Project MISSION: Developing a multicomponent, Multilevel Implementation Strategy for Syncope OptImalCare thrOugh eNgagement
项目使命:通过参与制定晕厥优化护理的多组成部分、多层次实施策略
基本信息
- 批准号:9755244
- 负责人:
- 金额:$ 50.94万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-08-15 至 2021-07-31
- 项目状态:已结题
- 来源:
- 关键词:Academic Medical CentersAccident and Emergency departmentActivities of Daily LivingAdherenceAdoptedAdoptionAdultAffectAmericanAmerican Heart AssociationAssessment toolAtrial FibrillationAttitudeCardiacCardiologyCardiovascular systemCaringCharacteristicsChronic low back painClimateClinicalClinical Practice GuidelineCollaborationsCommunity HospitalsComplexDangerousnessDataDiagnosisDiagnosticDistressEffectivenessEmergency Department PhysicianEmergency MedicineEmergency department visitEtiologyEvaluationEventFunctional disorderGoalsGuidelinesHealthHospitalizationHospitalsHybridsImpairmentInterviewKnowledgeMediatingMedicineMental HealthMorbidity - disease rateOrganizational CultureOrthostatic HypotensionParticipantPatient-Focused OutcomesPatientsPerceptionPopulationPrevalenceProcessProviderPublic HealthQuality of lifeReadinessRecommendationRecurrenceReflex actionReportingResearchRheumatoid ArthritisRiskSocial EnvironmentSocietiesStandardizationStructureSurveysSymptomsSyncopeSystemTestingTimeTranslationsUnconscious StateVasovagalWorkadverse outcomebaseclinical careclinical practicecollegecommon symptomdesignevidence baseexperienceheart rhythmhigh riskimplementation researchimplementation strategyimplementation trialimprovedmortalitymortality risknoveloutcome forecastphysical conditioningsocial organizationtool
项目摘要
Project Abstract
Syncope is a complex presenting symptom that requires thoughtful and efficient evaluation to
determine the etiology of a patient's loss of consciousness. Prevalence rates of syncope have been reported
as high as 41%, with recurrent syncope occurring in 13.5%. A common symptom, approximately 1% to 3% of
all emergency department (ED) visits (as many ED visits as atrial fibrillation) and up to 6% of all hospital
admissions are due to syncope. The prognosis among patients with syncope depends on the etiology and
underlying cardiovascular condition. A cardiac etiology of syncope is associated with significantly higher rates
of morbidity and mortality than other causes such as vasovagal reflex mediated or orthostatic hypotension. The
Framingham study documented a doubling of the risk of death among participants with cardiac syncope
compared with those with non-cardiac syncope. Notably, experiencing syncope affects patients' quality of life
(QoL), and those with more frequent syncope report poorer QoL with perceptions of low overall physical and
mental health and impairment in activities of daily living. The QoL among patients with recurrent syncope
appears equivalent to severe rheumatoid arthritis and chronic low-back pain in an adult population. Though
research in the past 25 years provides substantial understanding of the pathophysiology of particular etiologies
of syncope, the diagnostic approach to such a perplexing symptom remains difficult and efficient diagnosis
remains elusive.
The major challenge in the evaluation of patients with syncope is that most patients are asymptomatic
at the time of their presentation. Because of concerns that patients presenting with syncope are at risk for an
impending catastrophic event, overuse and inappropriate use of testing and hospital admission are common.
Aiming to provide guidance on optimizing the evaluation and management of syncope, a collaboration of the
American College of Emergency Physicians, Society for Academic Emergency Medicine, American College of
Cardiology (ACC), American Heart Association (AHA) and Heart Rhythm Society (HRS) issued a Guideline for
the Evaluation and Management of Patients with Syncope in 2017. Adopting a standardized approach to
syncope based on this guideline offers an effective opportunity for delivering high value care to patients
suffering this distressing and potentially dangerous event. Aiming for more rapid translation from guideline to
clinical practice and improved health, the proposed study will identify barriers and facilitators for
implementation of an evidence-based, high value approach to diagnosis and management of patients
presenting with syncope. The research team will develop a multi-level, multi-component implementation
strategy for evidence-based syncope evaluation and management and plan for a subsequent hybrid
effectiveness-implementation trial, guided by the Consolidated Framework for Implementation Research
(CFIR).
项目摘要
项目成果
期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Value-based syncope evaluation and management: Perspectives of health care professionals on readiness, barriers and enablers.
- DOI:10.1016/j.ajem.2020.05.029
- 发表时间:2020-09
- 期刊:
- 影响因子:0
- 作者:Li J;Gupta V;Smyth SS;Cowley A;Du G;Sirrine M;Stearley S;Chadha R;Bhalla V;Williams MV
- 通讯作者:Williams MV
Developing and Demonstrating the Viability and Availability of the Multilevel Implementation Strategy for Syncope Optimal Care Through Engagement (MISSION) Syncope App: Evidence-Based Clinical Decision Support Tool.
