Clinical Epidemiology and Health Services Research (CEHSR)

项目总结(见说明)： 对观察性HIV临床研究以补充随机对照试验提供的宝贵信息的需求大幅增长，这就是为什么我们于1997年在华盛顿大学(UW)建立了CFAR临床流行病学和卫生服务研究(CE&HSR)项目，并成为美国首批这样做的CFAR之一。UW CE和HSR Core开创了艾滋病毒/艾滋病研究所需的临床艾滋病毒数据标准化、内容和整合的先河，并已成为地方、国家和国际基于队列的卫生研究的关键引擎，这对该领域以及艾滋病毒感染者的临床护理和结果产生了巨大影响。UW/FHRC CFAR CE和HSR核心将致力于以下具体目标：1.促进改善艾滋病毒疾病结果的比较有效性研究：促进和支持艾滋病毒/艾滋病临床研究，将常规临床护理中艾滋病毒感染患者的治疗策略的有效性进行比较，包括管理与艾滋病毒相关的严重慢性疾病，如心血管、肾脏和肝脏疾病，以改善艾滋病毒疾病结果。核心正在组建慢性病研究小组，以制定分析计划，以定义和验证在艾滋病毒相关肺部和神经并发症、心血管、肝脏和代谢性疾病领域进行研究所需的数据，并确定社会行为状况和艾滋病毒相关差异对临床结果的影响。我们将继续培训初级调查人员，并从其他学科招募新接触艾滋病毒研究的调查人员，以合作解决有关艾滋病毒/艾滋病的新问题。目的2.扩展威斯康星大学艾滋病毒信息系统(UWHIS)：提供广泛的研究专业知识和全面的前瞻性、纵向患者数据来源，以捕获快速变化的艾滋病毒治疗和结果，以支持创新的跨学科艾滋病毒/艾滋病研究。我们将促进临床研究人员、流行病学家、生物统计学家、基础科学家、社会行为和卫生服务研究人员之间的合作，使用新的方法来解决艾滋病毒/艾滋病治疗和预防方面最紧迫的问题。目的3.促进翻译和基础艾滋病毒研究：支持旨在确定艾滋病毒慢性炎症的根本发病机制和导致慢性终末器官疾病的机制的翻译和基础研究，方法是扩大在UWHIS中跟踪的UW HIV队列收集的临床样本，将其与患者数据链接并存储在UW HIV标本储存库中。

PROJECT SUMMARY (See Instructions): The need for observational HIV clinical research to complement the invaluable information provided by randomized controlled trials has grown tremendously, which is why we established the CFAR Clinical Epidemiology and Health Services Research (CE&HSR) program at the University of Washington (UW) in 1997 and were among the first CFARs in the US to do so. The UW CE&HSR Core pioneered approaches to standardization, content, and integration of clinical HIV data required for HIV/AIDS research and has become a key engine for cohort-based health research locally, nationally, and internationally, which has had tremendous impact on the field and on the clinical care and outcomes of HIV-infected individuals. The UW/FHRC CFAR CE&HSR Core will address the following specific aims: Aim 1. Facilitate Comparative Effectiveness Research to Improve HIV Disease Outcomes: promote and support HIV/AIDS clinical research comparing the effectiveness of treatment strategies for HIV-infected patients in routine clinical care, including the management of serious HIV-associated chronic diseases, such as cardiovascular, renal, and liver disease with the goal of improving HIV disease outcomes. The Core is forming Chronic Disease Study Groups to develop analysis plans for defining and validating data needed to conduct research in the areas of HIV-related pulmonary and neurological complications, cardiovascular, liver and metabolic diseases, and determining the impact of socio-behavioral conditions and HIV-related disparities on clinical outcomes. We will continue to train junior investigators and recruit investigators from other disciplines who are new to HIV research to collaborate in addressing emerging questions regarding HIV/AIDS. Aim 2. Expand the UW HIV Information System (UWHIS): provide a wide range of research expertise and a comprehensive source of prospective, longitudinal patient data capturing rapidly changing HIV treatment and outcomes to support innovative interdisciplinary HIV/AIDS research. We will promote collaboration between clinician researchers, epidemiologists, biostatisticians, basic scientists, socio-behavioral and health services researchers using novel approaches to address the most pressing questions concerning HIV/AIDS treatment and prevention. Aim 3. Facilitate Translational and Basic HIV Research: support translational and basic research aimed at defining the underlying pathogenesis of chronic inflammation in HIV and mechanisms leading to chronic end organ disease by expanding clinical specimens collected on the UW HIV Cohort tracked in the UWHIS linked to patient data and stored in the UW HIV Specimen Repository.