About Us

Our mission is to make patient-reported outcome (PRO) measures more practical and comparable so that norms from population surveys and results from studies of treatment and individual patient outcomes can be compared and more useful in improving the quality of health care. To do this, we improved and integrated disease-specific (QDIS) and general (QGEN) health-related quality of life (QOL) measures. We also developed short-form survey algorithms that adapt to individual levels of QOL and the presence of multiple chronic conditions. These tools are available from http://mapi-trust.org/
John Ware Research Group (JWRG) was founded in 2009 by John E. Ware, Jr., PhD to continue innovative improvements in general (generic) and disease-specific health-related quality of life (QOL) measures and other patient-reported outcome (PRO) tools for use in population surveys, clinical research and clinical practice worldwide. JWRG maintains offices in Watertown, MA and Portsmouth, RI.

Our Approach Includes:

  • Identifying a core subset of health domains
  • Integrating disease-specific and generic measures
  • Standardizing data collection methods across platforms
  • Improving the efficiency of screening and estimating outcomes
  • Cross-calibrating metrics so that results can be compared
  • Providing guidelines to interpret PRO data

Our History

  • 1970'sHIE

    Health Insurance Experiment (HIE)
    Largest experiment in health care; studied cost, quality and patient-reported outcomes across fee-for-service and prepaid plans.
  • 1980'sMOS

    Medical Outcomes Study (MOS)
    Comprehensive 4-year observational study of patient-reported outcomes for chronically-ill adults treated in different systems of care.
  • Early 1990'sSF-36

    MOS 36-Item Short-Form Health Survey
    More practical 36- and 12-item short-forms made available by the Medical Outcomes Trust for scholarly research.
  • Later 1990'sIRT

    Item Response Theory (IRT)
    IRT-based computer adaptive health assessments based on item banks calibrated from MOS study data.
  • 2000'sR&D

    R&D at QualityMetric
    Industry- and NIH-sponsored R&D of web-based electronic data capture for both generic and disease-specific PROs.
  • 2009JWRG Founded

    John Ware Research Group (JWRG)
    JWRG founded to improve patient-reported outcome (PRO) tools for use in research and clinical practice worldwide.
  • 2010-2014QOLIX Developed

    QOLIX with QGEN & QDIS powered by ASLX
    A web-based PRO monitoring system that integrates disease-specific (QDIS) and generic (QGEN) measures using more powerful survey logic (ASLX) to automatically adapt to the requirements of diverse applications.

John Ware Research Group inherits a rich legacy from the research efforts launched by Dr. Ware in the early 1970's while completing his graduate school training in measurement and statistics at Southern Illinois University. His early focus was on the development of self-assessed health and patient satisfaction measures. After receiving his doctorate, he joined Rand Corporation, where he was the lead psychometrician on the Health Insurance Experiment (HIE), the largest social experiment in health care, and continued to advance health status and patient satisfaction measurement for adults and children. While at RAND, the measurement tools he developed for use in health policy studies began to be successfully used in clinical trials and he shifted his focus to adapting them for widespread use and to standardizing data collection and scoring methods so that results could be compared and meaningfully interpreted across all applications. In addition, he began work as the Principal Investigator of the Medical Outcomes Study (MOS), the most comprehensive and longest observational study of health outcomes for chronically ill adults treated in different systems of care.

Tufts Medical Center (TMC) recruited Dr. Ware in 1988 to introduce his pioneering work in health outcomes measurement into the information systems being developed to improve health care and to help build its new Health Institute. Early in his tenure at Tufts, while completing the MOS, he developed and published a more practical 36-item short-form health survey (SF-36®), which is now the most widely-used patient-reported health survey worldwide. He co-founded the not-for-profit Medical Outcomes Trust to assure availability of the SF-36 and other MOS tools for scholarly research. Additionally, with industry support he initiated the International Quality of Life Assessment (IQOLA) Project to translate the SF-36 for use in multi-national clinical trials. Other contributions at TMC included co-development of the Child Health Questionnaire (CHQ), participation in the Medicare Health Outcomes Survey (MHOS) and developing the Understanding Health Outcomes multimedia educational programs - the first comprehensive and accredited educational series for teaching the language, concepts, science, and practical applications of PRO surveys. He also began applying item response theory (IRT) to health status measures at TMC and led the effort to program the first IRT-based computer adaptive health assessment based on a mental health item bank calibrated from MOS study data.

