Center to Improve Clinical Diagnosis

改善临床诊断中心

• 批准号: 10642289
• 负责人: MARY DOLANSKY
• 金额: $ 99.87万
• 依托单位: UNIVERSITY HOSPITALS OF CLEVELAND
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2026-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10642289
• 关键词: Center; Improve; Clinical; Diagnosis

Abstract: Diagnostic errors are common and frequently extremely serious. Unfortunately, strategies to identify diagnostic standards and best diagnostic practices for a variety of problems are scarce. The focus of the Center to Improve Clinical Diagnosis will be to tackle diagnostic problems using a data and consensus driven approach. The goals of the Center are to (a) assemble a diverse, multidisciplinary team to provide formal input about standards and best practices; (b) to implement a 4-step strategy to develop recommended diagnostic practices; and (c) to sustain the Center by creating a set of policies, methods, a future agenda, and partnerships within and outside our organization. Our Center will be fully integrated into a larger health services research center within University Hospitals Health System. Our general 4-step process to develop recommended practices includes (1) identifying problems which are common, associated with high rates of diagnostic error, and for which guidance is lacking and identify current diagnostic practice (or practices in response to diagnostic interventions) (2) identify outcomes of diagnostic practices; (3) in collaboration with a panel of diagnosticians, review data about practice and outcomes and formulate recommendations; (4) implement recommendations and monitor their impact. We have chosen three problems as demonstration projects based on how common and serious they are and the expertise and experience of our research team: (1) The best approach to identifying and evaluating unintentional weight loss in adults; (2) The best approach to screening for hypertension in African American adolescents using home-BP devices; (3) Improved diagnosis of sepsis in children in community emergency department (ED) settings, and adults in community (ED) and inpatient settings through implementation and most importantly, refinement of electronic sepsis trigger tools. We believe our systematic approach to developing standards and best practices for these and future problems will provide a system for badly needed diagnostic guidance that is useful for patients, clinicians, and health systems.

摘要：诊断错误很常见，而且往往非常严重。不幸的是，确定 针对各种问题的诊断标准和最佳诊断做法很少。这次会议的重点是 中心将利用数据和共识来解决诊断问题，以改善临床诊断 接近。该中心的目标是：(A)组建一个多样化、多学科的团队，提供正式投入 关于标准和最佳做法；(B)实施4步战略，以制定建议的诊断 (C)通过制定一套政策、方法、未来议程和 我们组织内外的合作伙伴关系。我们的中心将完全融入更大的健康服务 大学医院卫生系统内的研究中心。我们一般的4步开发流程 建议的做法包括：(1)找出与高比率有关的常见问题 诊断错误，缺乏指导，并确定当前的诊断实践(或 对诊断干预措施的反应)(2)确定诊断做法的结果；(3)与 诊断专家小组，审查有关实践和结果的数据并提出建议；(4) 落实建议并监测其影响。我们选择了三个问题作为演示 项目基于它们的普遍程度和严重性以及我们研究团队的专业知识和经验： (1)识别和评估成人非故意减肥的最佳方法；(2)最佳方法 使用家用血压设备对非裔美国青少年进行高血压筛查；(3)改进诊断 社区急诊科(ED)的儿童和社区(ED)和成人的脓毒症 通过实施和最重要的是改进电子脓毒症触发工具进行住院设置。 我们相信，我们为这些问题和未来问题制定标准和最佳实践的系统方法 将为患者、临床医生和健康人员提供急需的诊断指导系统 系统。