Mass Casualty Triage Validation Study

大规模伤亡伤员分类验证研究

• 批准号: 7943442
• 负责人: Joan Marie Culley
• 金额: $ 17.86万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7943442
• 关键词: Acute; Address; Adult; Age; Area; Benchmarking; Biocompatible Materials; Caring; Categories; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chemicals; Chlorine; Classification; Clinical; Code; Consensus; Data; Data Set; Development; Disasters; Effectiveness; Emergency Situation; Environmental Health; Event; Goals; Health; Health Personnel; Healthcare; Informatics; Information Services; Injury; Intervention; Life; Link; Measurement; Measures; Medical; Medical Research; Modeling; Outcome; Outcome Study; Oxygen; Patients; Physiological; Publishing; RQ2; Randomized; Research; Resources; Respiratory Signs and Symptoms; Severities; Sorting - Cell Movement; Source; South Carolina; Statistical Models; Symptoms; System; Testing; Time; Training; Transportation; Triage; United States; United States National Library of Medicine; chemical incident; decision research; demographics; emergency service responder; hazard; improved; injured; innovation; interest; medical attention; prevent; prospective; public health research; research study; tool; validation studies

DESCRIPTION (provided by applicant): The management of large numbers of injured patients expected during catastrophic events - either from natural, unintended or deliberate incidents (e.g. 'all hazards events') could quickly overwhelm existing healthcare resources jeopardizing the lives of victims and healthcare providers. No consensus currently exists on standardized definitions or data needed for effective mass casualty triage. No outcome studies validate data needed for incidents involving chemical, radiological, or biological material, and none are appropriate for use with victims of all ages. Our broad long-term goal is to validate the accuracy of triage systems that are appropriate for use in chemical events with adult victims. We propose a study using health outcome data from a large chlorine leak to determine whether the data collected in four triage systems accurately predict actual clinical status. Six datasets collected from a chlorine leak that occurred in 2005 include patient demographics, exposure estimates, symptoms, outcome categories, and physiological measurements for more than 900 victims. Research studies published on these data indicate that oxygen saturation was predictive of acute medical outcomes. These data will be used to address the following specific aims: 1) Generate a research dataset useful for further analysis by linking actual data from six chlorine leak datasets to explore measures for completeness and robustness (to test RQ1). 2) Develop a statistical model using medical outcome categories and oxygen saturation levels as measures of medical outcome to compare four adult triage systems (to test RQ1). 3) Evaluate the ability of four adult triage systems to accurately predict medical outcomes using the statistical model (SA2) and research dataset (SA1). 4) Explore the development of a data driven model to triage patients using the research dataset (SA1) to predict medical outcomes for adults (to test RQ2). Research questions that frame the study: 1) What is the association between data collected in the four adult triage systems most frequently used in the U.S. and severity of respiratory signs/symptoms necessitating medical intervention from chlorine leak patient datasets? 2) What additional information in an adult mass casualty triage system sufficiently improves the prediction of an accurate triage classification for initial treatment that involves a chemical incident?

描述（由申请人提供）：在灾难性事件期间预期的大量受伤患者的管理-无论是自然的，意外的还是故意的事件（例如“所有危害事件”）都可能迅速压倒现有的医疗资源，危及受害者和医疗保健提供者的生命。对于有效的大规模伤亡分类所需的标准化定义或数据，目前还没有达成共识。没有任何成果研究证实涉及化学、放射性或生物材料的事件所需的数据，也没有任何研究适合用于所有年龄的受害者。我们广泛的长期目标是验证适合用于成年受害者的化学品事件的分类系统的准确性。我们提出了一项研究，使用从一个大的氯泄漏的健康结果数据，以确定是否在四个分流系统收集的数据准确地预测实际的临床状态。从2005年发生的氯泄漏收集的六个数据集包括患者人口统计数据，暴露估计，症状，结果类别和900多名受害者的生理测量。根据这些数据发表的研究表明，血氧饱和度可预测急性医疗结果。这些数据将用于实现以下具体目标：1）通过链接六个氯泄漏数据集的实际数据来生成可用于进一步分析的研究数据集，以探索完整性和稳健性的措施（测试RQ 1）。2)开发一个统计模型，使用医疗结果类别和血氧饱和度水平作为医疗结果的指标，以比较四种成人分诊系统（以检验RQ 1）。3)使用统计模型（SA 2）和研究数据集（SA 1）评估四个成人分诊系统准确预测医疗结局的能力。4)探索数据驱动模型的开发，使用研究数据集（SA 1）对患者进行分类，以预测成人的医疗结局（以测试RQ 2）。研究框架的研究问题：1）在美国最常用的四个成人分诊系统中收集的数据与氯气泄漏患者数据集中需要医疗干预的呼吸体征/症状的严重程度之间的关联是什么？2)成人大规模伤亡分类系统中的哪些额外信息足以提高对涉及化学事件的初始治疗的准确分类分类的预测？