CLINICAL OUTCOMES RESEARCH: AN ENDOSCOPIC DATABASE

提高医疗质量和降低医疗成本的压力促使人们有必要了解医疗干预措施的有效性，例如胃肠道(GI)内窥镜检查。尽管内窥镜手术被广泛使用，但人们对社区环境中的内窥镜实践模式和患者结局知之甚少。研究内窥镜检查程序的理想方法是直接找到来源：内窥镜检查报告。随着计算机化数据库的出现，现在可以在生成内窥镜报告的同时创建数据文件。我们已经开发了一个由不同实践环境中的GI专家组成的网络，他们使用通用的计算机化内窥镜报告生成器。来自这些临床附属机构的内窥镜数据以电子方式传输到中央数据储存库，并与来自多个临床附属机构的数据合并以进行分析。然后，这些合并的数据可用于检查实践模式和解决重要的研究问题。基于建立内窥镜研究临床网络的丰富经验，我们的团队能够满足当前提案中规定的要求是独一无二的。这项建议的主要目标是利用现有的内窥镜数据库来获取信息，以提高胃肠病学临床实践的质量。这项提议的具体目标是利用内窥镜数据库：对内窥镜检查结果的利用率、频率和严重性、实践模式、实践变化(地理区域、临床实践类型)和患者人口统计(年龄、性别、种族)进行描述性分析。。使用描述性分析形成制定假设和风险分层的基础。。观察慢性胃肠道疾病的自然病史，并确定适当的监测间隔时间。。决定内窥镜治疗和新的内窥镜创新的成功和有效性。。确定内窥镜诊断和治疗对患者预后的影响。。评估内窥镜并发症的频率和并发症的危险因素。。将数据库用于特定的研究项目，并为临床试验创建患者登记。

Pressure to improve quality and lower cost of health cre has created the need to understand the effectiveness of medical interventions, such as gastrointestinal (GI) endoscopy. Despite widespread use of endoscopic procedures, very little is known about endoscopic practice patterns and patient outcomes in community-based settings. The ideal method for studying endoscopic procedures is to go directly to the source: the endoscopy report. With the advent of computerized databases, it is now possible to generate endoscopic reports while simultaneously creating a data file. We have developed a network of GI specialists in diverse practice settings who utilize a common computerized endoscopic report generator. Endoscopic data from these Clinical Affiliates is transmitted electronically to a centralized data repository and merged with data from multiple Clinical Affiliates for analysis. These merged data can then be used to examine practice patterns and address important research questions. Based on extensive experience in building a clinical network for endoscopic research our group is unique able to meet the requirements stipulated in the current proposal. The primary goal of this proposal is to use the existing endoscopic database to acquire information that will improve the quality of clinical practice in gastroenterology. The specific aims of this proposal are to use the endoscopic database to: . Perform descriptive analyses of utilization, frequency and severity of endoscopic findings, practice patterns, practice variation (geographic region, type of clinical practice), and patient demographics (age, gender, race). . Use descriptive analyses to form the basis for developing hypotheses and risk stratification. . Observe the natural history of chronic GI diseases, and determine appropriate intervals for surveillance. . Determine the success and effectiveness of endoscopic therapies and new endoscopic innovations. . Determine the impact of endoscopic diagnoses and therapies on patient outcomes. . Evaluate the frequency of endoscopic complications, and risk factors for complications. . Use the database for specific research projects and to create patient registries for clinical trials.