Assessing and Predicting Outcomes in Children with Minor Injury

描述（由申请人提供）：该研究者是一名儿科急诊医学（PEM）临床医生，其长期目标是成为该领域的独立临床研究者，在儿科急诊科（FED）护理后以患者为导向的结果评估方面具有专业知识。这些短期结果包括与健康相关的生活质量（HRQOL）和家庭影响，以及感兴趣的临床标志物。这项工作是评估美联储对儿童照顾有效性的关键先决条件，其中大部分目前都没有证据。这个项目的总体目标是描述在联邦医疗服务中心治疗轻微伤害的儿童的短期结果，为这些儿童在联邦医疗服务中心出院后制定定量的结果衡量标准，并创建一个预测工具来识别有不良结果风险的儿童。在损伤、PEM、流行病学和儿科健康状况测量方面的知名研究人员的指导下，候选人提出了一个量身定制的职业发展计划，该计划将导师指导的临床研究和独立学习教程与教学课程和研讨会相结合。该计划将为我的短期目标提供必要的理论和研究技能培训：1)增加损伤研究的知识和方法技能，以及儿童HRQOL和健康状况测量的使用，开发和验证，2)有效地沟通我的研究想法和发现，3)有效地管理我的研究生涯，4)建立和维护我的领域同事网络。本提案中计划的研究将首先描述（第一次），然后开发一种方法来衡量（定量结果量表），儿童及其家人在美联储治疗轻伤后的前两周是如何做的。最重要的是，我们可以用这种方法来测试我们目前治疗它们的方法是否有效，以及新的治疗方法如何比较。这项研究还将提供一种预测工具，使联邦储备系统的临床医生能够在联邦储备系统护理时识别出患有轻伤的儿童，这些儿童可能面临患者和家庭预后不佳的风险，从而使他们能够量身定制治疗和后续护理计划，以试图改善儿童出院后的病程。将采取重要步骤，确定和检验目前对轻伤儿童的护理所需要的变化。对轻伤护理的反应进行比较的能力，以及识别针对特定亚群体（文化、种族和社会经济）的护理问题的能力将大大促进，从而加强儿童的急诊护理。

DESCRIPTION (provided by applicant): This investigator is a pediatric emergency medicine (PEM) clinician whose long-term objective is to become an independent clinical investigator in this field, with expertise in the assessment of patient-oriented outcomes after pediatric emergency department (FED) care. These short-term outcomes include health- related quality of life (HRQOL) and family impact, as well as clinical markers of interest. This work is a critical prerequisite to evaluating the effectiveness of the care given to children in the FED, most of which is not currently evidence-based. The overall goals of this project are to describe the short-term outcomes in children after FED care for minor injury, to develop a quantitative outcomes measure for these children after FED discharge, and create a predictive tool to identify children at risk for poor outcomes. Under the mentorship of well-established investigators in injury, PEM, epidemiology, and pediatric health status measurement, the candidate proposes a tailored career development program that combines mentor-guided clinical research and an independent study tutorial with didactic courses and seminars. The plan will provide necessary training in the theory and research skills specific to my short term goals: 1) to increase knowledge and methodological skills in injury research as well as in the use, development, and validation of HRQOL and health status measures in children, 2) effectively communicate my research ideas and findings, 3) effectively manage my research career, and 4) establish and maintain a network of colleagues in my field. The research planned in this proposal would first describe (for the first time), then develop a way to measure (a quantitative outcome scale), how children and their families do in the first 2 weeks after care in the FED for minor injury. Most importantly, we could use the measure to test if our current ways of treating them are effective, and how new treatments would compare. This research would also provide a predictive tool that would allow FED clinicians to identify children with minor injury, at the time of their FED care, who are at risk for poor patient and family outcomes, allowing them to tailor treatment and follow-up care plans to try to improve the child's course after discharge. Important steps towards the identification and testing of needed changes in current care for children with minor injuries will be made. The ability to make comparisons of the responses to care of minor injury, and identify care issues specific to particular subgroups (cultural, ethnic, and socioeconomic) of the FED population will be greatly facilitated, thus enhancing the ED care of children.