Computerized Adaptive Assessment of Disease Impact

疾病影响的计算机化自适应评估

• 批准号: 8003532
• 负责人: JOHN E WARE
• 金额: $ 83.5万
• 依托单位: JOHN WARE RESEARCH GROUP, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8003532
• 关键词: Disease; computerized

DESCRIPTION (provided by applicant): This SBIR Phase II project will develop and evaluate a more practical and comprehensive approach to standardizing the self-assessment of disease-specific Health-Related Quality of Life (HRQOL) in the growing population of aging (45+ years) adults with, and at-risk of, co-morbid chronic conditions. Specifically, we propose to simplify disease impact screening (for prevention and early warning), and monitoring of HRQOL outcomes by adapting a consumer-focused Smart Measurement" system, developed using item response theory (IRT) to improve outcomes measures, utilizing computerized adaptive testing (CAT) software to improve data capture and score estimation, and deliver content via the Internet. Phase I demonstrated administrative feasibility and supported the assumptions underlying the standardization of the content of disease-specific impact items and their calibration across diseases to achieve measures that are more responsive to outcomes as well as meaningfully comparable across diseases. Other complimentary SBIR projects focusing on single diseases have demonstrated the potential for more practical and precise assessments over a wide range of severity levels - and the possibility of eliminating "ceiling" and "floor" effects. In Phase II we will combine these efforts and expand our tests of standardized disease-specific and generic measurement models among larger samples of aging adults with multiple co-morbid conditions by administering items from new standardized disease specific item banks as well as previously-validated disease-specific and generic HRQOL measures to address the following aims: (1) Improve the instrument and item pools using (a) qualitative methods and expert/consumer evaluation, (b) quantitative studies among large samples of the most prevalent and burdensome chronic conditions (e.g., asthma, CHF, CKD, depression, diabetes, headache, obesity, osteoarthritis), and (c) head-to-head comparisons between more efficient static and dynamic short forms versus "legacy" (previously-validated) tools; (2) Develop and evaluate aggregated disease-specific and generic feedback report(s), suitable for consumers (who are and are not currently "patients") and their clinicians, with user-friendly normative/benchmark interpretive information; (3) Evaluate the self-assessment system in a longitudinal prospective panel study to replicate tests of psychometric properties, test predictive validity (medical expenditures, role/social participation, mortality) and responsiveness, and address data quality, context and mode effects, accessibility of the Internet, and effects of respondent characteristics; (4) Gather norms by administering generic and disease specific measures to representative US population samples with and without chronic conditions. The Phase II product will be a fully operational self-assessment system for screening and monitoring disease impact for the aging population with multiple co-morbid conditions, including: improved "static" and dynamic (CAT) short forms for assessing disease impact and generic health outcomes, user-friendly feedback reports and documentation. PUBLIC HEALTH RELEVANCE: The Disease Impact Assessment Tool will measure the impact of multiple co-morbidities across the spectrum of physical functioning and mental well-being. It will simplify disease burden screening and provide more actionable information for use in early warning and health care stratification, and enable more practical monitoring of health outcomes for use by providers, payors, governments, researchers and most importantly, consumers that encourage self-management and patient-centered care delivery.

描述（由申请人提供）：该SBIR II期项目将在不断增长的年龄（45岁以上）成年人的人口（45岁以上）和处于共同生效的慢性慢性病的成年人中，开发和评估一种更实用，更全面的方法来标准化与疾病特异性健康相关的生活质量（HRQOL）的自我评估。具体而言，我们建议通过调整以消费者为中心的智能测量来简化疾病影响筛查（用于预防和预警），并通过调整以消费者为中心的智能测量来监视HRQOL结果”，使用项目响应理论（IRT）开发的系统，以改善计算机化的适应性测试（CAT捕获和分数），并通过互联网提供了互联网。对特定疾病的含量的标准化及其跨性别疾病的校准，以实现对结果的反应，并且在其他疾病之间有意义地相当。通过从新的标准化疾病特异性物品库中管理项目以及先前验证的特异性疾病特异性和通用HRQOL测量的较大较大的衰老成年人样本中的标准化疾病特异性和通用测量模型，以解决以下目的：（1）使用（1）使用（A）进行（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a）（a））（a）（a）（a）（a）（a）（A）繁重的慢性疾病（例如哮喘，冠心，CKD，抑郁症，糖尿病，头痛，肥胖，骨关节炎），以及（c）更有效的静态和动态短形式与“遗产”（以前validated）工具之间更有效的静态和动态短形式与更有效的静态短形式和更有效的静态短形式的比较； （2）开发和评估综合的疾病特异性和通用反馈报告，适用于消费者（当前不是“患者”）及其临床医生及其临床医生，并提供用户友好的规范/基准分析解释信息； （3）在纵向前瞻性小组研究中评估自我评估系统，以复制心理计量学特性，测试预测有效性（医学支出，角色/社会参与，死亡率）和反应能力以及解决数据质量，上下文和模式效应，Internet的可访问性，互联网的访问性以及受访者特征的影响； （4）通过对有或没有慢性条件的代表性美国人群样本进行仿制药和疾病的特定措施来收集规范。 II期产品将是一种全面运行的自我评估系统，用于筛查和监测多个合并状况的衰老人群的疾病影响，包括：改善“静态”和动态（CAT）简短形式，用于评估疾病影响和通用健康结果，用户友好的反馈报告和文档。公共卫生相关性：疾病影响评估工具将衡量多种合并症在身体机能和心理健康方面的影响。它将简化疾病负担筛查，并提供更多可行的信息，以用于预警和医疗保健分层，并能够对提供者，付款人，政府，研究人员，最重要的是鼓励自我管理和以患者为中心的护理服务的消费者进行更实际的健康结果监控。