Outcomes Research in Rheumatic Diseases: A Mentoring Program

描述（由申请人提供）：本申请的目的是在贝勒医学院制定一个以患者为导向的风湿性疾病指导和研究计划。通过建立一个全面的方法和内容为基础的计划，我们将提供指导和研究机会，学生，研究员，初级医生和博士教师有兴趣追求独立的研究事业在成果研究和临床流行病学在风湿性疾病。拟议的计划将是跨学科的性质，并将促进医生和科学家之间的互动，在卫生服务研究和免疫学，过敏和流变学在贝勒医学院的部门。申请人拥有医学博士和哲学博士学位，是一名风湿病学家和临床流行病学家。她是贝勒两个部门的教师。她的研究兴趣是风湿性疾病的结果，特别是类风湿性关节炎和骨关节炎，重点是这些疾病的护理效果，患者和医生的偏好和决策过程，以及这些疾病患者报告结果的测量。拟议的计划是基于申请人目前持有的赠款和本研究所产生的计划继续项目，包括： (1)关节置换术中的决策-关节置换术的使用变化有据可查。这项研究的目的是确定患者和医生的决定因素，这种变化，并开发基于证据的决策辅助工具，以帮助患者在他们的决定。 (2)风湿性疾病患者的治疗依从性-我们正在进行一项前瞻性队列研究，以评估类风湿性关节炎和系统性狼疮患者的治疗依从性。初步数据显示，坚持是有问题的。该研究的结果将为评价多方面干预措施以提高依从性提供基础。 (3)全膝关节置换术结局的认知决定因素-尽管技术上取得了成功，但大约20-25%接受膝关节置换术的患者对结果不满意。我们正在评估一组接受膝关节置换术的患者的临床和心理社会决定因素。有证据表明，这可能与手术后前三个月内的康复不足有关。在研究结束时，我们计划开发，实施和评估围手术期干预，旨在通过目标设定和各种其他认知技术来改善结果。 (4)针灸治疗膝骨关节炎患者的医患互动对针灸疗效的影响-这是一项比较针灸和假针灸治疗膝骨关节炎的随机对照试验。本研究的主要目的是评估不同的患者-提供者沟通方式对针灸和安慰剂反应的影响。

DESCRIPTION (provided by applicant): The aim of this application is to develop a patient-oriented mentoring and research program in rheumatic diseases at Baylor College of Medicine. By establishing a comprehensive methodological and content-based program we will provide mentorship and research opportunities to students, fellows, and junior physician and PhD Faculty interested in pursuing independent research careers in Outcomes Research and Clinical Epidemiology in rheumatic diseases. The proposed program will be interdisciplinary in nature and will be facilitated by the interaction between physicians and scientists in the Sections of Health Services Research and Immunology, Allergy and Rheumatology at Baylor College of Medicine. The applicant has MD and PhD degrees and is a rheumatologist and clinical epidemiologist. She is Faculty in both Baylor Sections. Her research interests are in the outcomes of rheumatic diseases, particularly rheumatoid arthritis and osteoarthritis, with an emphasis on the effectiveness of care in these disorders, patient and physician preferences and decision-making processes, and measurement of patient reported outcome in these diseases. The proposed program is based on current grants held by the applicant and the planned continuation projects arising from this research, including: (1) Decision-Making in Joint Replacement - Variations in the use of joint replacement are well documented. The aim of the study is to identify patient and physician determinants of this variation, and to develop evidence-based decision aids to assist patients in their decisions. (2) Treatment Adherence in Patients with Rheumatic Disease - We are conducting a prospective cohort study to evaluate treatment adherence in patients with rheumatoid arthritis and systemic lupus. Preliminary data shows that adherence is problematic. The results of the study will provide the groundwork for an evaluation of a multifaceted intervention to improve adherence. (3) Cognitive Determinants of Outcomes in Total Knee Replacement- Approximately 20-25% of patients undergoing knee replacement are not satisfied with the results, despite technical success. We are evaluating the clinical and psychosocial determinants of this dissatisfaction in a cohort of patients undergoing knee replacement. There is evidence that this may be related to deficient rehabilitation within the first three months after surgery. At the end of the study, we are planning to develop, implement and evaluate a perioperative intervention designed to improve outcomes through goal-setting and various other cognitive techniques. (4) Impact of Patient-Provider Interaction in the Response to Acupuncture in Patients with Knee Osteoarthritis - This is a randomized controlled trial comparing acupuncture and sham acupuncture in the treatment of knee osteoarthritis. The main aim of the study is to evaluate the effects of different patient-provider communication styles on acupuncture and placebo responses.