Benefits and Obstacles for Development of Health Status Assessment Measures in Clinical Settings

Health status measures offer scientific, humanistic, and economic benefits for clinical medicine. The main problem is the many intellectual and pragmatic obstacles that block successful development of these measures. The inventory of such problems includes the following: definition of health; medical components of health status; who makes the choice about what to include and emphasize; attributes to be rated by patients or clinicians; indexes to be created from those attributes (including mega-variable indexes, global indexes, and oligo-category indexes); different measurements of the same entity; and clinimetric problems in nonclinimetric models. Several solutions to these multiple, complex difficulties can be offered: 1) ensure that a specific purpose, focus, and setting are clearly identified for every health status index; 2) recognize that an off-the-shelf index with high statistical scores for so-called reliability and validity may not be pertinent for a given current situation in which it is to be used; 3) avoid indexes involving combinations of excessive numbers of variables; 4) let patients choose the most significant foci and components of the indexes; 5) seek greater communication and understanding among multidisciplinary collaborators, who may have many differences in the ethos and goals with which they approach the construction of health status indexes; and 6) recognize that the construction of suitable health status indexes is an outstanding challenge in basic scientific inquiry, and, in this spirit, support major alterations in the current ideology for conceptualization and funding of what is basic science in clinical medicine

Actuarial science · Business · Conceptualization · Index (typography) · Management science · Multidisciplinary approach · Reliability (semiconductor) · Social science · Sociology · Artificial Intelligence · Climate Change and Health Impacts · Computer Science · Health Systems, Economic Evaluations, Quality of Life · Healthcare cost, quality, practices · Medicine · Psychology

• Using patient-reported outcomes in clinical practice

  Open Access•Kathleen N Lohr, Brad Zebrack et al.•Quality of Life Research•2008

  Incluir item

• Evaluating patient-based outcome measures for use in clinical trials.

  Open Access•Fitzpatrick Fitzpatrick, Davey Davey et al.•Health Technology Assessment•1998

  Incluir item

• Using quality of life measures in the clinical setting

  Open Access•Irene J Higginson, Alison J Carr•BMJ•2001

  Incluir item

• A new patient focused index for measuring quality of life in persons with severe and persistent mental illness

  Open Access•M Becker, R Diamond et al.•Quality of Life Research•1993

  Incluir item

• Techniques For Developing Health Quality of Life Scales for Point of Service Use

  Open Access•Young-Sun Lee, Jeffrey Douglas et al.•Social Indicators Research•2006

  Incluir item

• Linking Clinical Relevance and Statistical significance in Evaluating Intra-Individual Changes in Health-Related Quality of Life

  Kathleen W Wyrwich, Nancy A Nienaber et al.•Medical Care•1999

  Incluir item

• Stability of Nursing Home Quality Indicators Over Time

  Sarita L Karon, François Sainfort et al.•Medical Care•1999

  Incluir item

• A Qualitative Study of Patients’ and Physicians’ Views about Practice-Based Functional Health Assessment

  Colleen A Mchorney, Donald Earl Bricker•Medical Care•2002

  Incluir item

• Measuring change over time

  Open Access•Gordon Guyatt, Gordon Guaytt et al.•Journal of Chronic Diseases•1987

  Incluir item

• Assessment of Coma and Impaired Consciousness

  Open Access•Graham Teasdale, Graham M Teasdale et al.•The Lancet•1974

  Incluir item