Clinical Decision Support Tool to Assess Risk and Prevent Agitation Events
用于评估风险和预防躁动事件的临床决策支持工具
基本信息
- 批准号:10683499
- 负责人:
- 金额:$ 10.8万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-09-15 至 2025-08-31
- 项目状态:未结题
- 来源:
- 关键词:Accident and Emergency departmentAddressAggressive behaviorAgitationAwardBehavioralBiometryCharacteristicsClinicalClinical Decision Support SystemsClinical TrialsCollectionComplexDataDissemination and ImplementationEarly DiagnosisEarly treatmentEducationElectronic Health RecordEmergency Department PhysicianEmergency MedicineEmergency department visitEnrollmentEnsureEnvironmentEnvironmental Risk FactorEquilibriumEventFaceFoundationsGoalsHarm ReductionHealth Services ResearchHealth systemInstitutionInterventionInterviewKnowledgeLaboratoriesLeadMedicalMental HealthMental Health ServicesMental disordersMentorsMethodsModelingModificationNational Institute of Mental HealthOutcomePatient riskPatient-Focused OutcomesPatientsPhysical RestraintPoliciesPredictive FactorPreventionProcessProviderPublic Health InformaticsQualitative MethodsRandomizedRecommendationRecording of previous eventsResearchResearch ActivityResourcesRiskRisk AssessmentRisk FactorsSafetySelf EfficacySudden DeathSymptomsSystemTechniquesTechnologyTestingTimeTrainingTraumatic injuryValidationVariantViolenceVisitWorkacute carebasecare deliverycareerclinical centerclinical decision supportclinical decision-makingclinical developmentclinical research siteclinical trial implementationcohortcomorbidityemergency settingsfeasibility testinghealth recordimprovedpatient safetypilot trialpredictive modelingpreemptive interventionpreventrapid diagnosisrestraintrisk prediction modelrisk stratificationsedativesevere mental illnessskillssupport toolstoolusabilityuser centered design
项目摘要
PROJECT SUMMARY/ABSTRACT
This award is a four-year plan to support Ambrose Wong, MD, MSEd, an emergency physician, in his
transition towards an independent research career that focuses on dissemination and implementation of
services for mental health crises in general, non-psychiatric emergency settings. The long-term goal of his
research is to improve safety related to symptoms of agitation. To date, Dr. Wong's training has focused on
emergency medicine, qualitative methods, and education-based interventions. Under a team of co-mentors
with expertise in biostatistics, psychiatric services research, health informatics, and clinical trial implementation,
Dr. Wong will build on his preliminary work on agitation prevention and management to accomplish the
following training goals: (1) acquire expertise in clinical prediction modeling, (2) gain foundational knowledge in
preventing, treating, and investigating mental health crises, (3) study health informatics and development of
clinical support tools, and (4) obtain fundamental skills in clinical trials. The application integrates formal
coursework and training through mentored research activities.
Behavioral conditions in acute care settings are rapidly rising in the U.S., with a 50% increase in number of
general emergency department (ED) visits for mental health conditions over the past decade. Agitation,
defined as excessive psychomotor activity leading to violent behavior, is often part of these patient encounters.
Of the 1.7 million agitation episodes occurring annually in general EDs, 83% are associated with an underlying
serious mental illness. Given the safety risks of agitation, clinicians commonly use physical restraint, which are
associated with up to 37% risk of complications including traumatic injuries and even sudden death in patients.
Thus, regulatory bodies and experts emphasize early risk assessment and use of behavioral techniques before
agitation occurs. However, variability in practice and policy of these techniques exists in emergency settings.
This is due to lack of knowledge regarding specific risk factors that predict the need for pre-emptive
intervention and challenges in assessing these risk factors in the busy environment of an ED. The objective of
this project is to develop and test the Early Detection and Treatment to Reduce Events with Agitation Tool (ED-
TREAT), a clinical decision support system embedded in the electronic health record that will guide clinicians
in early risk assessment and appropriate treatment of mental health patients likely to develop agitation. We will
first derive a clinical model using health record data and preliminary analyses by our team that predicts which
at-risk patients will develop agitation and require use of physical restraint. Next, we will develop and refine ED-
TREAT through user-centered design techniques with clinicians and patients. Finally, we will conduct a pilot
trial to test the feasibility, fidelity, and bedside acceptability of ED-TREAT. Aligned with NIMH's strategic
priorities to use technology for improving mental health delivery in non-specialty settings, this study will form
the basis for a subsequent full-scale clinical trial to examine ED-TREAT's effect on clinical outcomes.
