Measurement, Design, and Analysis Methods for Health Outcomes Research Course: Ware Lecture

September 18-25, 2023 | Harvard School of Public Health, Boston, MA

After almost 30 years of lecturing at Harvard, Dr. Ware presented his last scheduled lecture entitled “State of the Art of Methods for Health Outcomes Measurement and Evaluation – I” during the September 16-23 course at the Harvard School of Public Health, Boston, MA.

The lecture covered the 40-year evolution of survey content and noteworthy conceptual and methodological milestones in the history of improving patient-reported outcome measures (PROMs).  The latter included: applications of item response theory (IRT) and waves of development of very homogeneous survey item banks; increases in the number of generic PRO scales; contrasting efforts to develop summary physical and mental measures that each cover a wider range and simplify reporting of outcomes; new “super” single-item-per-domain (SIPD) short-forms that improve psychometric performance by increasing score range and reducing ceiling effects in comparison with legacy tools; and standardized IRT-based metrics common to new and legacy generic PROs. 

A new generation of more valid and responsive disease-specific PROs was also discussed.  These new methods, which are standardized in both content and scoring across diseases and norm-based, use disease-specific attributions to achieve a summary score that fills the gap between disease-specific symptoms that are not QOL and generic QOL measures that are not disease-specific. 

A new kind of adaptive survey logic that automatically adapts to the presence of multiple conditions was also discussed as a more practical solution to integrating disease-specific and generic measures into a common “dashboard” of PROs.