Outcomes approach clinical problems in dermatology

描述(由申请人提供)： 这项建议详细说明了一项以患者为导向的结果研究培训计划，并将这些技能应用于更好地理解皮肤病患者的护理。长期目标是将专业知识应用于各种皮肤病相关项目的结果研究，这些项目将随着医疗保健经济学面貌的变化和对资源分配的持续辩论而出现。总体假设是，受过结果研究培训的皮肤科医生将更好地装备，以改善皮肤科的患者护理。这项拟议的研究将通过以下具体目标来检验这一假设：1.获得皮肤科临床以患者为导向的结果研究所需的定量和分析技能培训。2.将这些技能应用于结果研究，利用皮肤科的通信技术加强患者护理。通信技术提供了一种新的手段，以远程医疗的形式向患者提供统一的高质量护理。最近对皮肤科门诊患者进行的一项评估通信技术知识、态度和实践的调查显示，超过65%的患者在家中可以访问和使用互联网。超过50%的人觉得使用通信技术发送医生的医疗信息或皮肤图像很舒服。下一步是评估引入远程皮肤科服务以加强患者护理的经济和实际影响。将进行成本效益分析和决策分析，以确定在我们机构提供远程皮肤科服务的可行性。接下来，将进行一项顺序对照临床试验，评估患者在培训之前和之后撰写和传输远程皮肤病数据集的能力。还将进行随机对照试验，以评估远程皮肤科的医疗效果和相关费用。将流行病学监测工具纳入纵向医疗记录将是了解疾病流行率和治疗干预质量的新步骤。作为这项建议的一部分产生的数据将使我们更好地了解皮肤科加强患者护理的战略。

DESCRIPTION (provided by applicant): This proposal details a program for training in patient-oriented outcomes research and applying these skills towards a better understanding of patient care in dermatology. The long-term objectives are to apply expertise in outcomes research in various dermatology-related projects that will emerge with the changing face of health care economics and persistent debate on resource allocation. The overall hypothesis is that dermatologists trained in outcomes research will be better equipped to improve patient care in dermatology. The proposed research will test this hypothesis via the following specific aims: 1. Acquire training in quantitative and analytical skills required for clinical patient-oriented outcomes research in dermatology. 2. Apply these skills in outcomes research to enhance patient care using communication technology in dermatology. Communication technology provides a novel means of delivering uniformly high-quality care to patients in the form of telemedicine. A recent survey of dermatology out-patients evaluating knowledge, attitude and practice of communication technology revealed that more than 65% of patient have access to and use the internet from their homes. More than 50% felt comfortable sending their physicians' medical information or images of their skin using communication technology. The next step is to evaluate the economic and practical impact of introducing a tele-dermatology service to enhance patient care. Cost-effectiveness analysis and decision analysis will be performed to determine the feasibility of a tele-dermatology service at our institution. Next, a sequentially controlled clinical trial will be performed evaluating the ability of patients to compose and transmit a tele-dermatology data set, before and after a training session. A randomized control trial will also be performed to evaluate the medical effectiveness of, and costs associated with the use of tele-dermatology. Incorporation of epidemiological surveillance tools into longitudinal medical records will be a new step in understanding disease prevalence and quality of therapeutic interventions. Data generated as part of this proposal will afford a better understanding of strategies to enhance patient care in dermatology.