- DOI:10.2196/25192
- 发表时间:2021-11-16
- 期刊:
- 影响因子:7.4
- 作者:Amin S;Gupta V;Du G;McMullen C;Sirrine M;Williams MV;Smyth SS;Chadha R;Stearley S;Li J
- 通讯作者:Li J
"Passing Out is a Serious Thing": Patient Expectations for Syncope Evaluation and Management.
- DOI:10.2147/ppa.s307186
- 发表时间:2021
- 期刊:
- 影响因子:2.2
- 作者:Clouser JM;Sirrine M;McMullen CA;Cowley AM;Smyth SS;Gupta V;Williams MV;Li J
- 通讯作者:Li J
Planning Implementation Success of Syncope Clinical Practice Guidelines in the Emergency Department Using CFIR Framework.
- DOI:10.3390/medicina57060570
- 发表时间:2021-06-03
- 期刊:
- 影响因子:0
- 作者:Li J;Smyth SS;Clouser JM;McMullen CA;Gupta V;Williams MV
- 通讯作者:Williams MV
Identifying Guideline-Practice Gaps to Optimize Evaluation and Management for Patients With Syncope.
- DOI:10.1016/j.cjca.2020.05.022
- 发表时间:2021-03
- 期刊:
- 影响因子:0
- 作者:Smyth S;Gupta V;Williams M;Cowley A;Sirrine M;Surratt H;Chadha R;Stearley S;Bhalla V;Li J
- 通讯作者:Li J
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Jing Li其他文献
Design and analysis of a novel low-temperature solar thermal electric system with two-stage collectors and heat storage units
新型两级集热器和蓄热装置低温太阳能热电系统的设计与分析
- DOI:
10.1016/j.renene.2011.02.008 - 发表时间:
2011-09 - 期刊:
- 影响因子:8.7
- 作者:
Gang Pei;Jing Li;Jie Ji - 通讯作者:
Jie Ji
Jing Li的其他文献
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{{ truncateString('Jing Li', 18)}}的其他基金
AIDen: An AI-empowered detection and diagnosis system for jaw lesions using CBCT
AIDen:使用 CBCT 的人工智能驱动下颌病变检测和诊断系统
- 批准号:
10383494 - 财政年份:2022
- 资助金额:
$ 50.94万 - 项目类别:
Physiologically Based Pharmacokinetic Modeling of Drug Penetration into the Human Brain and Brain Tumors
基于生理学的药物渗透到人脑和脑肿瘤的药代动力学模型
- 批准号:
10674753 - 财政年份:2021
- 资助金额:
$ 50.94万 - 项目类别:
Physiologically Based Pharmacokinetic Modeling of Drug Penetration into the Human Brain and Brain Tumors
基于生理学的药物渗透到人脑和脑肿瘤的药代动力学模型
- 批准号:
10459595 - 财政年份:2021
- 资助金额:
$ 50.94万 - 项目类别:
Physiologically Based Pharmacokinetic Modeling of Drug Penetration into the Human Brain and Brain Tumors
基于生理学的药物渗透到人脑和脑肿瘤的药代动力学模型
- 批准号:
10298016 - 财政年份:2021
- 资助金额:
$ 50.94万 - 项目类别:
Effect of Medicare Reimbursement for Care Planning on End of Life Care among Patients with Alzheimer's Disease and Related Dementias: A Quasi-Experimental Study
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- 批准号:
10172824 - 财政年份:2020
- 资助金额:
$ 50.94万 - 项目类别:
Effect of Medicare Reimbursement for Care Planning on End of Life Care among Patients with Alzheimer's Disease and Related Dementias: A Quasi-Experimental Study
医疗保险报销护理计划对阿尔茨海默病和相关痴呆症患者临终护理的影响:一项准实验研究
- 批准号:
10677882 - 财政年份:2020
- 资助金额:
$ 50.94万 - 项目类别:
Effect of Medicare Reimbursement for Care Planning on End of Life Care among Patients with Alzheimer's Disease and Related Dementias: A Quasi-Experimental Study
医疗保险报销护理计划对阿尔茨海默病和相关痴呆症患者临终护理的影响:一项准实验研究
- 批准号:
10408777 - 财政年份:2020
- 资助金额:
$ 50.94万 - 项目类别:
Effect of Medicare Reimbursement for Care Planning on End of Life Care among Patients with Alzheimer's Disease and Related Dementias: A Quasi-Experimental Study
医疗保险报销护理计划对阿尔茨海默病和相关痴呆症患者临终护理的影响:一项准实验研究
- 批准号:
10690298 - 财政年份:2020
- 资助金额:
$ 50.94万 - 项目类别:
Impact of the Physician Payments Sunshine Act on Prescription Drug Utilization and Spending
医生支付阳光法案对处方药使用和支出的影响
- 批准号:
9807060 - 财政年份:2019
- 资助金额:
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Development of nucleic acid delivery platform based on polymeric CXCR4 antagonists
基于聚合CXCR4拮抗剂的核酸递送平台的开发
- 批准号:
9045744 - 财政年份:2016
- 资助金额:
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