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: 7937832
• 负责人: Victor William Mark
• 金额: $ 24.35万
• 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 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7937832
• 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在神经疾病人群中的新临床工具。新的临床工具之一是NIH工具箱，这是一个2小时的评估电池，已开发用于标准化特定临床人群的评估，用于神经发育和变化，疾病恢复和治疗干预的调查。该工具箱集成了各种各样的神经系统评估到一个单一的仪器。评估单元包括4个广泛的神经学领域（认知、情感、感觉和运动），并在可能的情况下结合计算机化测试。最终的工具箱测试组件将于2009年10月在标准数据范围的广泛多站点开发之后提供。到那时，研究可以开始测试工具箱在特定神经学人群中的有效性和可行性。这项为期两年的挑战基金研究将评估工具箱在急性康复住院患者中的可行性和初步验证。神经系统康复领域目前缺乏一种综合、全面、多学科和多功能的评估工具来评估各种常见的急性致残神经系统疾病（如中风、创伤性脑损伤、肿瘤后手术）后的损伤。因此，工具箱可能最终证明有价值的住院设置的治疗和出院计划，并实验测试综合假设的神经系统恢复。我们的研究将测试120名成年急性康复住院患者，他们正在从致残性脑部疾病中恢复。我们将把他们的工具箱结果与120名没有已知脑部疾病的康复住院患者进行比较，以区分住院治疗的一般影响（例如，多种药物治疗，并发医学疾病），从而确定工具箱对急性脑部疾病的敏感性和特异性。我们还将从住院患者的护理人员中抽取120名社区生活、年龄相似、大脑健康的参与者进行测试，以在评估患者时控制社会经济背景、年龄、种族和原籍地区的影响。我们的对照人口也将为国家工具箱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迷你精神状态检查是否能够区分哪些患者能够或不能够遵守测试来确定工具箱评估的认知障碍限制。这种可行性分析将有助于后续的建议，以针对谁是最有能力与工具箱进行评估的患者。