Outcomes Based Appropriateness/Ronald Dale Hays

基于结果的适当性/罗纳德·戴尔·海斯

• 批准号: 8573685
• 负责人: Ian Douglass Coulter
• 金额: $ 33.72万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8573685
• 关键词: Adult; Caring; Chiropractic manipulation; Chronic; Chronic neck pain; Cognitive; Complementary and alternative medicine; Data; Databases; Economics; Evaluation; Focus Groups; Future; Health; Health Personnel; Health Planning; Health Services Research; Health Surveys; Healthcare; Healthcare Systems; Information Systems; Intervention; Interview; Judgment; Literature; Measurement; Measures; Medicare; Mental Health; Modification; Musculoskeletal; National Health Interview Survey; Neck Pain; Outcome; Outcome Measure; Pain; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Perception; Personal Satisfaction; Property; Psychometrics; Random Allocation; Reporting; Research; Research Methodology; Safety; Sampling; Science; Site; Surveys; Time; Treatment Effectiveness; United States; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Variant; Veterans; Visit; Work; base; chiropracty; clinical practice; comparative; comparative effectiveness; daily functioning; experience; health care quality; health related quality of life; improved; innovation; interest; physical conditioning; preference; prevent; response; systematic review

Project Description This project will conduct a systematic literature with the support of the Systematic Review Core to locate prior work on associations between variation in chiropractic care for chronic cervical pain care and patient-reported outcomes (PROs). We will also conduct focus groups to evaluate the applicability of standardized PROs that assess patient experiences of care (Consumer Assessment of Healthcare Providers and Systems or CAHPS¿) and health-related quality of life (Patient-Reported Outcomes Measurement and Information System or PROMIS¿) to chiropractic patients who have experienced M/M for cervical pain. This information will be used to determine if modifications to existing measures are needed and if there are gaps that require new items. Revisions to existing items and new items will then be drafted and subjected to cognitive interviews with chiropractic patients who have experienced M/M for cervical pain. The revised and new items will be finalized based on the cognitive interviews and then included along with the CAHPS Clinician and Group Adult Visit Survey and the PROMIS-57 Survey in the national sample of chiropractic patients shared by each of the four projects in this Center of Excellence. The national sample data will be collected from a random selection of practitioners and their patients in four national sites geographically distributed across the US. Project 1 will assess the treatment given chronic cervical pain and the number of times M/M is done. Project 1 with help from the Research Methods Assessment and Evaluation Core will estimate the appropriateness of chiropractic M/M care. We will conduct a thorough evaluation of the psychometric properties of these PRO measures in the national sample of chiropractic patients with chronic cervical pain, including an evaluation of measurement equivalence by comparing the national sample responses to data collected in large samples of other patients: the CAHPS comparative database and PROMIS wave 1 sample. In addition, we will estimate the associations between appropriateness of care (defined by Project 1) and PROs in the national sample. The health-related quality of life outcomes we use will also be useful to Project 4 (Economic Based Appropriateness), especially the EQ-5D preference-based single summary score we will estimate based on the PROMIS-57 domain scores. This work provides an essential assessment of the applicability of the leading state-of-the-science patient centered outcome measures to CAM in terms of acceptability to chiropractic patients and psychometric quality. In addition, it provides unique information about the extent to which the current approach tor evaluating appropriateness of care relates to patient-centered outcomes of care. The findings of this study will provide a basis for future evaluations of the comparative effectiveness of CAM versus other health care interventions in the United States.

项目描述 该项目将在系统审查核心的支持下开展系统文献研究，以找出慢性颈椎疼痛护理的脊椎按摩疗法与患者报告结果 (PRO) 之间的关联的先前工作，我们还将开展焦点小组来评估其适用性。评估患者护理体验（医疗保健提供者和系统的消费者评估或 CAHPS）和健康相关生活质量（患者报告的结果测量和信息系统或 PROMIS）的标准化 PRO经历过颈痛 M/M 治疗的脊椎按摩治疗患者将使用此信息来确定是否需要修改现有措施以及是否存在需要对现有项目进行修订的差距，然后将起草并实施新项目。对经历过颈痛 M/M 的脊椎按摩治疗患者进行认知访谈 修订后的新项目将根据认知访谈最终确定，然后与 CAHPS 临床医生和团体成人访问调查以及全国的 PROMIS-57 调查一起纳入。的样本该卓越中心的四个项目共享脊椎按摩疗法患者。 全国样本数据将从分布在美国各地的四个国家地点随机选择的医生及其患者收集，项目 1 将评估慢性颈椎疼痛的治疗以及项目 1 的治疗次数。研究方法评估和评估核心的帮助将评估脊椎按摩疗法 M/M 护理的适当性。 我们将在慢性颈椎疼痛脊椎按摩治疗患者的全国样本中对这些 PRO 测量的心理测量特性进行彻底评估，包括通过将全国样本响应与其他患者大样本中收集的数据进行比较来评估测量等效性：CAHPS此外，我们将估计国家样本中护理的适当性（由项目 1 定义）与 PRO 之间的关联，我们使用的健康相关生活质量结果也将对项目 4 有用。 （基于经济的适当性），尤其是基于 EQ-5D 偏好的单一汇总分数，我们将根据 PROMIS-57 领域分数进行估计。 这项工作从脊椎按摩治疗患者的可接受性和心理测量质量方面对领先的以患者为中心的科学结果测量的适用性进行了重要评估。此外，它还提供了有关当前的程度的独特信息。评估护理适当性的方法与以患者为中心的护理结果相关。这项研究的结果将为未来评估 CAM 与美国其他医疗保健干预措施的比较有效性提供基础。