Towards a diagnosis of sarcopenia: collaboration with the FNIH

描述(由申请人提供)：骨质疏松症，这里的定义是肌肉质量减少，在老年人中很常见。它是一个潜在的可改变的因素，导致肌肉无力，这与身体表现和残疾的下降密切相关。骨质疏松症仍然很难诊断，部分原因是拟议的标准没有基于临床结果，没有跨数据集进行比较和/或正式评估诊断测试特征。对于一种新的情况或治疗方法，需要广泛的结构化证据来支持正式的共识过程。在此之前，石棺减少症的诊断仍然悬而未决。虽然石棺减少症的诊断尚不清楚，但潜在的干预措施正在迅速出现，但许多试验在资格得到明确定义之前无法实施。因此，在明确石棺减少的诊断标准方面的进展可能有助于对现有文献的评估，指导未来研究的合格性和测量，并有助于在实践中创建临床治疗的适应症。为了解决对肌肉质量、力量和衰老的进一步证据的需求，在美国国立卫生研究院基金会(FNIH)的支持下开发了一项倡议。代表9项研究和23,000多名不同老年人的研究人员被选中加入SarCopenia项目团队，该团队根据与活动障碍相关的并发和预测准确性进行汇集分析，以支持临床上重要的虚弱和低肌肉质量的标准。作为建立对石棺减少诊断达成共识的证据基础的下一步，我们建议展示我们的工作，以征求相关专业的学者和卫生保健专业人员的反馈和建议。在为期2/12天的会议基础上，我们将介绍我们的概念框架、方法和发现，以及与其他诊断方法的潜在关系。我们将使用结构化调查和互动小组方法来评估对我们初步建议的同意程度，指导进一步的分析，制作出版物，并征求卫生专业组织的书面评论。因此，这项U13提案是NIA、FNIH和多名研究人员共同发起的倡议，其目的是：1)介绍并与广泛的感兴趣的各方讨论由SarCopenia项目团队执行的数据分析的过程和结果；2)就达成一致的领域、知识中的剩余差距和进一步研究获得建议；3)为年轻研究人员提供一个场所，从事关于衰老、石棺减少和诊断测试开发的研究；以及4)传播我们的工作结果。我们的短期目标是在诊断石棺减少的循证标准上取得共识，并为其他重要的老年健康问题的循证诊断建立一个合作过程的模型。我们的长期目标是实现对石棺减少症的临床认识，并最终为其他复杂的衰老问题确定一条以循证为基础的临床诊断指南的途径。

DESCRIPTION (provided by applicant): Sarcopenia, defined here as reduced muscle mass, is common in older adults. It is a potentially modifiable contributor to muscle weakness, which is strongly related to decreased physical performance and disability. Sarcopenia remains difficult to diagnose, in part because proposed criteria have not been based on clinical outcomes, compared across data sets and/or formally evaluated for diagnostic test characteristics. For a novel condition or treatment, extensive structured evidence is needed to support formal consensus processes. Until then, the diagnosis of sarcopenia remains in limbo. While the diagnosis of sarcopenia is unclear, potential interventions are emerging rapidly, but many trials cannot be implemented until eligibility can be clearly defined. Thus progress toward clear diagnostic criteria for sarcopenia might aid in appraisal of existing literature, guide eligibility and measurement in future studies and help create indications for clinical treatments in practice. In order to address the need for further evidence about muscle mass, strength and aging, an initiative was developed under the aegis of the Foundation of the NIH (FNIH). Investigators representing nine studies and over 23,000 diverse older adults were selected to join the Sarcopenia Project Team, which has performed pooled analyses in support of criteria for clinically important weakness and low muscle mass, based on concurrent and predictive accuracy related to mobility disability. As a next step in building the evidence-base toward consensus on the diagnosis of sarcopenia, we propose to present our work for feedback and suggestions from scholars and health care professionals in relevant specialties. Based on a 2/12 day conference, we will present our conceptual framework, methods and findings, as well as potential relationships to other diagnostic approaches. We will use both structured surveys and interactive group approaches to assess agreement with our preliminary recommendations, guide further analyses, generate publications and seek written commentary by health professional organizations. Therefore the aims of this U13 proposal, a shared initiative of NIA, FNIH and multiple investigators, are to: 1) Present and discuss with a wide range of interested parties, the processes and results of the data analyses performed by the Sarcopenia Project Team, 2) Obtain recommendations for areas of agreement, remaining gaps in knowledge and further research, 3) Provide a venue for young investigators to engage in research on aging, sarcopenia, and diagnostic test development, and 4) Disseminate the results of our work. Our short term goals are to progress toward consensus on evidence-based criteria for the diagnosis of sarcopenia and to model a collaborative process for evidence-based diagnoses of other important geriatric health problems. Our long term goal is to achieve clinical recognition of sarcopenia and ultimately to define a pathway toward evidence-based clinical diagnostic guidelines for other complex problems of aging.