Developing an oral health screening tool for an integrated model of care to reduce treatment-related oral morbidity in head and neck cancer survivor

开发口腔健康筛查工具，用于综合护理模式，以减少头颈癌幸存者与治疗相关的口腔发病率

• 批准号: 10781183
• 负责人: Derek Kyle Smith
• 金额: $ 2.98万
• 依托单位: ADA SCIENCE AND RESEARCH INSTITUTE LLC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2023-07-03
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10781183
• 关键词: Abscess; Academic Medical Centers; Activities of Daily Living; Address; American; Award; Bayesian Modeling; Biometry; Cancer Burden; Cancer Patient; Cancer Survivor; Caregiver Burden; Caring; Chemotherapy and/or radiation; Childhood; Chronic; Clinic; Clinical; Complement; Counseling; Data; Dental; Dental Care; Dental caries; Dentistry; Dentists; Deterioration; Development; Development Plans; Diagnosis; Disease; Disparity population; Doctor of Philosophy; Early Diagnosis; Early identification; Eating; Education; Educational Technics; Esthetics; Evaluation; Failure; Fatigue; Fellowship Program; Financial Hardship; Foundations; Future; Goals; Guidelines; Head and Neck Cancer; Head and neck structure; Health Personnel; Health Professional; Healthcare; Incidence; Indiana; Infrastructure; Interview; Life; Maintenance; Malignant Neoplasms; Medical; Mental Depression; Mentors; Mentorship; Minority Groups; Modeling; Morbidity - disease rate; Mouth Diseases; Oncology; Oral; Oral Health Impact Profile; Oral Pathology; Oral cavity; Oral health; Outcome Measure; Patient Care; Patient Outcomes Assessments; Patient Participation; Patient Self-Report; Patients; Periodontal Diseases; Population; Procedures; Provider; Public Health; Qualifying; Quality of life; Radiation therapy; Recommendation; Reporting; Research; Research Assistant; Research Project Grants; Research Proposals; Risk; Sampling; Schedule; Screening procedure; Structure; Surveys; Survivors; Symptoms; Taste Perception; Testing; Time; Training; Treatment-Related Cancer; Trismus; Uninsured; United States; Universities; Update; Validation; Validity and Reliability; Visit; Xerostomia; barrier to care; cancer therapy; care providers; care systems; career development; chronic pain; cost; cost effective; effective therapy; experience; follow-up; head and neck cancer patient; health assessment; health care model; high risk; improved; information gathering; innovation; integrated care; member; novel; oral care; oral condition; oral pain; oral surgery specialty; patient oriented; patient subsets; prevent; professor; programs; prosthesis fitting; recruit; research and development; response; screening; success; support tools; survivorship; tool

Summary Approximately 62,000 Americans develop head and neck cancer (HNC) each year. Cancer treatments can result in a myriad of changes to the normal function of the oral structures. These treatment-related oral morbidities can persist for the duration of the patient’s life leaving HNC survivors in a state of rapidly deteriorating oral health. In addition to other barriers to oral care likely experienced by HNC survivors, many of these patients are uninsured and cannot afford dental visits to maintain surveillance of their oral condition. Failure to identify these oral morbidities early can result in expensive, less effective treatments that contribute to poor quality of life. In response to this shortfall, Dr. Derek Smith (PI) is proposing a career development project which will improve our understanding of the barriers to care and develop the statistical infrastructure required to implement a novel oral care model. The proposed model of care would integrate medical professionals and their support staff into the oral health team by providing them with a screening tool that allows them to identify patients that are at high risk for oral disease. Dr. Smith is uniquely qualified to pursue this research completing his training as a dentist at Indiana University in 2008 and his PhD in Biostatistics at Vanderbilt University in 2017. He has participated in numerous research projects and preliminary studies, and has a wealth of experience in clinical dentistry making him an outstanding candidate for this award. Dr. Smith is currently a Research Assistant Professor in the Departments of Biostatistics and Oral Maxillofacial Surgery at Vanderbilt and has been given protected time, infrastructure, and excellent mentorship to aid in the development of this research plan. The proposed career development plan involves participating in the AT Still University dental public health fellowship program and mentoring on the conduct of patient-centered research. This development plan is complemented by the mentored research proposal. The model of care Dr. Smith has proposed requires a well-validated screening tool that medical professionals can use to identify patients at high risk for oral morbidity and a data-driven decision rule that helps providers decide when a referral to oral health professionals is warranted. In Aim 1 of this proposal we will conduct a validation of the Vanderbilt Head and Neck Symptom Survey’s oral subscale by correlating patient reported outcomes with clinician’s findings on exam. Having established validity of the tool, in Aim 2 a screening tool will be developed out of a combination of items from the VHNSS and other well-validated patient reported outcome measures including the Oral Health Impact Profile. Lastly, for Aim 3 interviews will be conducted with HNC survivors to gain a better understanding of non-financial barriers to oral care in the HNC population. At the completion of this project our team will have the tools necessary to implement the integrated care model at Vanderbilt, which will improve oral health surveillance and facilitate our future research efforts. !

总结 每年大约有62，000名美国人患上头颈癌（HNC）。癌症治疗可能会 导致口腔结构正常功能的无数变化。这些治疗相关的口服 发病率可以持续患者的生命周期，使HNC幸存者处于快速死亡的状态。 口腔健康恶化。除了HNC幸存者可能经历的其他口腔护理障碍外，许多 这些病人没有医疗保险，也负担不起看牙医的费用，因此无法继续监察他们的口腔状况。 未能及早发现这些口腔疾病可能导致昂贵的，不太有效的治疗， 生活质量差。针对这一不足，德里克史密斯博士（PI）提出了职业发展 该项目将提高我们对护理障碍的认识，并发展统计基础设施 需要实施一种新的口腔护理模式。拟议的护理模式将整合医疗 专业人员和他们的支持人员进入口腔健康团队，为他们提供一个筛选工具， 帮助他们识别口腔疾病高危患者。史密斯博士是唯一有资格 这项研究完成了他的培训作为一个牙医在印第安纳州大学在2008年和他的博士学位在生物统计学 2017年的范德比尔特大学。他参与了许多研究项目和初步研究， 他在临床牙科方面的丰富经验使他成为该奖项的杰出候选人。史密斯博士 目前是生物统计学和口腔颌面外科学系的研究助理教授 在范德比尔特，并已被给予保护的时间，基础设施和优秀的导师，以帮助在 制定这项研究计划。拟议的职业发展计划包括参加AT Still 大学牙科公共卫生奖学金计划和指导以病人为中心的研究行为。 这一发展计划得到了指导研究建议的补充。史密斯医生的护理模式 建议需要一个经过充分验证的筛选工具，医疗专业人员可以用来识别患者在高 口腔疾病的风险和数据驱动的决策规则，帮助提供者决定何时转诊到口腔健康 专业人士是有保证的。在本提案的目标1中，我们将对范德比尔特股骨头进行确认， 通过将患者报告的结局与临床医生的发现相关联， 考试在确定了该工具的有效性之后，在目标2中，将从一个组合中开发一个筛选工具， 来自VHNSS和其他经过充分验证的患者报告结局指标的项目，包括口服 健康影响简介。最后，为实现目标3，将与刚果难民委员会的幸存者进行面谈， 了解HNC人群口腔护理的非经济障碍。在这个项目完成后，我们 团队将拥有在范德比尔特实施综合护理模式所需的工具，这将改善 口腔健康监测，并促进我们未来的研究工作。!