ETHNIC DISPARITY IN THE USE OF JOINT ARTHROPLASTY

5.对候选人的环境和机构承诺。 5.制度环境描述 Dennis Ang博士是风湿病学系临床医学助理教授 在密歇根州立大学医学院的医学系。学术环境为博士提供了帮助。 以及为他的职业发展提供关键资源，每一种资源如下所述。 印第安纳大学医学院：在过去的3年里，为印第安纳大学医学院提供的外部资金 药费从7500万美元上涨到1.05亿美元。它在PHS/NIH医学院中排名34M 它的医学系在全国所有医学部中排名第15位。 1989年，研究投资基金成立，承诺投入约22%的回收资金 在印第安纳大学进行研究开发的间接成本。该基金支持研究的发展 资源，以及跨学科研究的新举措。第二个项目，研究冒险 该奖项还支持研究方面的举措。从1998年开始，新成立的克莱安健康公司 研究委员会建议拨出3,000,000元，以支持 基础设施和直接支持的形式。王博士目前一半以上的工资来自于 印第安纳大学医学院。 印第安纳大学风湿科：风湿科成立于1975年 随着马里兰州肯尼斯·勃兰特印第安纳大学的到来。临床研究一直在不断增长 风湿科自那时以来的部分活动，支助来自 国家卫生研究院(NIH)和制药业。NIH的支持包括 继续资助一个多用途关节炎肌肉骨骼疾病中心，以及几个人 研究人员补助金(RO-1)和方案项目类型补助金。制药业赞助 项目包括研究人员发起的研究，以及行业发起的多中心临床研究 审判。伊利诺伊大学风湿科是全国以风湿性关节炎为主的三个科室之一 研究重点。已被研究的治疗药物包括止痛药、非类固醇 抗炎药(NSAIDs)、关节内透明质酸盐制剂和“新型”药物。这个 风湿科位于龙医院大楼(伊利诺伊州医学中心的一部分)的5楼， 勃兰特博士和昂博士的办公室所在的地方。四名全职研究护士(三名RN， 1个LPN)协助该司的研究活动。勃兰特博士慷慨地同意提供 资助候选人的一名兼职研究助理和一名全职研究助理 研究项目，如果这项申请是由美国国立卫生研究院资助的。 多功能关节炎和肌肉骨骼疾病中心(MAC)：该中心由一个 生物医学研究部分，教育/流行病学/卫生服务研究(EEHSR) 组件和一个管理单元。该中心的使命是追求主要的生物医学 与风湿病相关的研究兴趣。最近，该中心成为了领头羊 多西环素的临床研究及其预防关节损伤进展的机制 由骨质疏松症引起。这项研究由美国国立卫生研究院830万美元的拨款资助。肯尼思·勃兰特博士是校长 这项全国性研究的调查员，也是该中心的首席主任。该中心支持 王博士通过获得秘书和计算机协助。候选人的办公室毗邻 关节炎中心。 雷根斯特里夫卫生保健研究所(RIHC)：RIHC成立于1969年，目前仍在维持 由慈善机构雷根斯特里夫基金会赞助。RIHC有18名全职调查人员(包括 库尔特·克伦克博士)，以及另外9名全职调查人员担任附属科学家职位。RIHC 为一个包括12名卫生实习生的奖学金计划提供大量实物支持 服务研究、医学信息学和老年学。获得真正丰富和支持性的研究 应聘者有合适的工作环境。事实上，Teresa Damush博士，一位社会心理学家(拥有 专注于健康心理学)和RIHC的全职调查员已同意担任 43 这个项目。(见达穆什博士的支持声明)。雷根斯特里夫研究所还容纳了8名 在候选人的研究提案中起关键作用的数据经理。RIHC是步行距离(2 几分钟)，离王博士的办公室很远。 Reqenstrief病历系统(RMRS)：RMRS是最大的一般医疗数据之一 世界上最大的系统。RMRS成立于1974年，已登记了100多万名患者， 有200多万条口述记录，每年有近500万次访问。目前， 印第安纳波利斯及周边地区的40多家住院和门诊机构正在使用RMRS。 是美国最大的编码、连续运行的病历系统 各州。它为数据库研究、基于计算机的干预、 以及医学信息学方面的培训。Ang博士可以从他的办公室电脑访问RMR。 综合临床研究中心(GCRC)：GCRC的主要目的是支持患者 由公共卫生服务资助的研究。GCRC支持相当大比例的 在印第安纳大学医学院拥有PHS/NIH基金的教职员工。GCRC用户对以下项目的赠款支持 1996-1997年超过4500万美元(直接)，其中超过3200万美元来自联邦来源，超过 来自工业的900万美元和来自基金会的超过150万美元。项目总监，门罗 皮科克，医学博士，于1987年7月被任命。GCRC是

5. ENVIRONMENT AND INSTITUTIONAL COMMITMENT TO CANDIDATE. 5 A. Description of Institutional Environment Dr. Dennis Ang is a Clinical Assistant Professor of Medicine in the Division of Rheumatology and in the Department of Medicine at IU School of Medicine. The academic environment provides Dr. Ang with critical resources for his professional development, and each is described below. Indiana University School of Medicine: Over the last 3 years the extramural funding for the School of Medicine rose from $75 million to $105 million. It ranks 34mamong schools of medicine in PHS/NIH funding, while its Department of Medicine ranks 15t" among all departments of medicine nationwide. In 1989, the Research Investment Fund was established to commit approximately 22% of recovered indirect costs to research development at IU. This Fund supports development of research resources, and new initiatives in interdisciplinary research. A second program, the Research Venture Award, also supports initiatives in research. Beginning in 1998, the newly formed Clarian Health Research Committee recommended that $3,000,000 be available to support clinical research in the form of infrastructure and direct support. More than half of Dr. Ang's current salary comes from the Indiana University School of Medicine. Indiana University Division of Rheumatology: The Rheumatology Division was established in 1975 with the arrival at Indiana University of Kenneth Brandt, MD. Clinical research has been a growing part of the activities of the Rheumatology Division since that time, with support coming from both the National Institutes of Health (NIH) and the pharmaceutical industry. NIH support has included continuous funding of a Multipurpose Arthritis Musculoskeletal Disease Center, and several individual investigator grants (RO-1), and program project-type grants. Pharmaceutical industry-sponsored projects have included