Building Musculoskeletal Outcomes Research at the University of Iowa

描述（由申请人提供）：在过去的八年里，我和我的同事一直在系统地进行骨质疏松症和关节成形术领域的以患者为导向的研究。在骨质疏松症领域，通过一系列渐进式研究，我们探索了如何最好地向患者传达双能X射线骨密度测量（DXA）结果，以及更广泛地，如何向患者传达测试结果。具体来说，我们已经研究了DXA检测中心如何通过将结果直接邮寄给患者来减少DXA结果的“遗漏”，提高患者的满意度和骨质疏松症的治疗。在骨科领域，我们系统地评价了全髋关节置换术（THA）和全膝关节置换术（TKA）结局和使用的变化。目前的K24中期职业研究者奖的目的是让我增加我在骨质疏松症和骨科领域的学员指导。在爱荷华州大学，特别是在内科专科和矫形外科中，非常需要这种指导。我们精心设计了三个项目，将在以下领域推进科学：A）DXA结果与患者的沟通; B）THA和TKA结局的评价。具体项目有：1）研究向患者传达DXA结果和骨折风险的最佳文本和图形方法; 2）将UI关节置换术数据纳入国家关节 登记册由AHRQ供资;和3）探讨关节置换术结局的变化和关键患者亚组（包括男性和女性以及老年人和年轻人）的利用率。这些项目将使学员能够参与尖端研究，同时接受定性和定量方法的培训。同样，这些研究将促进肌肉骨骼健康关键领域的知识。

DESCRIPTION (provided by applicant): Over the past eight years my colleagues and I have been systematically conducting patient-oriented research in the areas of osteoporosis and joint arthroplasty. In the area of osteoporosis, through a series of progressive studies, we have explored how best to communicate dual energy x-ray absoroptiometry (DXA) results to patients and, more broadly, how to communicate tests results, in general, to patients. Specifically, we have examined how DXA testing centers can reduce "missed" DXA results and improve patient satisfaction and treatment of osteoporosis by mailing results directly to patients. In the area of orthopaedics, we have systematically evaluated variations in total hip arthroplasty (THA) and total knee arthroplasty (TKA) outcomes and utilization. The objective of the current K24 Midcareer Investigator Award is to allow me to increase my mentoring of trainees in the areas of osteoporosis and orthopaedics. There is significant need for such mentoring here at the University of Iowa particularly among Internal Medicine subspecialties and Orthopaedic Surgery. We have carefully designed three projects that will advance science in the areas of: A) communication of DXA results to patients; B) evaluation of THA and TKA outcomes. The specific projects are: 1) To investigate optimal textual and graphical methods for conveying DXA results and fracture risk to patients; 2) To bring UI joint arthroplasty data into a national joint registry being funded by AHRQ; and 3) To explore variations in joint arthroplasty outcomes and utilization in key patient subgroups including men and women and older and younger adults. Together, these projects will allow mentees to be involved in cutting-edge research while being trained in qualitative and quantitative methods. Likewise these studies will advance knowledge in key areas of musculoskeletal health.