Implementation and Evaluation of a Risk Assessment Tool for Periodontal Disease

描述(由申请人提供)：这个指导临床科学家奖(K08)的目标是帮助Thankam Paul Thyvalikakath，BDS，MDS，MS，在她之前的培训和经验的基础上成为一名完全合格的牙科信息学研究员。通过本申请中提出的多学科指导、培训和研究经验，Thyvalikakath博士希望成为一名独立资助的研究员，能够领导多学科团队并在这些团队中工作，这些团队对牙科实践中的临床决策支持干预进行尖端研究。尽管已有大量研究，但牙科临床决策支持尚未在患者护理和结果方面产生类似于医疗护理的进展。在诊断和治疗牙病的基于风险的方法方面尤其如此，这些方法尚未被广泛转化并在一般实践中采用。口腔疾病的发展和进展涉及多种因素，缺乏完善的工具将基于风险的诊断和治疗整合到工作流程中，这使得临床医生难以始终如一地和系统地应用基于风险的方法。Thyvalikakath博士的研究项目的目标是将基于计算机的风险评估工具-牙周风险计算器(PRC)(Previser Corp.，华盛顿州芒特弗农)与基于商业计算机的患者记录系统(CPR)、Dentrix Dental System(Henry Schein，American Fork，UT)集成，并衡量其对临床医生决策的影响。该项目的三个具体目标是：1)确定临床医生对在实践中使用基于风险的护理和基于风险的工具的意见和建议；2)确定在实践中常规实施基于风险的工具(如PRC)的障碍和促进者；以及3)将风险评估工具与CPR集成，并进行可行性研究，评估牙医办公室用于决策的风险评估工具的有效性。为了让Thyvalikakath博士开展拟议的研究项目，她将通过完成匹兹堡大学生物医学信息学系的博士课程，进一步发展她的牙科信息学知识和技能。她将接受一个多学科团队的指导，该团队由蒂图斯·施莱耶、DMD、博士、阿西姆·斯梅拉吉奇、博士、格雷格·库珀、医学博士、博士、凯伦·诺瓦克、DDS、博士、查尔斯·斯费尔、DDS、博士和查里蒂·摩尔、MSPH和博士组成，他们都是资金充足的研究人员，并有可靠的先前指导记录。培训和有指导的研究项目，再加上多学科指导团队的指导和牙医学院的承诺，将为Thyvalikakath博士作为牙科信息学独立调查员的成功职业生涯做好最佳准备。 公共卫生相关性：这个项目将为开发有效的方法来整合普通牙科实践中的决策支持系统铺平道路，从而加强预防管理和改善患者结果。

DESCRIPTION (provided by applicant): The goal of this Mentored Clinical Scientist Award (K08) is to help Thankam Paul Thyvalikakath, BDS, MDS, MS, build on her previous training and experience to become a fully qualified investigator in dental informatics. Through the multidisciplinary mentorship, training and research experience proposed in this application, Dr. Thyvalikakath expects to become an independently funded researcher capable of leading and working in multidisciplinary teams that conduct cutting-edge research on clinical decision support interventions in dental practice. Despite an existing body of research, clinical decision support in dentistry has yet to produce advances in patient care and outcomes similar to those seen in medical care. This is especially true regarding risk-based approaches to diagnosing and treating dental disease, which have not been widely translated to and adopted in general practice. The multiple factors involved in the development and progression of oral diseases, and the lack of well-developed tools to integrate risk-based diagnosis and treatment into the workflow make it difficult for clinicians to consistently and systematically apply a risk-based approach. The objective of Dr. Thyvalikakath's research project is to integrate a computer-based risk assessment tool, the Periodontal Risk Calculator (PRC) (Previser Corp., Mount Vernon, WA), with a commercial computer-based patient record system (CPR), Dentrix Dental System (Henry Schein, American Fork, UT) and measure its impact on clinicians' decision-making. The three specific aims in this project are: 1) determine clinicians' opinions and recommendations on using risk-based care and risk-based tools in practice ; 2) determine the barriers and facilitators for routine implementation of risk-based tools such as the PRC in practice ; and 3) integrate the risk assessment tool with a CPR and perform a feasibility study assessing the effectiveness of risk- assessment tool for decision-making in a dentist's office. In order for Dr. Thyvalikakath to carry out the proposed research projects, she will further develop her dental informatics knowledge and skills by completing the doctoral program at the Department of Biomedical Informatics at the University of Pittsburgh. She will be mentored by a multidisciplinary team consisting of Titus Schleyer, DMD, PhD, Asim Smailagic, PhD, Greg Cooper, MD, PhD, Karen Novak, DDS, PhD, Charles Sfeir, DDS, PhD and Charity Moore, MSPH, PhD all of whom are well-funded investigators and have proven track records of prior mentorship. The training and mentored research project, combined with the guidance of the multidisciplinary mentoring team and commitment of the School of Dental Medicine, will prepare Dr. Thyvalikakath optimally for a successful career as an independent investigator in dental informatics. PUBLIC HEALTH RELEVANCE: This project will pave the way to developing effective methods to integrate decision support systems in general dental practice and thus enhance preventive management and improve patient outcomes.