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

摘要 颞下颌关节紊乱病(TMD)是一个重大的公共卫生和社会问题，其表现在 疼痛，损害关节和整体功能，影响多达10%的人口。因为经常感到疼痛 出现过多的主要是主观症状，TMD经常被误诊，治疗 经常是非标准化和低效的。虽然在TMD研究方面的投资是在 在过去的几十年里，在将这种研究转化为临床方面取得的成功有限。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， 使疾病病因和发病机制的理解复杂化，并损害证据的发展-- 以治疗为基础。因此，TMD的基础和临床研究往往脱离了一个 另一个问题是，基本发现和临床需求之间的联系不足。为了提高基础知识， 临床和翻译TMD研究的集成方式，我们将建立一个互动的，多层次的 密歇根的纪律团队与临床实践社区合作，作为一种手段 形成以患者为中心的协同生态系统。我们的Impact计划的目标是将 通过翻译与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、工程和健康技术在翻译中解决临床定义的问题 基础设施环境。在这里，我们将制定一个组织结构、生态系统和运营 建立一个整合TMD基础和临床研究并指导 最有希望的研究是以循证的方式进行翻译，以改善临床护理。要实现 在这一愿景中，我们利用NIDCR中心项目在再生医学方面的经验和领导能力 (DOCTRC)在密歇根指导我们的计划，如何通过翻译最好地催化基础研究 管道并进入诊所。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)发展多学科的组织结构 以及为基础研究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的机械性理解 以及开发适合转化为临床实践的诊断和治疗方法。2)整合多种形式 支持基础和临床研究的协作以及选择研究的流程的团队 可转化为临床实践的主题和项目。3)制定操作规程，以 支持创新TMD技术和疗法的临床转化。在完成目标后，我们 将在推进基础和临床TMD研究、研究培训和翻译方面发挥独特的作用 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.