Washington Heights Initiative Community-based Comparative Effectiveness Research

描述（由申请人提供）：该项目的总体目标是通过建立现有的以机构为中心的数据基础设施，创建一个强大的以社区为中心的数据基础设施，来推进旨在改善高血压护理服务和人口结果的比较有效性研究，该数据基础设施将支持有效解决看似棘手的公共卫生问题所需的各种创新研究。这将通过以社区为中心的比较有效性研究（WICER）的华盛顿高地/因伍德信息基础设施来完成。WICER包含一个研究数据仓库，它集成了患者层面的数据，包括来自多个设施、设置和护理地点的临床数据，以及个人层面的自我报告信息，并将关联数据映射到支持前瞻性比较有效性研究的变量。它还将提供工具，支持研究人员访问这一基础设施，进行回顾性分析和招募患者进行研究。然后，我们将展示该基础设施如何支持高血压的三个比较有效性研究。这三项研究将涉及高血压患者的诊断、治疗和管理。我们的项目将增强现有的数据基础设施，通过最先进的科学工具增强访问能力，并实现数据和提供数据的医疗保健组织的更大整合。反过来，这将使我们能够进行拟议的和随后的比较有效性研究，为有效诊断和治疗高血压提供证据，并最终解决更广泛的相关社区卫生问题。

DESCRIPTION (provided by applicant): The overall goal of this project is to advance comparative effectiveness research designed to improve hypertension care delivery and population outcomes by building on an existing institution-focused data infrastructure to create a robust community-focused data infrastructure that will support the kinds of innovative studies needed to effectively tackle seemingly intractable public health problems. This will be done through the Washington Heights/Inwood Informatics Infrastructure for Community-Centered Comparative Effectiveness Research (WICER). WICER contains a research data warehouse that integrates patient-level data, including clinical data from multiple facilities, settings and sites of care, with person-level self-reported information and will map the linked data to variables that support prospective comparative effectiveness research studies. It also will provide tools to support researchers in accessing this infrastructure to perform retrospective analyses and recruit patients for research studies. We will then demonstrate how this infrastructure can support three comparative effectiveness studies on hypertension. These three studies will relate to the diagnosis, treatment and management of hypertension in patients. Our project will augment an existing data infrastructure, enhance access through state of the science tools, and achieve greater integration of both the data and the health care organizations that contribute to it. This in turn will enable us to conduct both the proposed and subsequent comparative effectiveness studies generating evidence to inform effective diagnosis and treatment of hypertension, and ultimately a wider range of related community health problems. PUBLIC HEALTH RELEVANCE: This research has the potential to improve the evidence base for treatment hypertension and other clinical conditions for a medically underserved, minority, low income, immigrant patient population. Currently, the evidence base for care delivery is not strong for this population, resulting in disparities in health care and outcomes. Insights gained through working with this specific population will then be generalizable to other such communities and populations.