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October 20, 2017

Improving Single-Item Generic Health Survey Measures

October 20, 2017 | 24th Annual Conference of the International Society for Quality of Life Research (ISOQOL), Philadelphia, Pennsylvania Because all surveys begin with the first item, at the core of advances in patient-reported outcome measurement are better single-item measures of the most frequently-measured health domains. For many outcomes monitoring and cost prediction purposes in the future, the shortest health survey forms will administer only the best single item for each domain. Also, because the first item determines what happens next in adaptive surveys, more efficient single-item measurement is crucial. At the 24th Annual ISOQOL Conference, Drs. Ware and Gandek summarized advances in understanding of the content that best represents health domains and the implications of better operational definitions for capturing the essence of each domain, focusing on the Physical Function, Vitality and Mental Health domains. Survey items were self-administered on the Internet to representative samples of U.S. adults (N=2,938), ages 18-94. Results for new General Quality of Life (QGEN®) 10-item form items were compared with SF-36 and PROMIS-29 items for the same domains and in terms of how well they predicted SF-36 physical and mental component summary measures, to identify the reasons for superior item performance. Multiple psychometric criteria and tests of convergent and discriminant validity were reported. They reported that the best single-item measures were not found within the Medical Outcomes Study SF-36 or PROMIS-29 multiple-item scales or global items from those projects. Significant improvements in QGEN single-item performance, in comparison with SF-36 and PROMIS-29 for the same […]
September 13, 2017

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

September 25th-27th, 2017 | 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 25-27 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 patient-reported outcomes (PROs) as well as some of the most innovative and important recent conceptual and methodological advances.  The latter include new features of items shown to improve their performance over legacy items, standardized underlying metrics for the domains common to most legacy generic PROs, and a new generation of standardized disease-specific PROs that fill the gap between disease-specific symptoms that are not QOL and generic QOL measures that are not disease-specific.  In the afternoon workshop, entitled “The How and Why of Integrating Disease-Specific and Generic Patient-Reported Outcome Measures (PROMS)”, Dr. Ware will discuss the use of QOL impact attributions to specific diseases to improve the validity and responsiveness of disease-specific measures, how improved measures can be integrated and compared in a profile that can be standardized across diseases, and the first norm-based scoring for disease-specific measures for the chronically-ill population.  Case studies from early adoptions of these advances in academic medical center applications and clinical trials will be discussed. 
August 20, 2017

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

August 17th – 19th, 2015 | Harvard School of Public Health, Boston, MA Dr. Ware presented 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 August 17-19 at the Harvard School of Public Health. The lecture covered noteworthy milestones in the history of patient-reported outcomes (PRO) as well as some of the most innovative and important recent conceptual and methodological advances.  The latter included a new generation of standardized (both content and scoring) disease-specific PROs that fill the gap between widely-used disease-specific measures that are not QOL and generic QOL measures that are not disease-specific.  In the afternoon workshop, entitled “Integrating Generic and Disease-Specific Assessments:  What Are the Issues?”  Dr. Ware discussed how both the content and scoring of disease-specific QOL impact measures can be standardized across diseases and how norm-based scoring of disease-specific measures can be accomplished in the chronically-ill population.  The recently-published QOL Disease-Specific Impact Scale (QDIS®) was used to illustrate how the convergent and discriminant validity of disease-specific QOL impact ratings is being tested among adults with multiple comorbid conditions (MCC) in an ongoing NIH/AHRQ-sponsored study.  A second case study from an ongoing national registry will focus on a powerful new adaptive survey logic that automatically adapts to the presence of  MCC while also estimating outcomes equivalent to the metrics underlying widely-used legacy PROs without administering the latter.  Despite the more comprehensive information collected in this small-sample field test,  surveys […]
August 20, 2017

Cutting Edge Research: Do health attributions make a difference in responses to questions about limitations in work and other role activities?

October 16, 2014 | Berlin, Germany International investigators who have been comparing health survey items with and without health attribution for more than 10 years teamed together and presented their findings at a special plenary session on Cutting Edge Research at the 21st Annual Conference of the International Society for Quality of Life Research (ISOQOL) in Berlin, Germany on October 16, 2014. This ISOQOL session highlighted high quality research from members of the ISOQOL community. The research team (Jakob Bjorner, Janine Devine, Barbara Gandek, Matthias Rose, Mark Kosinski, and John Ware) presented results from studies of a representative sample of US adults (N=900) who completed sets of questions about role functioning which differed in attribution (no attribution or attribution to health, physical health, or emotional health) but were otherwise identical in content. For example, some standard measures, such as the SF-36 Role Physical and Role Emotional subscales, use items with health attribution (e.g., “… have you had any of the following problems with your work or other regular daily activities as a result of your physical health?”). Other measures, such as the PROMIS Ability to Participate in Social Roles and Activities items, do not use health attribution (e.g., ‘I have trouble doing all of my usual work (include work at home)”). The team found that the prevalence of limitations in role participation was greater for items without health attribution. The practical implications of these differences, were apparent in tests of validity in discriminating between clinical groups, which favored items with […]
August 20, 2017

40th Anniversary Celebration of the RAND Health Insurance Experiment

June 9th – 10th, 2016 | Rand Corporation, Santa Monica, California Dr. Ware participated in the 2-day celebration of the 40th anniversary of the RAND Health Insurance Experiment (HIE), the largest health policy study in U.S. history. He reunited with his colleagues on the HIE research team and others at RAND’s Santa Monica headquarters for discussions about how this landmark study has changed the health policy landscape over the last few decades.
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