Patient-Reported Outcomes for Acute Asthma Care and Treatment (PROAACT)

项目总结/摘要 这个K23奖将使候选人，米歇尔林，医学博士，公共卫生硕士，MS，成为一个 独立医生科学家专注于改善患者报告的急诊结果 哮喘和其他急性心肺疾病的科室（艾德）护理。哮喘影响1 在美国每12个人中，导致每年有190万艾德就诊;然而， 急性加重后艾德治疗对患者报告结果的影响尚不清楚， 限制了对改善艾德哮喘护理的干预措施的评价。在她的试点工作中，林博士 确定了新的急性脑梗死患者报告结局的候选项目和量表 哮喘护理和治疗（PROAACT）仪器。在K23期间，林博士将1）评估 PROAACT工具的有效性和可靠性; 2）测试是否收到更多指南- 协调的艾德护理与PROAACT反应改善相关; 3）评估 PROAACT评分与随后的艾德复诊和住院之间的相关性， 将告知未来风险调整中纳入PROAACT和其他候选预测因子 模型为了实现这些目标，该建议包括一个综合课程，包括 在以病人为中心的研究、仪器方面的强化指导和教学课程 开发和验证，包括心理测量方法、临床数据管理，以及 采用地理空间技术衡量成果的新办法， 已知对哮喘和健康结果有不同影响的社会和环境数据。博士 林的职业发展和培训活动还包括建立一个研究网络， 同行和合作者，与当地社区的哮喘患者接触，并参与 在国家科学会议上。林博士召集了一个由国家领导人组成的导师团队 在以病人为中心的哮喘和急诊医学研究方面具有专业知识， 结果研究，工具开发，医疗质量测量和结果 考核拟议的研究和教学计划将使林博士发展专业知识， 患者报告结果性能指标开发，成为患者- 以哮喘和急救护理研究为中心，使林博士能够过渡到一个 独立的临床研究者，专注于开发，测量和改善患者 报告了哮喘和其他心肺疾病的结局。完成本项目 将导致成人艾德哮喘患者的新型PROM， 护理影响患者报告的结果，并使干预措施能够改善结果， 对患有哮喘的艾德患者很重要。

PROJECT SUMMARY/ ABSTRACT This K23 award will enable the candidate, Michelle Lin, MD, MPH, MS, to become an independent physician scientist focused on improving patient-reported outcomes for emergency department (ED) care of asthma and other acute cardiopulmonary conditions. Asthma affects 1 in every 12 persons in the U.S., resulting in 1.9 million ED visits annually; however, the impact of ED care on patient-reported outcomes after acute exacerbations is unknown—a gap which limits the evaluation of interventions to improve ED asthma care. In her pilot work, Dr. Lin has identified candidate items and scales for the novel Patient-Reported Outcomes for Acute Asthma Care and Treatment (PROAACT) instrument. During this K23, Dr. Lin will 1) evaluate the validity and reliability of the PROAACT instrument; 2) test whether receiving more guideline- concordant ED care is associated with improved PROAACT responses; and 3) evaluate the association between PROAACT scores and subsequent ED revisits and hospitalizations, which will inform the inclusion of PROAACT and other candidate predictors in future risk adjustment models. To achieve these aims, this proposal includes an integrated curriculum consisting of intensive mentorship and didactic coursework in patient-centered research, instrument development and validation including psychometric methods, clinical data management, and novel approaches to outcome measurement applying geospatial techniques to incorporate social and environmental data known to differentially affect asthma and health outcomes. Dr. Lin’s career development and training activities also include building a research network of peers and collaborators, engaging with asthma patients in local communities, and participating in national scientific meetings. Dr. Lin has assembled a mentorship team of national leaders with expertise in patient-oriented asthma and emergency medicine research, patient-centered outcomes research, instrument development, health care quality measurement, and outcome assessment. The proposed research and didactic plan will allow Dr. Lin to develop expertise in patient-reported outcome performance measure development, become a leader in patient- centered asthma and emergency care research, and enable Dr. Lin's transition to an independent clinical investigator focused on developing, measuring and improving patient- reported outcomes for asthma and other cardiopulmonary conditions. Completion of this project will result in a novel PROM for adult ED asthma patients, advance the understanding of how ED care impacts patient-reported outcomes, and enable interventions to improve outcomes that matter to ED patients with asthma.