项目摘要/摘要
该奖项是一项为期四年的计划,旨在支持急诊医生Ambrose Wong,医学博士,MSED
向专注于传播和实施的独立研究生涯过渡
在一般的非精神科急诊环境中为精神健康危机提供服务。他的长期目标是
研究是为了改善与激越症状相关的安全性。到目前为止,王博士的培训主要集中在
急诊医学、定性方法和基于教育的干预。在一个共同导师的团队下
拥有生物统计学、精神科服务研究、健康信息学和临床试验实施方面的专业知识,
王博士将在预防和管理骚乱的前期工作的基础上,完成
以下培训目标:(1)获得临床预测建模方面的专业知识;(2)获得基础知识
预防、治疗和调查心理健康危机;(3)研究健康信息学及其发展
临床支持工具,以及(4)在临床试验中获得基本技能。该应用程序集成了正式的
通过有指导的研究活动进行课程作业和培训。
在美国,急性护理环境中的行为状况正在迅速上升,患者数量增加了50%
在过去的十年里,普通急诊科(ED)就诊于精神健康状况。激动人心,
定义为过度的精神运动活动导致暴力行为,通常是这些患者遭遇的一部分。
在普通急诊室每年发生的170万次激动发作中,83%与潜在的
严重的精神疾病。考虑到骚动的安全风险,临床医生通常使用身体束缚,这是
与高达37%的并发症风险有关,包括患者的创伤损伤甚至猝死。
因此,监管机构和专家强调早期风险评估和使用行为技术之前
就会出现骚动。然而,在紧急情况下,这些技术的实践和政策存在可变性。
这是由于缺乏关于预测需要先发制人的特定风险因素的知识。
在急诊室繁忙的环境中评估这些危险因素的干预和挑战。的目标是
该项目是开发和测试早期发现和处理,以减少事件与激荡工具(ED-
Treat),嵌入在电子健康记录中的临床决策支持系统,将指导临床医生
在早期风险评估和适当治疗下,精神健康患者容易发生躁动。我们会
首先,使用健康记录数据和我们团队的初步分析得出临床模型,预测
高危患者会出现烦躁不安,需要使用身体约束。接下来,我们将开发和完善ED-
通过临床医生和患者以用户为中心的设计技术进行治疗。最后,我们将进行一次试点
试验以测试ED治疗的可行性、保真度和床边可接受性。与NIMH的战略保持一致
在非专科环境中优先使用技术来改善精神卫生服务,这项研究将形成
为随后的全面临床试验检查ED-Treat对临床结果的影响奠定了基础。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Ambrose H Wong其他文献
Ambrose H Wong的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Ambrose H Wong', 18)}}的其他基金
Characterizing Bias and Care Disparities with Physical Restraint Use in the Emergency Setting Using Natural Language and Cognitive Data
使用自然语言和认知数据描述紧急情况下使用身体约束的偏见和护理差异
- 批准号:
10431043 - 财政年份:2022
- 资助金额:
$ 10.8万 - 项目类别:
Characterizing Bias and Care Disparities with Physical Restraint Use in the Emergency Setting Using Natural Language and Cognitive Data
使用自然语言和认知数据描述紧急情况下使用身体约束的偏见和护理差异
- 批准号:
10633167 - 财政年份:2022
- 资助金额:
$ 10.8万 - 项目类别:
Clinical Decision Support Tool to Assess Risk and Prevent Agitation Events
用于评估风险和预防躁动事件的临床决策支持工具
- 批准号:
10365272 - 财政年份:2021
- 资助金额:
$ 10.8万 - 项目类别:
Clinical Decision Support Tool to Assess Risk and Prevent Agitation Events
用于评估风险和预防躁动事件的临床决策支持工具
- 批准号:
10687170 - 财政年份:2021
- 资助金额:
$ 10.8万 - 项目类别:
相似海外基金
Rational design of rapidly translatable, highly antigenic and novel recombinant immunogens to address deficiencies of current snakebite treatments
合理设计可快速翻译、高抗原性和新型重组免疫原,以解决当前蛇咬伤治疗的缺陷
- 批准号:
MR/S03398X/2 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
Fellowship
Re-thinking drug nanocrystals as highly loaded vectors to address key unmet therapeutic challenges
重新思考药物纳米晶体作为高负载载体以解决关键的未满足的治疗挑战
- 批准号:
EP/Y001486/1 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
Research Grant
CAREER: FEAST (Food Ecosystems And circularity for Sustainable Transformation) framework to address Hidden Hunger
职业:FEAST(食品生态系统和可持续转型循环)框架解决隐性饥饿
- 批准号:
2338423 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
Continuing Grant
Metrology to address ion suppression in multimodal mass spectrometry imaging with application in oncology
计量学解决多模态质谱成像中的离子抑制问题及其在肿瘤学中的应用
- 批准号:
MR/X03657X/1 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
Fellowship
CRII: SHF: A Novel Address Translation Architecture for Virtualized Clouds
CRII:SHF:一种用于虚拟化云的新型地址转换架构
- 批准号:
2348066 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
Standard Grant
BIORETS: Convergence Research Experiences for Teachers in Synthetic and Systems Biology to Address Challenges in Food, Health, Energy, and Environment
BIORETS:合成和系统生物学教师的融合研究经验,以应对食品、健康、能源和环境方面的挑战
- 批准号:
2341402 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
Standard Grant
The Abundance Project: Enhancing Cultural & Green Inclusion in Social Prescribing in Southwest London to Address Ethnic Inequalities in Mental Health
丰富项目:增强文化
- 批准号:
AH/Z505481/1 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
Research Grant
ERAMET - Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
ERAMET - 快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
- 批准号:
10107647 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
EU-Funded
Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
- 批准号:
10106221 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
EU-Funded
Recite: Building Research by Communities to Address Inequities through Expression
背诵:社区开展研究,通过表达解决不平等问题
- 批准号:
AH/Z505341/1 - 财政年份:2024
- 资助金额:
$ 10.8万 - 项目类别:
Research Grant














{{item.name}}会员




