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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 25 Research Studies DisplayedGreenlee MC, Bolen S, Chong W
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to improve diabetes treatment and reduce complications.
This paper is the fourth in a series of five articles describing the recommendations of the National Clinician Care Commission (NCCC) on diabetes care. This paper focused on the recommendations of the Treatment and Complications subcommittee of the National Clinical Care Commission. The Commission made recommendations at all levels: patient, practice, health system, and health policy. They also identified several areas that need additional research, such as studying the barriers to uptake of diabetes self-management education and support, exploring methods to implement team-based care, and evaluating the importance of digital connectivity as a social determinant of health.
AHRQ-funded.
Citation: Greenlee MC, Bolen S, Chong W .
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to improve diabetes treatment and reduce complications.
Diabetes Care 2023 Feb; 46(2):e51-e59. doi: 10.2337/dc22-0621..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention, Quality of Life
McEntee ML, Gandek B, Ware JE
Improving multimorbidity measurement using individualized disease-specific quality of life impact assessments: predictive validity of a new comorbidity index.
This study evaluated systematically compared legacy and improve method effects of aggregating multiple chronic conditions (MCC) on the accuracy of predictions of quality of life (QOL) outcomes. The study used online surveys that administered generic physical (PCS) and mental (MCS) QOL outcome measures, the Charlson Comorbidity Index (CCI), an expanded chronic condition checklist (CCC), and individualized QOL Disease-specific Impact Scale (QDIS) ratings in a developmental sample (N = 5490) of US adults. Regression models compared 12- and 35-condition checklists, mortality vs. population QOL-weighting, and population vs. individualized QOL methods. Analyses were cross-validated in an independent sample (N = 1220) representative of the adult general population. Models compared estimates of variance explained and model fit (AIC) for generic PCS and MCS across aggregation methods at baseline and nine-month follow-up. In comparison with sociodemographic-only regression models and Charlson CCI models, increased variance was accounted for using the 35-item population MCS/PCS QOL weighting and individualized QDIS weighting. The new model more accurately predicted physical and mental outcomes using an expanded MCC checklist, population QOL rather than mortality CCI weighting, and individualized rather than population QOL weighting for each reported condition.
AHRQ-funded; HS023117.
Citation: McEntee ML, Gandek B, Ware JE .
Improving multimorbidity measurement using individualized disease-specific quality of life impact assessments: predictive validity of a new comorbidity index.
Health Qual Life Outcomes 2022 Jul 12;20(1):108. doi: 10.1186/s12955-022-02016-7..
Keywords: Quality of Life, Chronic Conditions
Bogetz JF, Revette A, DeCourcey D
Bereaved parent perspectives on the benefits and burdens of technology assistance among children with complex chronic conditions.
The objective of this study was to understand bereaved parent perspectives on technology assistance among children with complex chronic conditions (CCCs). Researchers analyzed data from the cross-sectional Survey of Caring for Children with CCCs. Parents described both benefits and burdens of technology, with two emergent subthemes related to goals of care: technology was necessary to give time for life extension and/or to say goodbye, and technology greatly impacted the child's quality of life and symptoms. The second theme to emergence was complications and regret. The researchers concluded that it is important to understand parents' most goals when supporting decisions about technology assistance for children with CCCs.
AHRQ-funded; HS022986.
Citation: Bogetz JF, Revette A, DeCourcey D .
Bereaved parent perspectives on the benefits and burdens of technology assistance among children with complex chronic conditions.
J Palliat Med 2022 Feb; 25(2):250-58. doi: 10.1089/jpm.2021.0221..
Keywords: Children/Adolescents, Caregiving, Quality of Life, Chronic Conditions
Chyr LC, DeGroot L, Waldfogel JM
Implementation and effectiveness of integrating palliative care into ambulatory care of noncancer serious chronic illness: mixed methods review and meta-analysis.
The purpose of this study was to assess the implementation of models for integrating palliative care into ambulatory care for adults with noncancer serious chronic illness. Between January 2000 to May 2020, the researchers reviewed 3 electronic databases and included qualitative, mixed methods studies, and randomized and nonrandomized controlled trial studies. Quantitative analysis included 14 studies of 2,934 US adult patients. The study found that when compared to usual care the models assessed were not more effective for improving patient health-related quality of life (HRQOL) or for patient depressive symptom scores. Qualitative analysis included 5 studies of 146 patients. There was variance in patient preferences for appropriate timing of palliative care; barriers to implementation included costs, additional visits, and travel. The researchers concluded that models were not more effective than usual care for improving HRQOL or depressive symptom scores and may have little to no effect on decreasing overall symptom burden but were more effective for increasing AD documentation.
