Evidence-Based Research in Hand Surgery

描述（由申请人提供）：本次K24续期申请将继续通过专注于桡骨远端骨折（DRF）的治疗来获取手外科领域的证据，以教授学员循证实践和原则。主要研究者（PI）是一名卫生服务研究人员，其兴趣包括循证医学，流行病学和结果研究。PI以前的研究集中在肌肉骨骼疾病，如类风湿性关节炎和桡骨远端骨折（DRF），特别是老年人。除了继续对DRF成果进行研究外，这笔赠款还将纳入一个指导计划，向越来越多的初级教师，外科住院医生，国际研究员和医学生教授循证医学和研究方法。该项目的目标是启动一项随机对照临床试验，以比较两种手部治疗方案对老年DRF患者的结果，DRF是影响这一不断增长的人群的最常见损伤。使用掌侧锁定钢板系统（VLPS）进行DRF切开复位和内固定治疗的患者将接受完全监督的手治疗（FHT）或最低监督的自我指导手治疗（MHT）。本研究的具体目的是（1）进行一项随机对照试验，比较MHT与传统FHT治疗接受VLPS治疗的老年人DRF的效果，以及（2）开发一个预测模型，以识别将从FHT中获益的患者。本研究得出的数据将提供有关该损伤术后处理的重要信息，并定义DRF切开复位内固定后功能结局的预测因素。此外，这项研究将提供证据，帮助医疗保健提供者为DRF患者提供最好的护理，并生成经济数据，以潜在地降低全国的成本。这个K24奖项的主要重点是应用这个项目 对受训人员进行循证医学、流行病学、统计学和研究方法方面的教育。整个应用程序（候选人，环境和研究）。包括候选人的近期和长期职业目标，研究职业发展计划的关键要素，以及研究项目的描述，如第I.4.4.6部分所示。提供整个应用程序的摘要（候选人，环境和研究）。包括候选人的近期和长期职业目标，研究职业发展计划的关键要素，以及研究项目的描述，如第I.4.4.6部分所示。CC

DESCRIPTION (provided by applicant): This K24 renewal application will continue to derive evidence in the field of hand surgery by focusing on the treatment of distal radius fractures (DRF) to teach trainees evidence-based practice and principles. The principal investigator (PI) is a health services researcher whose interests include evidence-based medicine, epidemiology and outcomes research. The PI's previous research has concentrated on musculoskeletal diseases such as rheumatoid arthritis and distal radius fractures (DRF), particularly among the elderly. In addition to continuing research on DRF outcomes, this grant will incorporate a mentoring program to teach evidence-based medicine and research methodology to a growing number of junior faculty, surgery residents, international fellows and medical students. The goal of this project is to initiate a randomized-controlled clinical trial to compare outcomes of two hand therapy programs for elderly patients with DRF, which is the most common injury affecting this growing population. Patients treated with open reduction and internal fixation of DRFs using the volar locking plating system (VLPS) will receive fully-supervised hand therapy (FHT) or minimally supervised self-directed hand therapy (MHT). The specific aims of the study are (1) To conduct a randomized controlled trial comparing MHT versus traditional FHT for DRFs in the elderly treated with VLPS, and 2) To develop a predictor model to identify patients who will benefit from FHT. The data derived from this study will provide vital information about the postoperative management of this injury and define predictors of functional outcomes after open reduction and internal fixation of DRFs. Furthermore, this study will yield evidence to assist healthcare providers in giving the best care to DRF patients and generate economic data to potentially reduce costs nationally. The principal focus of this K24 award is to apply this project to educate trainees about evidence-based medicine, epidemiology, statistics and study methodology. entire application (candidate, environment, and research). Include the candidate's immediate and long-term career goals, key elements of the research career development plan, and a description of the research project, as indicated in Part I.4.4.6. Provide an abstract of th entire application (candidate, environment, and research). Include the candidate's immediate and long-term career goals, key elements of the research career development plan, and a description of the research project, as indicated in Part I.4.4.6. CC