Gastrointestinal Surgery Outcomes Research Fellowship

项目摘要/摘要 美国人一生中平均经历9次外科或介入性手术，其中许多与 与肥胖有关的消化系统疾病或状况。尽管很常见，但大多数 没有对这些程序的有效性进行严格评估。此外，最佳实践 需要实现最佳结果、人群级别的结果、患者报告的观点和成本 考虑因素尚未得到解决。随着医疗保健系统努力提供更大的价值并提高 他们提供的护理的有效性，填补这些差距是至关重要的。短缺的一个原因是 严格的胃肠道疾病临床研究通常采用手术治疗，缺乏正规的 对外科医生进行卫生服务、临床试验和比较效果研究方面的培训。要解决这个问题 需要，我们建议继续华盛顿大学在临床、卫生服务方面的T32奖学金 以及外科医生的比较有效性研究。这种团契包括说教训练和实践。 在高级临床研究方法学方面的经验侧重于与胃肠道相关的干预 系统、糖尿病和肥胖相关疾病。培训的重点是6个领域(研究使用 观察性数据、以患者为中心的结果和偏好评估、健康经济学和行为学 医疗保健、实施和卫生系统科学、临床试验和研究运作方面的经济学 管理)，旨在培养将成为成功的科学家和领导者的外科学者 学术医学。授课内容包括获得公共卫生硕士学位或 理科硕士学位。受训者使用全方位的研究完成一系列项目和研究 方法和途径。学员的经验是由一个结构化的指导计划培养的，该计划由 致力于培训并在高水平研究和实践中取得成功的调查人员 将证据融入实践。许多由研究员领导的项目都涉及与一个独特的、 全州范围的45家医院的数据共享网络和15家40多家医院的全国性研究平台 各州。这些网络允许观察性队列研究，并支持在#年进行随机试验。 常见胃肠道疾病的处理(例如，阑尾炎和憩室炎)。实习生 参加两年的团契，然后再服务3-5年的临床培训。过去和 目前的研究员从出版物和演示文稿来看，已经取得了很高的研究成功，而且 该计划对学员、社区和国家都产生了相当大的影响。之前的受训人员具有 他们完成了临床培训，现在正在从事学术工作，并取得了成功 独立调查人员。本周期计划进行的培训的重大变化包括更加注重 与胃肠道疾病相关的临床试验和学习卫生系统研究。这一强调 与导师领导的资助随机对照试验和卫生系统科学研究的数量增加相平行。

PROJECT SUMMARY/ABSTRACT The average American undergoes nine surgical or interventional procedures over their lifetime, many related to diseases of the digestive track or conditions associated with obesity. Despite being common, most of these procedures have not been subjected to rigorous evaluation of their effectiveness. In addition, the best practices needed to accomplish the best outcomes, population-level results, patient-reported perspectives, and cost considerations have yet to be addressed. As healthcare systems strive to deliver greater value and increase the effectiveness of the care they deliver, addressing these gaps is critical. One reason for the shortfall in rigorous clinical research in gastrointestinal conditions commonly treated with surgery is a paucity of formal training in health services, clinical trials, and comparative effectiveness research for surgeons. To address this need, we propose the continuation of the University of Washington's T32 fellowship in clinical, health services, and comparative effectiveness research for surgeons. This fellowship involves didactic training and practical experience in advanced clinical research methodology focused on interventions related to the gastrointestinal system, diabetes, and obesity-related conditions. The training is focused in 6 areas (research using observational data, patient-centered outcome and preference assessment, health economics and behavioral economics in healthcare, implementation and health system science, clinical trials, and research operations management) and is intended to develop surgeon-scholars who will be successful scientists and leaders in academic medicine. The didactic component includes coursework that results in a Master of Public Health or Master of Science degree. Trainees complete a set of projects and studies using the full spectrum of research methods and approaches. The trainee's experience is fostered by a structured mentorship program, led by investigators who have a career commitment to training and demonstrated success in high-level research and integrating evidence into practice. Many of the projects led by fellows involve collaboration with a unique, statewide data sharing network of 45 hospitals and a national research platform of over 40 hospitals in 15 states. These networks allow for observational cohort studies and support the conduct of randomized trials in the management of common gastrointestinal conditions (e.g., appendicitis and diverticulitis). Trainees participate in the fellowship for two years and then serve an additional 3-5 years of clinical training. Past and current fellows have had high levels of research success judged by publications and presentations, and the program has had a considerable impact on trainees, the community, and the nation. Prior trainees who have completed their clinical training are now taking academic positions and have been finding success as independent investigators. The significant changes planned for the training in this cycle include a greater focus on clinical trials and learning health systems research related to gastrointestinal conditions. This emphasis parallels the increased number of funded RCTs and health system science studies being led by the mentors.