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September 10, 2018

Ware Lecture Tour in Japan

September 29th – October 26th, 2018 | Kyoto, Sapporo, Tokyo, Isehara, and Nara City in Japan Dr. Ware will present a series of lectures at conferences and university medical schools in September and October.  Lectures begin with a September 29 plenary keynote entitled “Patient-reported Health Measures are Linking Treatment Outcomes to Population Health” at the Society for Clinical Epidemiology annual meeting in Kyoto followed by a September 30 lecture on new JWRG disease-specific and generic health-related quality of life measures translated for use in population surveys and clinical research in Japan.  New surveys include a 10-item quality of life (QOL) short-form (QGEN®) developed in the US as an improvement over the SF-36® Health Survey and being normed in Japan, and a new 7-item QOL Disease-specific Impact Scale (QDIS®) that uses disease-specific attributions to increase validity and responsiveness to one condition in the presence of multiple comorbid conditions.  Dr. Ware also will comment on the history of conceptualization and measurement of QOL and important new survey tools and computerized adaptive test (CAT) developments in Japan, US and elsewhere at the Kyoto meeting and in subsequent lectures at Hokkaido University in Sapporo (October 3), Tokai University in Isehara (October 19), Kyoto University (October 22), and a symposium entitled “Consider QOL for Diabetes Patients” at the Ligare Kasugano hotel in Nara City (October 26) sponsored by MSD K.K. These lectures will cover the more than 40-year evolution of conceptualizing and measuring patient-reported outcomes (PROs) and noteworthy milestones. Advances include: applications of item response […]
September 10, 2018

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

September 24th-26th, 2018 | Harvard School of Public Health, Boston, MA Dr. Ware will present his annual lecture entitled “New Techniques for Health Outcomes Measurement and Evaluation” at the Measurement, Design, and Analysis Methods for Health Outcomes Research course held from September 24-26 at the Harvard School of Public Health. The lecture will cover the 40-year evolution of survey content and noteworthy milestones in the history of conceptualizing patient-reported outcomes (PROs), as well as the most innovative and important methodological advances.  The latter include: applications of item response theory (IRT) and waves of development of very homogeneous item banks that require increasing the number of generic PRO scales; contrasting efforts to develop summary measures that each cover a wider range; new “super” short-form items that improve psychometric performance over 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 will be discussed.  These new methods, which are standardized across diseases and norm-based, yield 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 will be discussed as a more practical solution to integrating disease-specific and generic measures into a common “dashboard” of PROs. 
March 7, 2018

Choosing Patient-Reported Outcomes and Measurement Methods for Team Based Health Care

March 7, 2018 | Integrated Health Care Conference, Arizona State University Doctor of Behavioral Health Program, Scottsdale, AZ In a keynote lecture, Dr. Ware provided an overview of the history of the conceptualization and measurement of patient-reported outcomes (PROs), and noteworthy methodological advances and their implications for going forward.  Applications of item response theory (IRT) methods have improved the quantification of health-related quality of life (QOL) domains and are the basis for more efficient computerized adaptive test (CAT) survey administrations and scoring.  However, a consequence of the development of very homogeneous survey item banks preferred by IRT models is a conceptual shift favoring measures of very specific symptoms (e.g., depression) and activities (e.g., walking) as opposed to broader concepts of mental, physical and social functioning and well-being.  In contrast, an emphasis on summary measures – the “tips of the QOL icebergs” that enable more efficient adaptive approaches – makes it practical to drill down to measure specific limitations in QOL only when are more likely to occur and to adapt automatically to multiple chronic conditions when they are present. This adaptive approach is the most practical and useful way represent PROs in “big data.” Dr. Ware presented examples of published and forthcoming JWRG findings from evaluations of new generic “super” short-form items that improve survey efficiency over legacy tools and use standardized IRT-based metrics to cross-calibrate new and legacy PROs.  New, more valid and responsive disease-specific PROs were also discussed.  The latter QOL Disease Impact Scale (QDIS) measures, which are standardized across diseases and […]
November 29, 2017

Integrating Generic Health Outcomes Monitoring and Depression Screening

April 12, 2018 | 39th Annual Meeting of the Society of Behavioral Medicine, New Orleans, Louisiana In a panel discussion session entitled “PHQ-9: Is it a Good Match for Integrated Primary Care?,” at the annual meeting of the Society of Behavioral Medicine, Dr. Ware will summarize how the adoption of measures used in the routine monitoring of generic physical and mental health outcomes can be used to more efficiently screen and manage patients in greatest need of mental and behavioral health services. The session will be chaired by Jennifer S. Funderburk, PhD from the VA Center for Integrated Healthcare. Other panelists will include Kurt Kroenke, MD, co-developer of the PHQ-9, and Rodger S. Kessler, PhD, an expert researcher on integrated care. The discussion will be led and summarized by William Douglas Tynan, PhD, a leader within the American Psychological Association on integrated health care.
October 21, 2017

Advances in the Measurement of Patient-Reported Outcomes: Implications for Comparative Effectiveness Research

November 5th-8th, 2017 | 2017 NCRI Cancer Conference, Liverpool, UK In a session entitled “Quality of Life – from PROMs to ICERs” at the 2017 NCRI Cancer Conference, Dr. Ware will summarize advances in PRO measurement and their implications for effectiveness research. Understanding has never been greater regarding the: (1) breadth of health concepts that are essential for validity in quantifying patient reported outcomes (PROs); (2) importance of matching operational definitions (e.g., behavioral functioning, subjective ill-being and well-being,personal evaluation) to each health concept; (3) advantages of better single items for both psychometric and utility methods; and (4) implications of standardizing metrics across a wide range of higher and lower levels of health to enable comparisons of results across diverse populations. For example,meaningful comparisons can be made between population norms, average scores for treated and untreated groups, and individual scores for patients with mild to severe conditions, using standardized metrics for a composite (psychometric or utility) score or a profile of outcome scores.Because all surveys begin with the first item, at the core of advances in both generic and disease-specific PRO surveys are significantly better single-item measures that can and should be standardized across psychometric and utility methods. Although the enumeration of these measures differs across the two methods, their concept representation and item content should not. For most respondents and for some measurement purposes (e.g., calculation of composite scores), the best single item can be the only one administered for each health concept. The proven features of such “super items” […]
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