National Endoscopic Database of the Clinical Outcomes Research Initiative

描述（由申请人提供）： 内镜检查在消化系统疾病的诊断和治疗中起着重要作用。据估计，在美国每年进行超过2000万例内窥镜手术。临床结局研究计划（科里）于20世纪90年代开发，旨在收集来自不同实践环境的内窥镜检查数据，目的是测量利用率和结局，以改善内窥镜检查实践。该联盟包括70个实践中的内窥镜医生，他们使用计算机生成内窥镜报告，这些报告以电子方式发送到中央数据库。资料库每年收到260 000多份报告。该联盟已经完成了内窥镜检查实践的描述性分析和前瞻性研究。自1999年以来，科里一直由NIDDK资助，并在同行评审的期刊上发表了47篇论文，涵盖了内窥镜检查的广泛主题，并获得了其他联邦和基金赠款，以支持特定的研究项目。目前建议的具体目的是利用现有的内窥镜数据库和联盟进行研究，这将提高内窥镜实践的质量。有三个主要主题。主题一：实践分析。这些研究将通过首先确定当前的实践模式和测量关键的内窥镜结果来确定改善实践的机会。我们将确定“最佳做法”和随着时间的推移在实践中的变化。主题二：提高内镜诊疗质量。我们将测量内窥镜质量指标，并研究旨在实现最佳实践的干预措施的影响。这些干预措施将包括将教育准则嵌入计算机软件，并向个别提供者提供个人质量保证报告。主题3：这个独特的数据库将成为美国和国外研究和公共卫生界的资源。 公共卫生相关性：内窥镜检查是美国最常进行的侵入性手术之一。科里进行了第一项研究，以衡量不同实践环境中的内窥镜实践质量。当前提案的主要目标是使用内窥镜数据库来监测实践，以确定质量改进的领域，并制定干预措施以提高质量。

DESCRIPTION (provided by applicant): Endoscopy plays an important role in the diagnosis and management of digestive diseases. It is estimated that more than 20 million endoscopic procedures are performed annually in the United States. The Clinical Outcomes Research Initiative (CORI) was developed in the 1990's to collect endoscopy data from diverse practice settings with goal of measuring utilization and outcomes to improve the practice of endoscopy. The consortium includes endoscopists in 70 practices, who use a computer to generate endoscopy reports which are sent electronically to a central data repository. The repository receives more than 260,000 reports annually. The consortium has completed both descriptive analyses of endoscopy practice and prospective studies. CORI has been funded by NIDDK since 1999, and produced 47 manuscripts in peer-reviewed journals covering a broad range of topics in endoscopy, and received other federal and foundation grants to support specific research projects. The specific aim of the current proposal is to use the existing endoscopic data repository and consortium to perform research which will improve the quality of endoscopic practice. There are three primary themes. Theme 1: analysis of practice. These studies will identify opportunities for improving practice by first identifying current practice patterns, and measuring key endoscopic outcomes. We will determine "best practices" and changes in practice over time. Theme 2: improving quality of endoscopic practice. We will measure endoscopic quality indicators and study the impact of interventions designed to achieve best practices. These interventions will include embedding educational guidelines into computer software and providing personal quality assurance reports to individual providers. Theme 3: This unique data repository will be a resource to the research and public health community in the United States and abroad. PUBLIC HEALTH RELEVANCE: Endoscopy represents one of the most commonly performed invasive procedures in the United States. CORI has performed the first studies to measure the quality of endoscopic practice in diverse practice settings. The primary goals of the current proposal are to use the endoscopic database to monitor practice over time to identify areas for quality improvement, and to develop interventions to improve quality.