Telemedicine For Anterior Eye Diseases

描述(申请人提供)：眼部远程医疗可以为数百万无法获得服务的美国人提供眼部护理。这项K23提案表明了玛丽亚·A·伍德沃德博士对满足国家和全球公共卫生保健需求的研究的承诺，以及她对追求研究员独立性的承诺。虽然在美国，后部眼病是导致视力损害的主要原因，但美国国家眼科研究所(NEI)的战略计划指出，前部眼部疾病导致全国大多数人去看眼科护理专业人员，并导致全球数百万人失明。NEI计划还强调，有必要进行研究，以“通过试点研究确定远程医疗程序的安全性、可靠性和可行性”，并“确定哪些眼科应用程序适合远程医疗，同时仍能保持面对面检查所达到的准确性、敏感性和特异性。”尽管资助的研究项目已经建立了用于远程评估糖尿病视网膜病变的眼底照相，但还没有试点项目专注于外眼和前眼。伍德沃德博士的职业公共卫生目标是将负担得起的、可获得的眼科护理扩展到服务不足的社区，以便在治疗过程中更早地发现眼睛状况。她的职业研究目标是测试可用于远程医疗的眼科技术的应用。近期的项目目标有两个方面。首先，申请人寻求开发严格和准确的方法来检测关键的外部和前部眼部疾病使用外部摄影。申请者将对患有已知前部眼病的受试者进行试验性研究，测试外部摄影方案。其次，申请人寻求验证视力问卷，该问卷将加强全面的远程医疗评估，以确定眼睛健康和是否存在前部眼部疾病。申请者将接受多份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。申请者将利用密歇根大学的大量资源和包括Paul Lee博士和David Musch博士在内的研究导师的支持，实现三个具体的培训目标：1)研究方法方面的专业知识，2)远程医疗计划开发的卓越，3)完善的眼科成像知识。伍德沃德博士制定了一项有针对性的课程作业、个性化指导和指导自学的计划，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项目的健康和保健研究硕士学位。

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.