Validating the NIH Toolbox in the Acute Neurorehabilitation Setting

在急性神经康复环境中验证 NIH 工具箱

• 批准号: 7818737
• 负责人: Victor William Mark
• 金额: $ 25.55万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7818737
• 关键词: Acute; Acute Brain Injuries; Address; Adult; Age; Area; Behavioral; Brain; Brain Diseases; Caregivers; Cerebrum; Characteristics; Clinical; Clinical assessments; Cognition; Cognitive; Data; Data Set; Databases; Decision Making; Development; Diagnosis; Disease; Emotions; Environment; Epidemiology; Esthesia; Ethnic Origin; Evaluation; Feasibility Studies; Functional disorder; Grant; Hand; Health Care Costs; Healthcare; Hospitalization; Hour; Impaired cognition; Impairment; Individual; Inpatients; Intervention; Investigation; Laboratories; Longitudinal Studies; Measures; Medical; Movement; Nervous System Physiology; Neurologic; Neurologic Deficit; Neurological rehabilitation; Neurorehabilitation; Onset of illness; Operative Surgical Procedures; Participant; Patients; Pharmaceutical Preparations; Population; Population Control; Prevalence; Recovery; Rehabilitation therapy; Relative (related person); Research; Research Proposals; Sensitivity and Specificity; Severities; Site; Stroke; Testing; Therapeutic Intervention; Therapeutic Studies; Time; Time Study; Traumatic Brain Injury; United States National Institutes of Health; Validation; cognitive function; community living; comparative effectiveness; computerized; diagnostic accuracy; effectiveness research; improved; instrument; mental state; motor control; multidisciplinary; nervous system disorder; preference; programs; public health relevance; research clinical testing; socioeconomics; tool; tumor; validation studies; young adult

DESCRIPTION (provided by applicant): This application addresses Challenge Area (05): Comparative Effectiveness Research and the specific Challenge Topic 05-NS-103, Validating NIH's New Clinical Tools in Populations with Neurological Disorders. Among the new Clinical Tools is the NIH Toolbox, a 2-hour assessment battery that has been developed to standardize evaluations in specific clinical populations for investigations of neurological development and change, disease recovery, and therapeutic interventions. The Toolbox integrates a wide variety of neurologic evaluations into a single instrument. The assessment battery comprises 4 broad neurologic domains (cognition, emotion, sensation, and movement) and incorporates computerized testing where possible. The final Toolbox test components will be made available in October 2009 following extensive multisite development of normative data ranges. At that time, studies can begin to test the validity and feasibility of the Toolbox in specific neurologic populations. This 2-year Challenge Grant study will evaluate the feasibility and initial validation of the Toolbox in the acute rehabilitation inpatient population. The field of neurologic rehabilitation presently lacks an integrated, comprehensive, multidisciplinary and multifunction assessment instrument to evaluate the impairments that follow the diverse and common, acutely disabling neurologic disorders (e.g., stroke, traumatic brain injury, post-tumor surgery). Thus, the Toolbox may eventually prove valuable in the inpatient setting for treatment and discharge planning and to experimentally test integrated hypotheses of neurologic recovery. Our study will test 120 adult acute rehabilitation inpatients who are recovering from disabling brain disorders. We will compare their Toolbox findings to 120 rehabilitation inpatients without known brain disease to distinguish the general effects of hospitalization (e.g., from multiple medications, concurrent medical illness) and thus to determine the Toolbox's sensitivity and specificity to acute brain illness. We will also test 120 community-living, age-similar, brain-healthy participants drawn from the caregivers of the inpatients, to control for the effects of socioeconomic background, age, ethnicity, and region of origin when evaluating the patients. Our control population will also contribute valuable normative data to the national Toolbox data set. Our study will also determine the cognitive impairment limits to Toolbox assessment, by determining whether the Mini-Mental State Examination can distinguish which patients are able or unable to comply with testing. This feasibility analysis will help subsequent proposals to target the patients who are best able to be evaluated with the Toolbox. PUBLIC HEALTH RELEVANCE: This 2-year Challenge Grant will conduct an initial and exploratory validation study of the NIH Toolbox in the acute neurologic inpatient rehabilitation environment. The Toolbox assesses diverse neurologic functions (cognition, emotion, sensation, and movement) in a 2-hour examination. The proposed research will determine the sensitivity and specificity of the Toolbox to acute neurological illness and its feasibility with assessing adult inpatients with a wide variety of debilitating neurological disorders.

描述（由申请人提供）：本申请涉及挑战领域（05）：比较有效性研究和特定挑战主题05-NS-103，验证NIH在神经系统疾病人群中的新临床工具。在新的临床工具中，有一种是NIH的神经发育评估工具，这是一种2小时的评估工具，用于对特定临床人群进行标准化评估，以研究神经发育和变化、疾病恢复和治疗干预。该系统将各种神经学评估集成到一个单一的仪器中。评估组合包括4个广泛的神经系统领域（认知、情感、感觉和运动），并在可能的情况下纳入计算机化测试。在广泛的多站点开发规范数据范围后，最终的可持续发展测试组件将于2009年10月提供。届时，研究可以开始测试工具箱在特定神经病学人群中的有效性和可行性。这项为期2年的挑战补助金研究将评估急性康复住院人群中的可行性和初步验证。神经康复领域目前缺乏一种综合的、全面的、多学科的和多功能的评估工具来评估各种和常见的急性致残性神经障碍（例如，中风、创伤性脑损伤、肿瘤后手术）。因此，在住院患者的治疗和出院计划，并通过实验测试神经功能恢复的综合假设，神经功能缺损可能最终被证明是有价值的。我们的研究将测试120名成人急性康复住院患者谁是从致残性脑功能障碍恢复。我们将他们的研究结果与120名没有已知脑部疾病的康复住院患者进行比较，以区分住院的一般影响（例如，从多种药物，并发的医疗疾病），从而确定的灵敏度和特异性急性脑疾病的神经网络。我们还将测试120名来自住院患者照顾者的社区生活、年龄相似、大脑健康的参与者，以控制评估患者时社会经济背景、年龄、种族和原籍地区的影响。我们的对照人群也将为国家健康数据集提供有价值的规范性数据。我们的研究还将通过确定简易精神状态检查是否可以区分哪些患者能够或不能遵守测试，来确定认知障碍对评估的限制。这一可行性分析将有助于随后的建议，以针对谁是最有能力进行评估的病人与心脏病。 公共卫生关系：这项为期2年的挑战补助金将在急性神经科住院康复环境中对NIH神经病学研究进行初步和探索性验证研究。工具箱在2小时的检查中评估多种神经功能（认知、情感、感觉和运动）。拟议的研究将确定急性神经系统疾病的敏感性和特异性，以及评估患有各种衰弱性神经系统疾病的成年住院患者的可行性。