Telemedicine For Anterior Eye Diseases

描述（由申请人提供）：眼科远程医疗可以为数百万无法获得服务的美国人提供眼科护理。K23的这份提案证明了玛丽亚·A博士的观点。伍德沃德致力于解决国家和全球公共卫生保健需求的研究，并致力于追求研究者的独立性。 虽然后眼部疾病导致美国大部分视力障碍，但国家眼科研究所（NEI）的战略计划指出，前眼部疾病导致全国大部分眼科护理专业人员就诊，并导致全球数百万人失明。NEI计划还强调了对研究的重大需求，这些研究可以“通过试点研究建立远程医疗程序的安全性，可靠性和可行性”，并“确定哪些眼科应用适合远程医疗，同时仍然保持现场检查的准确性，灵敏度和特异性。“虽然资助的研究项目已经建立了眼底照相用于糖尿病视网膜病变的远程评估，但没有试点项目集中在外眼和前眼。 伍德沃德博士的职业公共卫生目标是将负担得起的和可获得的眼科护理扩展到服务不足的社区，以便在他们的过程中更早地检测眼部疾病。她的职业研究目标是测试适合远程医疗的眼科技术应用。项目的近期目标有两个方面。首先，申请人寻求开发使用外部摄影检测关键外部和前眼部疾病的严格和准确的方法。申请人将开展试点研究，测试已知患有前眼部疾病的受试者的外部摄影方案。第二，申请人寻求验证视力调查表，该调查表将加强全面的远程医疗评估，以确定眼睛健康状况以及是否存在前眼部疾病。申请人将管理多个预先验证的视力问卷（例如，国家眼科研究所视觉功能问卷），并将答案与临床检查结果相关联。 伍德沃德博士的研究得到了培训目标的支持，这些目标将为她发展成为一名独立的调查员奠定基础。申请人将利用密歇根大学的巨大资源和研究导师的支持，包括Paul Lee和大卫穆什博士，以实现三个具体的培训目标：1）研究方法的专业知识，2）远程医疗程序开发的卓越性，以及3）眼科成像的精细知识。伍德沃德已经制定了一个有针对性的课程，个性化的指导计划，并指导自学，以确保实现这些目标。在此过程中，她将获得罗伯特伍德约翰逊基金会临床学者计划的健康和医疗保健研究硕士学位。

DESCRIPTION (provided by applicant): Ocular telemedicine can deliver eye care to millions of Americans who do not have access to services. This K23 proposal demonstrates Dr. Maria A. Woodward's commitment to research that addresses a national and global public health care need and her commitment to the pursuit of investigator independence. Although posterior eye diseases cause the majority of visual impairment in the United States, the National Eye Institute's (NEI) strategic plan states that anterior eye diseases result in the majority of visitsto eye care professionals nationally and cause blindness in millions globally. The NEI plan also emphasizes the significant need for research that can "establish the safety, reliability and feasibility of telemedicine procedures through pilot studies" and "determine which ophthalmic applications are amenable to telemedicine, while still preserving the accuracy, sensitivity and specificity achieved with in-person examinations." Although funded research projects have established fundus photography for remote assessment of diabetic retinopathy, no pilot projects have focused on the external and anterior eye. Dr. Woodward's career public health goal is to extend affordable and accessible eye care to underserved communities in order to detect eye conditions earlier in their course. Her career research goal is to test applications of ophthalmic technology that are amenable to telemedicine. The immediate project goals are two-fold. First, the applicant seeks to develop rigorous and accurate methods for detecting key external and anterior eye diseases using external photography. The applicant will conduct pilot studies testing external photography protocols on subjects with known anterior eye diseases. Second, the applicant seeks to validate a vision questionnaire that will augment comprehensive telemedicine assessments to determine eye health and whether or not anterior eye diseases are present. The applicant will administer multiple pre-validated vision questionnaires (e.g., the National Eye Institute Visual Function Questionnaire) and correlate answers with clinical examination findings. Dr. Woodward's research is supported by training goals that will provide the foundation for her to develop into an independent investigator. The applicant will utilize the immense resources at the University of Michigan and the support of research mentors, including Drs. Paul Lee and David Musch, to accomplish three specific training aims: 1) expertise in research methodology, 2) excellence in telemedicine programmatic development, and 3) refined knowledge of ophthalmic imaging. Dr. Woodward has set forth a plan for targeted coursework, individualized mentorship, and directed self-study to assure achieving these aims. In the process, she will obtain a master's degree in health and health care research from the Robert Wood Johnson Foundation Clinical Scholars Program.