Developing an Innovative Decision Support Tool for Pediatric Neuromuscular Scoliosis

项目总结/摘要 该提案描述了一个为期5年的研究培训计划，为Jody Lin，MD，MS，儿科住院医师， 犹他州大学。林博士的长期目标是成为一名独立的医生科学家， 可扩展的决策支持工具，通过共享， 决策支持（SDM）。该奖项将支持林博士实现以下目标：1）获得专业知识， 决策心理学，2）在环境中接受风险沟通策略的高级培训 3）获得将实施科学应用于决策支持工具设计的经验， 4)获得领导技能，组装和管理多学科科学团队。林医生将 由一个杰出的导师团队谁是致力于她的成功和拥有不同的专业知识的支持 在决策科学（Fagerlin博士）、健康传播（Kaphingst博士）、实施科学（Asch博士） 和儿科整形外科（Narayanan博士）。林博士还有三位专家顾问， 医学复杂性、职业发展和生物统计学。 尽管SDM被广泛认为是一种有前途的方法，可以改善患有医学疾病的儿童的结果， 由于SDM的复杂性，关于如何在临床环境中改善这些儿童的SDM知之甚少。该项目将 开发并测试一种新的手术治疗决策支持工具的可行性， 神经肌肉性脊柱侧凸（NMS）儿童。该项目的目标如下。在目标1中，林博士将申请 健康沟通的新技能，以确定有效的风险沟通方法， NMS儿童决策的不确定性。在目标2中，林博士将设计一个决策支持工具， 在NMS儿童骨科咨询期间使用，包括目标1的发现。在目标3中，林博士 将对决策支助工具进行可行性和可接受性试验研究。这项研究将为 开发一项针对NMS儿童的决策支持工具的大型多中心试验。 通过本提案中的培训和研究活动，林博士将解决我们在 了解如何支持NMS儿童的治疗决策。这项研究将作为 在不断增长的儿童人群中为临床决策制定决策支持的关键模型 医学复杂性完成拟议的活动将准备林博士独立领导一个更大的 评估和发展决策支持以改善儿童群体的结果的研究计划 和患有多种共病的成年人通过更好的SDM。

PROJECT SUMMARY/ABSTRACT This proposal describes a 5-year research training program for Jody Lin, MD, MS, a pediatric hospitalist at the University of Utah. Dr. Lin’s long-term goal is to become an independent physician scientist who develops scalable decision support tools to improve outcomes for children with medical complexity through shared decision making (SDM). The award will support Dr. Lin to accomplish the following goals: 1) Gain expertise in the psychology of decision making, 2) Undergo advanced training in risk communication strategies in settings of uncertainty, 3) Obtain experience in applying implementation science to the design of decision support tools, 4) Acquire leadership skills in assembling and managing multidisciplinary scientific teams. Dr. Lin will be supported by an outstanding team of mentors who are dedicated to her success and possess diverse expertise in decision science (Dr. Fagerlin), health communication (Dr. Kaphingst), implementation science (Dr. Asch), and pediatric orthopaedics (Dr. Narayanan). Dr. Lin also has three advisors with expertise in children with medical complexity, career development, and biostatistics. In spite of broad recognition that SDM is a promising approach to improving outcomes for children with medical complexity, little is known about how to improve SDM for these children in the clinical setting. This project will develop and test the feasibility of a novel decision support tool on surgical treatment decision making for children with neuromuscular scoliosis (NMS). The aims of the project are as follows. In aim 1, Dr. Lin will apply new skills in health communication to identify effective risk communication methods to communicate uncertainty in decision making for children with NMS. In aim 2, Dr. Lin will design a decision support tool for use during orthopaedic consultation for children with NMS, including discoveries from aim 1. In aim 3, Dr. Lin will conduct a pilot feasibility and acceptability study of the decision support tool. This study will inform the development of a large, multicenter trial of the decision support tool for children with NMS. Through the training and research activities embedded in this proposal, Dr. Lin will address gaps in our understanding of how to support treatment decision making for children with NMS. This study will serve as a critical model for developing decision supports for clinical decisions in the growing population of children with medical complexity. Completion of the proposed activities will prepare Dr. Lin to independently lead a larger research program evaluating and developing decision support to improve outcomes for populations of children and adults with multiple comorbid conditions through better SDM.