Unsolicited R24 for the CFAR-Network of Integrated Clinical Sciences, CNICS

高效抗逆转录病毒治疗(HAART)时代的艾滋病毒/艾滋病的临床治疗是极其重要的 前所未有的治疗组合以及无数的患者和病毒学反应 心理治疗。长期结果研究是必要的，以向临床医生提供有关 根据患者的个人情况采取的最佳策略。从历史上看，临床护理的证据 决策是通过进行随机对照临床试验、流行病学- 基于前瞻性临床队列和轶事报道。一种新的方法将与这些 方法是基于对直接来自新开发的数据的利用的结果研究 电子病历(EMR)系统，并将这些数据汇编到新的研究网络中。这样的电子病历 该系统已经在美国的几个艾滋病研究中心(CFAR)的地点存在。 CFAR综合临床系统网络(CNICs)项目是第一个这样的资源网络 可以对当代艾滋病毒研究议程作出重大贡献。作为一个基于临床的研究网络， CNICs直接反映了日常护理中使用的临床决策和管理选项的结果 艾滋病病毒感染者。与通过结构化访谈或回溯性医疗收集的数据不同 记录审查，CNIC确保了与快速变化的进程相关的更广泛的信息 通过在护理地点收集数据来管理艾滋病毒疾病。CNICs项目支持一个数据 该系统是来自七个CFAR站点的EMR的核实和质量控制数据的中央储存库。 为个别患者护理记录的电子病历数据通过CNIC提供，以人群为基础 成果研究，它促进联网，并有助于对所载数据进行标准化 CNICs数据系统。CNICs还在开发一个标本库，与来自 现场的EMR。 CNICs是HIV临床、翻译和基础研究的独特资源，并将提供 基础设施和数据，以解决艾滋病毒护理和研究中具有挑战性和迅速演变的问题。这个 这项提案的主要目标是建设和支持CNICS基础设施，以应对 不断演变的艾滋病毒流行的研究议程，通过制定 促进数据质量控制和传输的标准操作程序和软件工具 在5年内将CNIC扩大8到10个地点，并作为发展类似项目的资源 研究网络。

The clinical treatment of HIV/AIDS in the era of Highly Active Anti-Retroviral Therapy (HAART) is extremely dynamic with unprecedented combinations of therapies and a myriad of patient and virologic responses to therapy. Long-term outcomes research is necessary to provide clinicians with up-to-date information on the best strategies to employ in their patients' individual situations. Historically, evidence for clinical care decisions has been generated through the conduct of randomized controlled clinical trials, epidemiology- based prospective clinical cohorts, and anecdotal reports. A new approach that will synergize with these methods is outcomes research based on the utilization of data derived directly from newly developed electronic medical record (EMR) systems and compiling such data into novel research networks. Such EMR systems are already in existence at several Centers for AIDS Research (CFAR) sites in the United States. The CFAR Network of Integrated Clinical Systems (CNICS) project is the first such resource network that can substantially contribute to the contemporary HIV research agenda. As a clinic-based research network, CNICS directly reflects the outcomes of clinical decisions and management options used daily in the care of HIV infected individuals. Unlike data collected in structured interviews or through retrospective medical record review, CNICS assures a broader range of information associated with the rapidly changing course of HIV disease management through collection of data at the point of care. The CNICS project supports a data system that is a central repository of verified and quality-controlled data from the EMRs at seven CFAR sites. The EMR data recorded for individual patient care are made available through CNICS for population-based outcomes research, which facilitates networking and contributes to the standardization of data contained in the CNICS data system. CNICS is also developing a specimen repository linked with clinical data from the sites' EMRs. CNICS is a unique resource for HIV clinical, translational, and basic research and will provide the infrastructure and data to address the challenging and rapidly evolving issues in HIV care and research. The principle goals of this proposal are to build and support the CNICS infrastructure, to address the challenging research agenda of the evolving HIV epidemic, to prepare for the expansion of CNICS by developing standard operating procedures and software tools to facilitate data quality control and transmission, to expand CNICS by 8 to 10 sites within 5 years, and to serve as a resource for the development of similar research networks.