In 1997, Dr. Ware co-founded QualityMetric Incorporated (QMI) and was QMI's first CEO and Chairman for more than 10 years (1997-2008). QMI’s goal was to develop a sustainable business model for generic PRO tools used in clinical research and for new information systems used to monitor population health and improve health care outcomes. During his tenure at QMI, Dr. Ware initiated a research and product development division sponsored largely by NIH grants including Small Business Innovation Research (SBIR) awards that compared short-form generic health measures (SF-36®, SF-12®, SF-8™) with legacy and new disease-specific surveys measuring the impact of chronic kidney disease, headache, asthma, and numerous other chronic conditions. He also joined forces with Jim Fries, MD as Co-PI on the Stanford-based Patient Reported Outcomes Management Information System (PROMIS®) Primary Research Site that applied IRT methods to develop the PROMIS physical functioning item bank.

In 2009, Dr. Ware was appointed Professor and Chief of the Outcomes Measurement Division within the Department of Quantitative Sciences (QHS) at the University of Massachusetts Medical School (UMMS) and founded John Ware Research Group. At UMMS, he provided oversight to psychometric cores within large NIH-sponsored patient registries focusing on PROs following total joint replacement (national FORCE-TJR registry) and treatment for acute coronary syndrome (TRACE-CORE). At JWRG, he focused on conducting research and development with NIH SBIR grant support and with JWRG’s own research funds. Products of this R&D included the Quality of Life Disease Impact Scale (QDIS®), the first disease-specific QOL impact measure to standardize content and norm-based scoring across diseases, and ASLX®, a more powerful survey logic that automatically adapts to the presence of multiple chronic conditions in administering disease-specific measures. ASLX has been successfully applied using QDIS item banks for nine chronic conditions and field tested in a national outcomes registry. An independent test supporting the psychometric methods underling QDIS standardized norm-based scoring was recently published in Quality of Life Research.

JWRG At A Glance

John E. Ware, Jr., PhD

Founder, Chief Science Officer

John E. Ware, Jr., PhD is Founder and Chief Science Officer at the John Ware Research Group and Adjunct Professor at Tufts University School of Medicine. Dr. Ware is an internationally recognized leader in the field of healthcare outcomes assessment and an elected member of the National Academy of Medicine. Dr. Ware founded QualityMetric Incorporated in 2009 and served as its CEO and Chairman for more than 10 years. He served for 12 years as Senior Scientist, The Health Institute, Tufts Medical Center in Boston, and was the Principal Investigator of the Medical Outcomes Study (MOS), where he led the development of the SF-36® Health Survey and other tools widely used in documenting disease burden and treatment outcomes. He has published more than 450 peer-reviewed articles, including papers on patient satisfaction and health outcomes measures used in the Health Insurance Experiment and the MOS. In the early 1990's, Dr. Ware was among the first to apply "modern" psychometric methods to PRO measurement in search of ways to cross-calibrate different PRO instruments and enable more efficient computerized adaptive test (CAT) administrations. This work has had substantial impact on the field of quality of life (QOL) research, leading to a 2003 President's Award from the International Society of Quality of Life Research. More recently, Dr. Ware successfully implemented a novel approach to measuring and standardizing the impact of multiple chronic conditions and norming these measures in the chronically ill population. This advance enabled the development of the QOL Disease Impact Scale (QDIS®). Dr. Ware’s other awards and honors include Pepperdine University's 25th Annual Dolores Award to the outstanding graduate in psychology and education, Academy Health’s 1994 Distinguished Investigator Award for "Significant and Long-lasting Contributions to the Field of Health Services Research," the 1998 Novartis/Zitter Group Outcomes Leadership Award for advancing the science of outcomes research, and the 1999 Foundation for Accountability (FACCT) Ellwood Award, presented in recognition of his lifetime efforts to create "a consumer-focused, accountable healthcare system". Dr. Ware was also the first recipient of the ISPOR Avedis Donabedian Outcomes Research Lifetime Achievement Award in 2002. He was elected as a Fellow in the National Academy of Inventors in 2013.

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