Laboratory for Early Psychosis Research (LEAP)

1.摘要 我们建议继续我们现有的NIMH P50快感中心(早期精神病或LEAP实验室 居中)。虽然协调专科护理(CSC)是首发精神病患者的标准护理 (FEP)，我们在选择和部署治疗方法方面的知识库中仍然存在空白。飞跃 中心一直在通过开发全州范围的CSC诊所系统来解决这些差距 马萨诸塞州，标准化数据收集和参与EPINET联盟，并适应 在心理健康之外发展的方法。在第一个飞跃中心时期，我们产生了强大的 临床医生、政策制定者/监管机构和利益相关者与FEP之间的跨学科协作 来自全国各地的专家加上来自心理健康以外的科学专家，例如数据科学， 机器学习、流行病学和卫生政策。在下一阶段，我们将利用这些协作来 进行随机临床试验并访问不同的数据来源以检查特定治疗的作用 FEP中的干预。我们还将应用和开发用于临床预测和比较的现代方法 FEP研究的有效性研究(CER)。我们有三个总体中心目标：1)协作；2) 临床研究；3)预测和CER方法。该中心将包括四个补充项目：1) 项目1是对增强型CSC进行整群随机临床试验的“标志性”项目。2)工程项目2 将在国际数据平台FEP-CALSE上应用因果推理技术；3)项目3将 利用EPINET国家登记数据评估项目1中研究的治疗暴露的影响；4) 项目4将在州一级比较CSC护理和非CSC护理，使用电子健康记录和 全州范围的管理数据集。管理核心和方法核心将这些项目与 多种类型的数据(例如，来自电子健康记录的实验数据和观测数据，国家 注册表或行政数据集)和分析方法。我们有一群科学的 顾问，来自不同科学学科的中心教师(例如，那些历史上智力有限的人 卫生研究暴露)和利益相关者(例如，政策制定者、组织领导人、患者和 家庭倡导者)，他们将深入参与中心的设计和传播。总体目标是 继续向全州范围的早期精神病学习卫生系统发展，该系统始于第一个 Leap Center期间并继续支持由NIMH发起的EPINET学习健康系统联盟。

1. Abstract We propose to continue our existing NIMH P50 ALACRITY Center (Laboratory for Early Psychosis or LEAP Center). Although coordinated specialty care (CSC) is standard of care for patients with first episode psychosis (FEP), there remain gaps in our knowledge base regarding selection and deployment of treatments. The LEAP Center has been addressing these gaps through development of a statewide CSC clinic system in Massachusetts, standardized data collection and participation in the EPINET consortium, and adapting methods developed outside of mental health. In the first LEAP Center period, we have generated strong interdisciplinary collaborations between clinicians, policy makers/regulators, and stakeholders, and FEP experts from across the country plus scientific experts from outside of mental health, e.g., in data science, machine learning, epidemiology, and health policy. In the next period, we will leverage these collaborations to conduct a randomized clinical trial and to access diverse data sources to examine the role of specific treatment interventions in FEP. We also will apply and develop modern methods for clinical prediction and comparative effectiveness research (CER) for FEP research. We have three overall Center aims: 1) Collaborations; 2) Clinical research; and 3) Prediction and CER methods. The Center will include four complementary projects: 1) Project 1 is a “signature” project to conduct a cluster randomized clinical trial of enhanced CSC. 2) Project 2 will apply causal inference techniques on FEP-CAUSAL, an international data platform; 3) Project 3 will leverage EPINET national registry data to estimate the effect of treatment exposures studied in Project 1; 4) Project 4 will compare CSC care with non-CSC care at the state level using both electronic health record and statewide administrative datasets. The Administrative Core and Methods Core bind these projects and the multiple types of data (i.e., experimental data and observational data from electronic health records, national registries, or administrative datasets) and analytic approaches together. We have a group of Scientific Advisors, Center Faculty from diverse scientific disciplines (e.g., those that historically have had limited mental health research exposure), and Stakeholders (e.g., policy makers, organizational leaders, and patient and family advocates) who will be deeply involved in the Center from design to dissemination. The overall goal is to continue the evolution towards a state-wide learning health system for early psychosis which started in the first LEAP Center period and to continue to support NIMH-sponsored EPINET learning health system consortium.