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糖尿病诊断后研究支持系统(ADDRESS)的原理与方案:一项英国1型糖尿病新发及高危队列研究

Rationale and protocol for the After Diabetes Diagnosis REsearch Support System (ADDRESS): an incident and high risk type 1 diabetes UK cohort study.

作者信息

Walkey Helen C, Kaur Akaal, Bravis Vassiliki, Godsland Ian F, Misra Shivani, Williams Alistair J K, Bingley Polly J, Dunger David B, Oliver Nick, Johnston Desmond G

机构信息

Department of Medicine, Imperial College London, London, UK.

School of Clinical Sciences, University of Bristol, Bristol, UK.

出版信息

BMJ Open. 2017 Jul 12;7(7):e013956. doi: 10.1136/bmjopen-2016-013956.

Abstract

INTRODUCTION

Type 1 diabetes is heterogeneous in its presentation and progression. Variations in clinical presentation between children and adults, and with ethnic group warrant further study in the UK to improve understanding of this heterogeneity. Early interventions to limit beta cell damage in type 1 diabetes are undergoing evaluation, but recruitment is challenging. The protocol presented describes recruitment of people with clinician-assigned, new-onset type 1 diabetes to understand the variation in their manner of clinical presentation, to facilitate recruitment into intervention studies and to create an open-access resource of data and biological samples for future type 1 diabetes research.

METHODS AND ANALYSIS

Using the National Institute for Health Research Clinical Research Network, patients >5 years of age diagnosed clinically with type 1 diabetes (and their siblings) are recruited within 6 months of diagnosis. Participants agree to have their clinical, laboratory and demographic data stored on a secure database, for their clinical progress to be monitored using information held by NHS Digital, and to be contacted about additional research, in particular immunotherapy and other interventions. An optional blood sample is taken for islet autoantibody measurement and storage of blood and DNA for future analyses. Data will be analysed statistically to describe the presentation of incident type 1 diabetes in a contemporary UK population.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the independent NHS Research Ethics Service. Results will be presented at national and international meetings and submitted for publication to peer-reviewed journals.

摘要

引言

1型糖尿病在临床表现和病情发展方面具有异质性。儿童与成人之间以及不同种族群体的临床表现差异,值得在英国进一步研究,以增进对这种异质性的理解。旨在限制1型糖尿病β细胞损伤的早期干预措施正在接受评估,但招募工作颇具挑战性。本文介绍的方案旨在招募临床诊断为新发1型糖尿病的患者,以了解其临床表现方式的差异,促进其参与干预研究,并创建一个开放获取的数据和生物样本资源库,用于未来的1型糖尿病研究。

方法与分析

利用英国国家卫生研究院临床研究网络,在确诊后6个月内招募临床诊断为1型糖尿病的5岁以上患者(及其兄弟姐妹)。参与者同意将其临床、实验室和人口统计学数据存储在安全的数据库中,同意利用英国国家医疗服务体系数字部门保存的信息监测其临床进展,并同意就其他研究(特别是免疫疗法和其他干预措施)与之联系。采集一份可选的血样用于胰岛自身抗体检测,并储存血液和DNA以供未来分析。将对数据进行统计分析,以描述当代英国人群中初发1型糖尿病的表现。

伦理与传播

已获得英国国家医疗服务体系独立研究伦理服务机构的伦理批准。研究结果将在国内和国际会议上公布,并提交给同行评审期刊发表。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c46/5541618/fb6297feed1d/bmjopen-2016-013956f01.jpg

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