Dizziness in the Emergency Department: A Population-Based Project

描述（由申请人提供）：头晕是门诊护理环境中最常见的主诉之一。最新进展显着提高了诊断和治疗常见头晕原因的能力，但这些信息可能无法充分传播给一线医生或培训主管，因为头晕专家并不常见。因此，缺陷和效率低下可能是普遍存在的，也许无处不在，但没有大规模的人口为基础的研究集中在评估这一重要问题。通常，患者进行广泛的评估，寻找中枢神经系统病因，而良性外周前庭 疾病得不到治疗，或者相反，当早期严重疾病是原因时，假定为良性疾病。因此，头晕患者的疾病负担和医疗保健利用可能不必要地高，但这些重要指标也尚未在基于人群的研究中确定。这些因素在确定NIH宣布优先考虑的疾病的影响方面至关重要。急诊科（艾德）是一个适当的设置，以集中初步的努力，因为头晕是常见的艾德和努力，以改善艾德过度拥挤是迫切需要的。利用在一项已建立的、NIH资助的、基于人群的研究中确定的患者，即科珀斯克里斯蒂脑攻击监测（BASIC）项目，我们假设这些患者的疾病负担和医疗保健利用率很高。在未来的R01应用中，解决本研究的重要发现可能会提高护理质量，降低医疗保健支出，并减少艾德过度拥挤。BASIC项目在招募大量受试者方面取得了成功，并与社区和当地公共卫生部门进行了长期合作。该候选人是一名接受过神经耳科培训的神经学家，致力于以患者为导向的研究。该申请提出了一个5年计划，包括通过密歇根大学的K30 NIH临床研究培训计划进行正式培训，以将候选人培养成为独立的临床研究人员。该K30计划包括核心课程，个性化的科学咨询委员会和针对重点研究领域的小组研讨会。一流的公立大学和导师的一流资源，在培养专注于这个和未来项目的关键要素的职业方面取得了成功，使密歇根大学成为理想的大学。 候选人的环境。相关性：识别护理缺陷对于提高护理质量、减少医疗支出和减少艾德过度拥挤至关重要。

DESCRIPTION (provided by applicant): Dizziness is among the most common principal complaints in the ambulatory care setting. Recent advances significantly improve the ability to diagnose and treat common causes of dizziness but this information may not be adequately disseminated to frontline physicians or training directors because specialists in dizziness are not common. As a result, deficiencies and inefficiencies are likely to be prevalent, perhaps ubiquitous, but no large population-based study has focused on evaluating this important issue. Often patients undergo extensive evaluations searching for central nervous system etiologies while a benign peripheral vestibular disorder goes untreated, or conversely a benign disorder is assumed when an early severe disorder is the cause. Therefore, burden of illness and healthcare utilization may be unnecessarily high in patients with dizziness, but these important measures also have not been determined in population-based studies. These factors are critical in determining the impact of an illness which the NIH has declared a priority. The emergency department (ED) is an appropriate setting to focus initial efforts because dizziness is common in the ED and efforts to improve ED overcrowding are desperately needed. Utilizing patients identified in an established, NIH funded, population-based study, the Brain Attack Surveillance In Corpus Christi (BASIC) project, we hypothesize that .0ed and that burden of illness and healthcare utilization are high among these patients. In a future R01 application, addressing the important findings of this study may improve quality of care, decrease healthcare expenditures, and decrease ED overcrowding. The BASIC project has demonstrated success in recruiting large numbers of subjects and involves long-term collaboration with the community and local Public Health Department. The candidate is a neurologist fellowship trained in neuro-otology, dedicated to a career in patient- oriented research. This application proposes a 5-year plan, including formal training through the K30 NIH Clinical Research Training program at the University of Michigan, to develop the candidate into an independent clinical researcher. This K30 program includes a core curriculum, individualized scientific advisory committee, and small group seminars on focused areas of research. Superb resources of a top public university and mentors with demonstrated success in fostering careers focused on key elements of this and future projects makes the University of Michigan an ideal environment for the candidate. Relevance: Identifying deficiencies in care is critical to improving quality of care, reducing healthcare expenditures, and decreasing ED overcrowding.