This proposal builds upon a five year research project, SEARCH for Diabetes in Youth, its standardized datacollection effort, experienced investigator team, established case ascertainment infrastructure, and ethnicallydiverse population base. This is a common, integrated application from the six SEARCH clinical sites, whichproposes to continue and expand the work performed by SEARCH in order to address the following specificresearch aims:
AIM 1 : Prospectively ascertain newly diagnosed (2006-2009) incident cases age less than20 years in order to estimate temporal trends in incidence of DM in youth;
AIM 2 : Conduct longitudinalfollow-up of incident cases already recruited to SEARCH in 2002-2005 in order to document the evolution ofnewly diagnosed DM according to clinical and biochemical factors;
AIM 3 : Complete analyses initiated in thefirst five years of SEARCH and expand the scope of quality of care assessment to encompass more broadlydefined concepts and measures of quality;
AIM 4 : Develop and validate simple and low-cost case definitionsand classifications of DM types in youth that can be used for public health surveillance. The novelty of thisproposal includes its comprehensive nature that brings together major and timely facets of childhood DMresearch: an epidemiologic study, unique in the United States, of temporal trends in the incidence of DM inyouth; a pathophysiologic component addressing the natural history of DM in youth; a study of processes ofcare and quality of life; and a public health perspective on case classification of DM in youth. This research iscritically important to public health as it will provide information about whether and how much DM isincreasing among youth of different racial/ ethnic groups in the United States, about how DM impacts on thephysical health, including complications, as well as valuable data regarding the quality of care and the qualityof life of these youth. The major stengths of the Ohio site are the dominant market postion of CincinnatiChilden's Hospital Medical Center (CCHMC), CCHMC's commitment to research and diabetes care, theexcellent rapport CCHMC has with the surrounding community, and the track record of Ohio SEARCHinvestigators for successful collaboration. Based on these strengths, the Ohio site used a comprehensivediabetes patient database at CCHMC and built a community network to ascertain 99.8% (estimate bycapture-recapture analysis) of the cases of diabetes in youth in the Ohio geographic area in SEARCH1.
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