AHRQ-funded; 2902015000061
Citation: Chyr LC, DeGroot L, Waldfogel JM .
Implementation and effectiveness of integrating palliative care into ambulatory care of noncancer serious chronic illness: mixed methods review and meta-analysis.
Ann Fam Med 2022 Jan-Feb;20(1):77-83. doi: 10.1370/afm.2754..
Keywords: Chronic Conditions, Palliative Care, Implementation, Patient-Centered Healthcare, Quality of Life
Fredericksen RJ, Harding BN, Ruderman SA
Patient acceptability and usability of a self-administered electronic patient-reported outcome assessment in HIV care: relationship with health behaviors and outcomes.
The authors assessed acceptability/usability of tablet-based patient-reported outcome (PRO) assessments among patients in HIV care and relationships with health outcomes using a modified Acceptability E-Scale (AES) within a self-administered PRO assessment. They found that higher acceptability was associated with better quality of life and adherence while lower acceptability was associated with higher depression symptoms, recent illicit opioid use, and multiple recent sex partners. While patients endorsing depression symptoms, recent opioid use, sex without condoms, or multiple sex partners found PROs less acceptable, overall, patients found the assessments highly acceptable and easy to use.
AHRQ-funded; HS026154.
Citation: Fredericksen RJ, Harding BN, Ruderman SA .
Patient acceptability and usability of a self-administered electronic patient-reported outcome assessment in HIV care: relationship with health behaviors and outcomes.
AIDS Care 2021 Sep;33(9):1167-77. doi: 10.1080/09540121.2020.1845288..
Keywords: Human Immunodeficiency Virus (HIV), Quality of Life, Patient-Centered Outcomes Research, Outcomes, Chronic Conditions
Izadi Z, Li J, Evans M
Socioeconomic disparities in functional status in a national sample of patients with rheumatoid arthritis.
This longitudinal study looked at the association of socioeconomic disparities and functional status in a national sample of patients with rheumatoid arthritis (RA). This study used a cohort from the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) registry from 2016 to 2018. Analyses included all adult patients with a confirmed RA diagnosis and at least 1 functional status (FS) score documented. The Area Deprivation Index (ADI), a zip code-based indicator of poverty, was used as a proxy for socioeconomic status (SES). The cohort included 83,965 patients, of which 77% were women and 72% were non-Hispanic White. Mean age was 63.4 years. The probability of functional decline was 14.1% in the highest SES quintile and 18.9% in the lowest SES quintile. By all measures FS score was worse at lower SES levels.
AHRQ-funded; HS025638; HS024412.
Citation: Izadi Z, Li J, Evans M .
Socioeconomic disparities in functional status in a national sample of patients with rheumatoid arthritis.
JAMA Netw Open 2021 Aug 2;4(8):e2119400. doi: 10.1001/jamanetworkopen.2021.19400..
Keywords: Arthritis, Chronic Conditions, Disparities, Social Determinants of Health, Quality of Life
Kirby JS, Hereford B, Thorlacius L
Validation of global item for assessing impact on quality of life of patients with Hidradenitis suppurativa.
Hidradenitis suppurativa (HS) is a chronic inflammatory disease. The HS core outcome set calls for a patient global assessment (PtGA). The objective of this study was to assess the validity, reliability and responsiveness of a candidate single-item PtGA for HS-specific health-related quality of life (HRQoL). The investigators concluded that the single-item PtGA exhibited reliability, validity and responsiveness in assessing HS-specific HRQoL in HS, making it a good provisional tool for HS clinical research.
AHRQ-funded; HS024585.
Citation: Kirby JS, Hereford B, Thorlacius L .
Validation of global item for assessing impact on quality of life of patients with Hidradenitis suppurativa.
Br J Dermatol 2021 Apr;184(4):681-87. doi: 10.1111/bjd.19344..
Keywords: Skin Conditions, Quality of Life, Chronic Conditions
Bajaj JS, Duarte-Rojo A, Xie JJ
Minimal hepatic encephalopathy and mild cognitive impairment worsen quality of life in elderly patients with cirrhosis.
