有著名的前庭和平衡研究项目，拥有最先进的设施。该项目广泛的长期规划目标是通过改善和完善前庭评估和管理的临床路径，解决评估和恢复头晕退伍军人的挑战。拟议研究的短期目标如下：1)确定眩晕的发生率，并确定具有眩晕/眩晕的退伍军人的特征；以及2)确定转诊为临床前庭评估的个人的比例和前庭功能障碍的发生率，以及3)评估在Mountain Home VAMC转诊进行前庭测试的退伍军人中特定的前庭末梢器官功能障碍的比例。为了实现目标1，将使用自然语言处理(NLP)、ICD-9编码和捕获重新捕获方法对临床数据进行VA范围的评估。对于目标2，我们将使用双管齐下的方法，其中我们将探索来自Mountain Home VAMC的全国VA范围数据和本地VA数据。首先，将对所有被确认为目标1一部分的患者进行分析，以确定他们是否接受了临床前庭测试。其次，我们将确定退伍军人中有前庭功能障碍的临床评估对象的发生率。最后，我们将确定特定的前庭末梢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.