Functional Health CAT in Chronic Kidney Disease

慢性肾脏病中的功能健康 CAT

基本信息

批准号：
7227816
负责人：
JOHN E WARE
金额：
$ 74.91万
依托单位：
QUALITYMETRIC, INC.
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-05-01 至 2009-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7227816
关键词：
Address Adopted Adult Affect Chronic Disease Chronic Kidney Failure Clinic Clinical Clinical Data Comorbidity Complex Computer Systems Development Computer software Data Data Collection Development Dialysis procedure Disease Disease Progression Evaluation Foundations Generic Drugs Goals Health Hemodialysis Individual Institution Kidney Kidney Diseases Kidney Failure Length Measurement Medical center Methods Metric Modality Modeling Monitor Needs Assessment New England Outcome Assessment Pain Patient Care Patient Outcomes Assessments Patients Performance Phase Physical Dialysis Population Process Provider Psychometrics Purpose Quality of life Quality-of-Life Assessment Questionnaires Range Renal Replacement Therapy Reporting Research Personnel Respondent SF-36 Sampling Score Severities Severity of illness Sleep Software Tools Solid Staging Standardization Standards of Weights and Measures Surveys System Technology Testing Validity and Reliability body system computerized cost health care delivery health related quality of life improved innovation instrument outreach programs prototype response simulation success theories tool

项目摘要

DESCRIPTION (provided by applicant): We propose to apply item response theory (IRT) and computerized adaptive testing (CAT) to achieve major advances in the standardization of Chronic Kidney Disease (CKD) health-related quality of life (HRQOL) metrics, in the efficiency of data collection and processing technologies, and in the usefulness of clinician and patient reports. In contrast to static instruments, which ask all respondents the same questions regardless of their answers and lack the precision to detect changes over a wide range of severity levels, we will use Dynamic Health Assessment (DYNHA¿) software to match questions to each patient's score and to the requirements of each application to achieve more practical and more useful assessments. In our Phase I test among hemodialysis patients, a prototype CKD-CAT application achieved comparable CAT scores and equivalent or better precision with substantial reductions in respondent burden compared to three full-length static scales (Effects of Kidney Disease, Sleep Functioning, and Bodily Pain) including items from the Kidney Disease Quality Of Life Questionnaire (KDQOL). Shortcomings of our approach were also identified: (a) the need for additional questionnaire item development, (b) limitations of sampling only hemodialysis patients to represent a wide range of CKD severity levels, and (c) problems with the interface between patients and data collection technologies. To address these concerns as well as meet the needs for assessment tools and software that are applicable across a wider range of disease severity levels, we propose a Phase II effort that matches samples and intensity/expense of data collection to the distinct requirements of each of the following aims: (1) Expand the item pool and evaluate the appropriateness of new items for CKD-specific applications; (2) Identify the most useful and feasible domains and calibrate their items by collecting and analyzing responses from large samples of adults varying across stages of CKD (Stages 3-5); (3) Create a fully operational CKD-CAT system and evaluate its performance through "real data" simulation studies, to determine reliability and clinical validity and the potential for reductions in respondent burden, in comparison with full-length forms; and (4) Confirm the administrative feasibility, patient acceptance, reliability and validity of scores, and the usefulness of clinician and patient reports from actual CKD-CAT administrations to patients (CKD Stages 3-5) sampled and assessed in clinical and in non-clinical settings. By greatly shortening surveys and lowering the costs of administering them, it will be possible to monitor the quality of life effects of CKD more accurately for more patients and help clinicians and patients better understand and communicate about treatment success.

描述（由适用提供）：我们建议将项目反应理论（IRT）和计算机化自适应测试（CAT）应用于慢性肾脏疾病（CKD）健康相关生活质量（HRQOL）度量的标准化，在数据收集和处理技术的效率中以及临床和患者报告的有用性。与静态仪器相反，静态仪器不管他们的答案如何，都提出所有回答相同的问题，并且缺乏检测到广泛严重性水平的变化的精确性，我们将使用动态健康评估（Dynha€）软件与每个患者的分数以及每个应用程序的要求匹配以实现更实用和更有用的评估。在血液透析患者的I期测试中，与三个全长静态量表（肾脏疾病，睡眠功能和身体疼痛的影响，包括来自Life Coodsnaire of Life Coodsnaire的肾脏疾病质量）相比，受访者Burnen的原型CKD-CAT应用可比性的CAT得分和同等或更好的精度，而受访者Burnen的大幅降低，而肾脏疾病，睡眠功能和身体疼痛的影响（KDQOL）（KDQOLE（KDQOL））。还发现了我们方法的缺点：（a）需要进行其他问卷项目开发，（b）仅采样血液透析患者以代表广泛的CKD严重程度，以及（c）患者和数据收集技术之间的界面问题。为了解决这些问题，并满足适用于广泛疾病严重程度的评估工具和软件的需求，我们提出了II期的努力，该努力与样品和数据收集的强度/费用符合以下每个目标的不同要求：（1）扩展项目池并评估CKD特定于CKD特定应用程序的新项目；（2）确定最有用和最可行的域，并通过收集和分析来自CKD阶段的大型成人样本的反应来校准其项目（第3-5阶段）；（3）创建一个完全运行的CKD-CAT系统，并通过“真实数据”模拟研究评估其性能，以确定可靠性和临床有效性以及与全长形式相比，响应燃烧的减少潜力；（4）确认分数的行政可行性，患者的接受度，可靠性和有效性以及对患者的临床和患者报告的有用性（CKD阶段3-5阶段）在临床和非临床环境中进行了采样和评估。通过大大缩短调查并降低管理调查的成本，可以更准确地监测CKD的生活质量，以便为更多的患者而言，并帮助临床医生和患者更好地了解和交流治疗成功。