investigator-initiated studies, as well as industry-initiated multi-center clinical trials. IU Division of Rheumatology is one of three Divisions in the country where OA is primary research focus. Therapeutic agents that have been investigated include analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), intra-articular hyaluronate preparations, and "novel" drugs. The Rheumatology Division is on the 5thfloor of the Long Hospital Building (part of IU Medical Center), where the offices of Dr. Brandt and Dr. Ang are located. Four full-time research nurses (three RNs, one LPN) assist in the research activities of the division. Dr. Brandt has generously agreed to provide funding for one part-time research associate and one full-time research assistant for the candidate's research project if this application is funded by NIH. Multipurpose Arthritis and Musculoskeletal Disease Center (MAC): The Center consists of a Biomedical Research Component, an Education/Epidemiology/Health Services Research (EEHSR) Component, and an Administration Unit. It is the mission of the Center to pursue major biomedical research interests relevant to the rheumatic diseases. Most recently, the center became the lead institution in a clinical study of doxycycline and its ability to prevent the progression of joint damage caused by OA. The study is funded by an $8.3 million NIH grant. Dr. Kenneth Brandt is principal investigator for the nationwide study and also the principal director of the center. The center supports Dr. Ang through access to secretarial and computer assistance. The candidate's office is adjacent to the Arthritis Center. Regenstrief Institutefor Health Care (RIHC): The RIHC was established in 1969 and is maintained by the philanthropic Regenstrief Foundation. The RIHC houses 18 full-time investigators (including Dr. Kurt Kroenke), and an additional 9 full-time investigators hold affiliated scientist positions. RIHC provides substantial in-kind support for a fellowship program that includes 12 trainees in health services research, medical informatics, and geriatrics. Access to truly rich and supportive research environment is available to the candidate. In fact, Teresa Damush PhD, a social psychologist (with a focus in health psychology) and full-time investigator in RIHC has agreed to serve as a consultant for 43 this project. (See Statement of Support from Dr. Damush). The Regenstrief Institute also houses 8 data managers who are crucial in the candidate's research proposal. RIHC is walking distance (2 minutes) away from Dr. Ang's office. Reqenstrief Medical Record System (RMRS): RMRS is one of the largest general medical data systems in the world. Established in 1974, the RMRS has registered more than 1 million patients, has over 2 million dictated records, and is accessed nearly 5 million times each year. Currently, the RMRS is used at more than 40 inpatient and outpatient facilities in Indianapolis and surrounding counties and is the largest coded, continuously operated medical records system in the United States. It provides innumerable opportunities for database research, computer-based interventions, and training in medical informatics. Dr. Ang can access RMRS from his office computer. General Clinical Research Center (GCRC): The primary purpose of the GCRC is to support patient research funded by the Public Health Service. The GCRC supports a substantial proportion of the faculty holding PHS/NIH funding at IU School of Medicine. The grant support of GCRC users for 1996-1997 was over $45,000,000 (direct) with over $32,000,000 from federal sources, over $9,000,000 from industry and over $1,500,000 from foundations. The Program Director, Munro Peacock, M.D., was appointed in July 1987. The GCRC was