Michigan Collaborative Hub for TMD Patient-Centric Research (MICH T PCR)

摘要 颞下颌关节紊乱病（TMD）是一个重要的公共卫生和社会问题， 疼痛，关节和整体功能受损，影响高达10%的人口。由于疼痛频繁 TMD通常伴随着大量的主观症状，经常被误诊，治疗方法 经常是不规范、不规范的。虽然对TMD研究的投资已经超过了 在过去几十年中，将这种研究转化为临床的成功有限。同样， 影响关节、肌肉和神经系统的疾病的症状和复杂性的异质性， 使对疾病病因和机制的理解复杂化，并损害证据的发展- 基础疗法。因此，TMD的基础研究和临床研究常常脱节 另一个是基础发现和临床需求之间联系不足。为了提高基础， 临床和转化TMD研究的综合方式，我们将建立一个互动的，多- 密歇根州的学科团队与临床实践社区合作， 形成以患者为中心的协作生态系统。我们的IMPACT计划的目标是改变 通过翻译临床相关的创新来治疗TMD患者。我们的愿景是整合 生命科学，工程和健康技术，以解决临床定义的问题， 基础设施环境。在这里，我们将建立一个组织结构，生态系统和运营 建立一个整合TMD基础和临床研究并指导 最有前途的研究，以循证方式翻译，以改善临床护理。实现 为了实现这一愿景，我们充分利用NIDCR中心在再生医学领域的经验和领导地位 （DOCTRC）在密歇根州指导我们规划如何通过转化最好地催化基础研究 管道和诊所。在本R34中，我们将设计结构并制定实施策略， 未来战区导弹防御系统的合作目标如下：1）发展一个多学科的组织结构 以及为基础和以患者为中心的研究提供信息的过程，这些研究产生了对TMD的机械理解 以及开发适合转化为临床实践的诊断和治疗方法。2)整合不同 支持基础和临床研究合作的团队以及选择研究的过程 可以转化为临床实践的主题和项目。3)制定操作规程， 支持创新TMD技术和疗法的临床转化。在完成目标后，我们 将处于独特的地位，以推进基础和临床TMD研究，研究培训和翻译， 循证治疗导致TMD护理的转变。

ABSTRACT Temporomandibular disorders (TMD) are a significant public health and societal problem that manifests itself in pain, compromised joint and overall function, and affecting up to 10% of the population. Since pain frequently occurs with a plethora of mostly subjective symptoms, TMD are frequently misdiagnosed and treatments are frequently non-standardized and ineffective. While investments in TMD research have been made over the past several decades, there has been limited success in translating such research to the clinic. Likewise, the heterogeneity in symptoms and complexity of a disease that impacts the joint, muscle, and nervous systems, complicates the understanding of disease etiology and mechanisms, and impairs the development of evidence- based therapies. As a result, basic and clinical research on TMD are frequently divorced from one another, with insufficient linkages between basic discoveries and clinical needs. To advance basic, clinical, and translational TMD research in an integrated manner, we will establish an interactive, multi- disciplinary team at Michigan in partnership with the clinical practice community as a means of forming a patient-centered collaborative ecosystem. The goal of our IMPACT program is to transform the treatment of TMD patients through the translation of clinically-relevant innovations. Our vision is to integrate life science, engineering and health technologies to solve clinically-defined problems in a translational infrastructure environment. Herein, we will develop an organizational structure, ecosystem and operational procedures for establishing a consortium that integrates basic and clinical research in TMD and guides the most promising research toward translation in an evidence-based manner to improve clinical care. To achieve this vision, we leverage the experience and leadership of the NIDCR center program in regenerative medicine (DOCTRC) at Michigan to guide our planning of how to best catalyze basic research through the translational pipeline and into the clinic. In this R34, we will design the structure and develop an implementation strategy for the future TMD collaborative via the following aims: 1) Develop a multi-disciplinary organizational structure and processes to inform basic and patient-centered research that yield a mechanistic understanding of TMDs and development of diagnostics and therapies suitable for translation to clinical practice. 2) Integrate diverse teams that support the collaboration of basic and clinical research and processes for selecting research themes and projects that can be translated into clinical practice. 3) Formulate operating procedures to support the clinical translation of innovative TMD technologies and therapies. Upon completion of the aims, we will be uniquely positioned to advance basic and clinical TMD research, research training, and translation to evidence-based treatments leading to a transformation in TMD care.