Measuring Multimorbidity with Individualized Disease-specific QOL Impact Scales

使用个体化疾病特定 QOL 影响量表测量多重发病率

• 批准号: 8727875
• 负责人: JOHN E WARE
• 金额: $ 18万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-01 至 2015-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8727875
• 关键词: Measuring; Multimorbidity; Individualized; Disease; specific

DESCRIPTION (provided by applicant): It is well documented that multimorbidity, or multiple chronic conditions (MCC), impairs patients' functioning and health-related quality of life (QOL). However, our ability to study the impact of and account for multimorbidity is hampered by methodological problems underlying its conceptualization and measurement. These include lack of a uniform definition, proliferation of diverse multimorbidity indexes, widespread reliance on indexes using population weights that were not developed to explain variations in patients' QOL, and a paucity of indexes that take individual assessments of disease burden into account. The goal of this project is to improve the assessment of MCC impact for the purposes of analyzing and interpreting generic patient- reported outcome (PRO) measures of QOL. We will conduct secondary analyses of cross-sectional and longitudinal data collected in 2011 and 2012 for 10,624 adults from two independent samples (one sampled to represent the US general population and a second cohort oversampled from adults pre-identified with arthritis, cardiovascular disease, chronic kidney disease, diabetes or respiratory disease), pursuant to the NIA- sponsored Computerized Adaptive Assessment of Disease Impact (DICAT) grant (R44 AG025589, Ware, PI). For 36 conditions, DICAT developed standardized disease-specific scales measuring the QOL impact attributed to each condition. These condition-specific QOL impact scores have been evaluated on a disease- by-disease basis but have not been evaluated collectively to determine how well they measure multimorbidity and its impact. We propose to extend this work to better understand the ability of patients to make valid QOL attributions to individual conditions in the context of MCC. We will also determine the importance of differences in alternative approaches to aggregating condition-specific patient QOL impact ratings in the presence of MCC, specifically for purposes of analyzing and interpreting generic PROs. The project has the following specific aims: (1) Explore the extent to which patients with MCC can make valid attributions to specific conditions when reporting disease impact on QOL. (2) Systematically evaluate different MCC aggregation methods used to predict generic PRO outcomes. (3) Cross-validate methods and results with independent data. Additional research will likely be required to fully implement the methodological advances proven to be useful in this research. However, the approach to conceptualizing and measuring MCC impact evaluated in this project ultimately may enable the use of standardized PRO-based MCC impact measures to better estimate and interpret differences in patient case-mix and PRO outcomes in comparative effectiveness research.

描述（由申请人提供）：有充分的文献证明，多种病或多种慢性病（MCC）会损害患者的功能和与健康相关的生活质量（QOL）。但是，我们研究多种病的影响和说明的能力受到其概念化和测量的方法论问题的阻碍。其中包括缺乏统一的定义，多种多发性指数的扩散，使用并非开发出来解释患者QOL的变化的人口权重的广泛依赖指数以及对疾病负担的个人评估的匮乏。该项目的目的是为了分析和解释QOL的通用患者预后（PRO）测量，改善MCC影响的评估。 We will conduct secondary analyses of cross-sectional and longitudinal data collected in 2011 and 2012 for 10,624 adults from two independent samples (one sampled to represent the US general population and a second cohort oversampled from adults pre-identified with arthritis, cardiovascular disease, chronic kidney disease, diabetes or respiratory disease), pursuant to the NIA- sponsored Computerized Adaptive Assessment of Disease Impact （DICAT）Grant（R44 AG025589，Ware，PI）。对于36条条件，DICAT开发了测量QOL影响的标准化疾病特异性量表，归因于每种情况。这些特定条件的QOL影响得分已在疾病辅助症的基础上进行了评估，但尚未集体评估以确定它们如何测量多种疾病及其影响。我们建议扩展这项工作，以更好地了解患者在MCC背景下对各个条件有效QOL归因的能力。我们还将确定替代方法中差异的重要性，即在存在MCC的情况下，特别是为了分析和解释通用专业人士，在存在MCC的情况下汇总了特异性患者的QOL影响评级。该项目具有以下特定目的：（1）探索MCC患者在报告疾病对QOL时的特定疾病的有效归因程度。 （2）系统地评估用于预测通用Pro的不同MCC聚合方法。 （3）具有独立数据的交叉验证方法和结果。可能需要进行其他研究，以充分实施被证明在这项研究中有用的方法论进步。但是，最终在该项目中评估的MCC影响的概念化和测量的方法最终可能使基于标准化的Pro MCC影响措施更好地估计和解释患者病例MIX和比较有效性研究中的PRO COT效果的差异。