Researchers investigated the performance of elderly patients with cirrhosis on tests for minimal hepatic encephalopathy (MHE) and predementia mild cognitive impairment (MCI) and their effects on quality of life (QOL). They found that, in a multicenter study of elderly patients with cirrhosis and controls, the presence of MHE, regardless of MCI, was associated with poor cognition and QOL. They created adjusted norms that defined the high sensitivity of EncephalApp for the detection of MHE in older individuals and validated it in a separate cohort.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Duarte-Rojo A, Xie JJ .
Minimal hepatic encephalopathy and mild cognitive impairment worsen quality of life in elderly patients with cirrhosis.
Clin Gastroenterol Hepatol 2020 Dec;18(13):3008-16.e2. doi: 10.1016/j.cgh.2020.03.033..
Keywords: Elderly, Chronic Conditions, Quality of Life, Dementia, Neurological Disorders
Singh SA, Bakshi N, Mahajan P
What is the future of patient-reported outcomes in sickle-cell disease?
Sickle cell disease (SCD) is a complex, chronic disease caused by abnormal polymerization of hemoglobin, which leads to severe pain episodes, fatigue, and end-organ damage. Patient reported outcomes (PROs) have emerged as a critical tool for measuring SCD disease severity and response to treatment. In this study, the authors reviewed the key issues involved when deciding to use a PRO in a clinical trial. They described the most highly recommended generic and disease-specific PRO tools in SCD and discussed the challenges of incorporating them in clinical practice.
AHRQ-funded; HS024953; HS026622.
Citation: Singh SA, Bakshi N, Mahajan P .
What is the future of patient-reported outcomes in sickle-cell disease?
Expert Rev Hematol 2020 Nov;13(11):1165-73. doi: 10.1080/17474086.2020.1830370..
Keywords: Sickle Cell Disease, Pain, Quality of Life, Chronic Conditions, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Rundell SD, Resnik L, Heagerty PJ
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
The Functional Comorbidity Index (FCI) is a comorbidity measure associated with physical function and may contribute to risk adjustment models in rehabilitation settings, but an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) of the FCI has not been tested in outpatient settings. The purpose of this cohort study was to examine the ability of an ICD-9-CM- based FCI to predict function, health-related quality of life, and overall health care use.
AHRQ-funded; HS01922201; HS022972.
Citation: Rundell SD, Resnik L, Heagerty PJ .
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
Pm r 2020 Sep;12(9):891-98. doi: 10.1002/pmrj.12315..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Rehabilitation
Knutzen KE, Schifferdecker KE, Murray GF
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
AHRQ-funded; HS022242.
Citation: Knutzen KE, Schifferdecker KE, Murray GF .
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
BMC Palliat Care 2020 Aug 27;19(1):136. doi: 10.1186/s12904-020-00641-x..
Keywords: Cancer, Quality of Life, Palliative Care, Quality of Care, Chronic Conditions
Rundell SD, Resnik L, Heagerty PJ
Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain.
The purpose of this prospective cohort study was to determine how well the functional comorbidity index (FCI) predicted outcomes in older adults with back pain compared to Quan's modification of the Charlson comorbidity index (Quan-Charlson comorbidity index) and the Elixhauser comorbidity index. The investigators concluded that all indices performed similarly in predicting outcomes. The authors indicated that there is still a need to develop better function-based risk-adjustment models that improve prediction of functional outcomes versus standard comorbidity indices.
AHRQ-funded; HS019222; HS022972.
Citation: Rundell SD, Resnik L, Heagerty PJ .
Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain.
J Orthop Sports Phys Ther 2020 Mar;50(3):143-48. doi: 10.2519/jospt.2020.8764..
Keywords: Elderly, Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Healthcare Utilization, Health Status
Parekh TM, Bhatia S, Cherrington A
Factors influencing decline in quality of life in smokers without airflow obstruction: the COPDGene study.
This study looked at factors influencing decline in quality of life (QoL) in smokers without airflow obstruction using participants from the COPDGene study, a multicenter, longitudinal US study designed to determine genetic determinants of chronic obstructive pulmonary disease (COPD). The authors hypothesized that exacerbations and changes in exacerbation status would predict QoL decline among normal spirometry and Preserved Ratio Impaired Spirometry (PRISm) populations. They enrolled study subjects from Phase 1 of COPDGene and performed multivariable logistic regression models to determine independent predictors of decline in quality of life. Independent predictors of QoL deterioration included current smoking, higher exacerbation frequency, and a change from infrequent to frequent exacerbation status in both groups.
