Gastrointestinal Surgery Outcomes Research Fellowship

项目总结/摘要 美国人一生中平均要接受9次外科手术或介入手术，其中许多与癌症有关。 消化道疾病或与肥胖相关的病症。尽管很常见，但大多数 这些程序的有效性没有经过严格的评估。此外，最佳做法 需要实现最佳结局、人群水平结果、患者报告的观点和成本 还需要考虑到一些因素。随着医疗保健系统努力提供更大的价值， 他们提供的护理的有效性，解决这些差距至关重要。造成这种短缺的一个原因是， 对通常用手术治疗的胃肠道疾病进行严格的临床研究， 为外科医生提供卫生服务、临床试验和比较有效性研究方面的培训。为了解决这个 需要，我们建议继续华盛顿大学的T32奖学金在临床，卫生服务， 和外科医生的比较有效性研究。该奖学金包括教学培训和实践 在先进的临床研究方法方面的经验，重点是与胃肠道相关的干预措施 系统、糖尿病和肥胖相关疾病。培训集中在6个领域（研究使用 观察数据，以患者为中心的结局和偏好评估，卫生经济学和行为 医疗保健经济学，实施和卫生系统科学，临床试验和研究操作 管理），旨在培养外科医生学者谁将是成功的科学家和领导者， 学术医学教学部分包括导致公共卫生硕士或 理学硕士学位。学员完成一套项目和研究使用全方位的研究 方法和途径。培训生的经验是由一个结构化的导师计划，由 研究人员谁有一个职业生涯的承诺，以培训和证明成功的高层次的研究， 将证据融入实践。研究员领导的许多项目涉及与一个独特的， 45家医院的全州数据共享网络和15个国家40多家医院的国家研究平台 states.这些网络允许进行观察性队列研究，并支持进行随机试验， 常见胃肠道病症的管理（例如，阑尾炎和憩室炎）。学员 参加两年的奖学金，然后再参加3-5年的临床培训。过去和 目前的研究员有高水平的研究成功判断的出版物和介绍， 该方案对受训者、社区和国家产生了相当大的影响。以前的受训人员， 完成了临床培训，现在正在担任学术职务，并取得了成功， 独立调查员。本周期培训计划的重大变化包括更加注重 临床试验和学习卫生系统研究有关胃肠道疾病。这种强调 与导师领导的资助RCT和卫生系统科学研究数量的增加相平行。

PROJECT SUMMARY/ABSTRACT The average American undergoes nine surgical or interventional procedures over their lifetime, many related to diseases of the digestive track or conditions associated with obesity. Despite being common, most of these procedures have not been subjected to rigorous evaluation of their effectiveness. In addition, the best practices needed to accomplish the best outcomes, population-level results, patient-reported perspectives, and cost considerations have yet to be addressed. As healthcare systems strive to deliver greater value and increase the effectiveness of the care they deliver, addressing these gaps is critical. One reason for the shortfall in rigorous clinical research in gastrointestinal conditions commonly treated with surgery is a paucity of formal training in health services, clinical trials, and comparative effectiveness research for surgeons. To address this need, we propose the continuation of the University of Washington's T32 fellowship in clinical, health services, and comparative effectiveness research for surgeons. This fellowship involves didactic training and practical experience in advanced clinical research methodology focused on interventions related to the gastrointestinal system, diabetes, and obesity-related conditions. The training is focused in 6 areas (research using observational data, patient-centered outcome and preference assessment, health economics and behavioral economics in healthcare, implementation and health system science, clinical trials, and research operations management) and is intended to develop surgeon-scholars who will be successful scientists and leaders in academic medicine. The didactic component includes coursework that results in a Master of Public Health or Master of Science degree. Trainees complete a set of projects and studies using the full spectrum of research methods and approaches. The trainee's experience is fostered by a structured mentorship program, led by investigators who have a career commitment to training and demonstrated success in high-level research and integrating evidence into practice. Many of the projects led by fellows involve collaboration with a unique, statewide data sharing network of 45 hospitals and a national research platform of over 40 hospitals in 15 states. These networks allow for observational cohort studies and support the conduct of randomized trials in the management of common gastrointestinal conditions (e.g., appendicitis and diverticulitis). Trainees participate in the fellowship for two years and then serve an additional 3-5 years of clinical training. Past and current fellows have had high levels of research success judged by publications and presentations, and the program has had a considerable impact on trainees, the community, and the nation. Prior trainees who have completed their clinical training are now taking academic positions and have been finding success as independent investigators. The significant changes planned for the training in this cycle include a greater focus on clinical trials and learning health systems research related to gastrointestinal conditions. This emphasis parallels the increased number of funded RCTs and health system science studies being led by the mentors.