AHRQ-funded; HS023009.
Citation: Parekh TM, Bhatia S, Cherrington A .
Factors influencing decline in quality of life in smokers without airflow obstruction: the COPDGene study.
Respir Med 2020 Jan;161:105820. doi: 10.1016/j.rmed.2019.105820..
Keywords: Respiratory Conditions, Chronic Conditions, Tobacco Use, Quality of Life
Cheng BT, Smith SS, Fishbein AB
Functional burden and limitations in children with chronic sinusitis.
The objective of this study was to use a validated pediatric quality of life (QOL) tool to quantify the impact of pediatric chronic rhinosinusitis (CRS) in a representative epidemiological sample. Findings showed that pediatric CRS was associated with substantial QOL burden across multiple psychosocial and cognitive domains and that CRS children with lower family income and comorbid asthma, anxiety, and depression had higher Columbia Impairment Scale scores associated with even greater functional impairment. These findings suggested that pediatric CRS might be a population requiring greater attention and screening for mental health symptoms.
AHRQ-funded; HS023011.
Citation: Cheng BT, Smith SS, Fishbein AB .
Functional burden and limitations in children with chronic sinusitis.
Pediatr Allergy Immunol 2020 Jan;31(1):103-05. doi: 10.1111/pai.13121..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Quality of Life, Healthcare Costs, Respiratory Conditions, Chronic Conditions
Andreae SJ, Andreae LJ, Richman JS
Peer-delivered cognitive behavioral training to improve functioning in patients with diabetes: a cluster-randomized trial.
Cognitive behavioral therapy (CBT)-based programs delivered by trained community members could improve functioning and pain in individuals who lack access to such programs. In this study, the investigators tested the effectiveness of a peer-delivered diabetes self-management program integrating CBT principles in improving physical activity, functional status, pain, quality of life (QOL), and health outcomes in individuals with diabetes and chronic pain.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Richman JS .
Peer-delivered cognitive behavioral training to improve functioning in patients with diabetes: a cluster-randomized trial.
Ann Fam Med 2020 Jan;18(1):15-23. doi: 10.1370/afm.2469..
Keywords: Diabetes, Chronic Conditions, Pain, Patient Self-Management, Quality of Life
Volerman A, Fierstein J, Boon K
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Guidelines recommend that children and families receive education about and demonstration of effective inhaler technique as part of asthma self-management education. For youth, improved inhaler technique is associated with better quality of life and decreased health care use, yet technique remains suboptimal. To understand potential reasons for differences in inhaler skills, this study examined individual- and health care-level factors associated with effective inhaler technique among children.
AHRQ-funded; HS026385.
Citation: Volerman A, Fierstein J, Boon K .
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Ann Allergy Asthma Immunol 2019 Nov;123(5):511-12.e1. doi: 10.1016/j.anai.2019.08.017.
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Keywords: Children/Adolescents, Asthma, Chronic Conditions, Patient Self-Management, Education: Patient and Caregiver, Medication, Quality of Life
Uy V, Hays RD, Xu JJ
Do the unlabeled response categories of the Minnesota Living with Heart Failure Questionnaire satisfy the monotonicity assumption of simple-summated scoring?
Half of the 21-item Minnesota Living with Heart Failure Questionnaire (MLHFQ) response categories are labeled (0 = No, 1 = Very little, 5 = Very much) and half are not (2, 3, and 4). In this study, the investigators hypothesized that the unlabeled response options would not be more likely to be chosen at some place along the scale continuum than other response options and, therefore, not satisfy the monotonicity assumption of simple-summated scoring.
AHRQ-funded; HS019311.
Citation: Uy V, Hays RD, Xu JJ .
Do the unlabeled response categories of the Minnesota Living with Heart Failure Questionnaire satisfy the monotonicity assumption of simple-summated scoring?
Qual Life Res 2020 May;29(5):1349-60. doi: 10.1007/s11136-020-02422-8..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Quality of Life
Taylor YJ, Tapp H, Shade LE
Impact of shared decision making on asthma quality of life and asthma control among children.
This study evaluated the impact of shared decision making (SDM) on quality of life and symptom control in children with asthma. The investigators found that implementation of SDM within clinical practices using a standardized toolkit was associated with improved asthma quality of life and asthma control for low-income children with asthma when compared to usual care with decision support.
AHRQ-funded; HS019946.
Citation: Taylor YJ, Tapp H, Shade LE .
Impact of shared decision making on asthma quality of life and asthma control among children.
J Asthma 2018 Jun;55(6):675-83. doi: 10.1080/02770903.2017.1362423..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Chronic Conditions, Decision Making, Quality of Life
Vakharia PP, Chopra R, Sacotte R
Burden of skin pain in atopic dermatitis.
This study sought to characterize the patient burden of skin pain in AD. It found that twenty-four (16.8 percent) patients thought the skin pain was part of their itch, 16 (11.2 percent) from scratching, and 77 (72.0 percent) from both. Patients with skin pain were more likely to describe their itch using terms that resembled neuropathic pain.
AHRQ-funded; HS023011.
Citation: Vakharia PP, Chopra R, Sacotte R .
Burden of skin pain in atopic dermatitis.
Ann Allergy Asthma Immunol 2017 Dec;119(6):548-52.e3. doi: 10.1016/j.anai.2017.09.076.
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Keywords: Chronic Conditions, Pain, Quality of Life, Skin Conditions
Silverberg JI
Selected comorbidities of atopic dermatitis: atopy, neuropsychiatric, and musculoskeletal disorders.
Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease with substantial morbidity and quality of life impairment. This review summarizes recent developments in the atopic and neuropsychiatric comorbidities of AD. For example, it concludes that persons with AD appear to be at higher risk for multiple neuropsychiatric disorders, including depression, attention-deficit/hyperactivity disorder, speech disorders in childhood, headaches, and seizures.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Selected comorbidities of atopic dermatitis: atopy, neuropsychiatric, and musculoskeletal disorders.
Clin Dermatol 2017 Jul - Aug;35(4):360-66. doi: 10.1016/j.clindermatol.2017.03.008.
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Keywords: Skin Conditions, Chronic Conditions, Behavioral Health, Quality of Life, Children/Adolescents
Waldfogel JM, Nesbit SA, Dy SM
Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: a systematic review.
This review systematically assessed the effect of pharmacologic treatments of diabetic peripheral neuropathy (DPN) on pain and quality of life. It concluded that for reducing pain, duloxetine and venlafaxine, pregabalin and oxcarbazepine, tricyclic antidepressants, atypical opioids, and botulinum toxin were more effective than placebo. However, quality of life was poorly reported, studies were short-term, drugs had substantial dropout rates, and opioids have significant risks.
AHRQ-funded; 2902015000061.
Citation: Waldfogel JM, Nesbit SA, Dy SM .
Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: a systematic review.
Neurology 2017 May 16;88(20):1958-67. doi: 10.1212/wnl.0000000000003882.
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Keywords: Diabetes, Chronic Conditions, Medication, Quality of Life, Patient-Centered Outcomes Research
Ware JE, Jr., Gandek B, Allison J
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
The objective of this study was to evaluate the convergent and discriminant validity of QOL attributions to specific diseases among adults with multiple chronic conditions (MCC). It concluded that, collectively, convergent and discriminant test results support the construct validity of disease-specific QOL impact attributions across MCC within the eight pre-identified conditions.
AHRQ-funded; HS023117.
Citation: Ware JE, Jr., Gandek B, Allison J .
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
Int J Stat Med Res 2016;5(1):17-40..
Keywords: Quality of Life, Chronic Conditions, Arthritis, Kidney Disease and Health, Heart Disease and Health
Ware JE, Jr., Gandek B, Guyer R
Standardizing disease-specific quality of life measures across multiple chronic conditions: development and initial evaluation of the QOL Disease Impact Scale (QDIS(R)).
The researchers document the development and evaluation of the Quality of life Disease Impact Scale (QDIS(R)), a measure that standardizes item content and scoring across chronic conditions and provides a summary, norm-based quality of life (QOL) impact score for each disease. Standardization of content and scoring across diseases was shown to be justified psychometrically and enabled the first summary measure of disease-specific QOL impact normed in the chronically ill population.
AHRQ-funded; HS023117.
Citation: Ware JE, Jr., Gandek B, Guyer R .
Standardizing disease-specific quality of life measures across multiple chronic conditions: development and initial evaluation of the QOL Disease Impact Scale (QDIS(R)).
Health Qual Life Outcomes 2016 Jun 2;14:84. doi: 10.1186/s12955-016-0483-x.
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Keywords: Quality of Life, Chronic Conditions, Outcomes
Chao MT, Abercrombie PD, Nakagawa S
Prevalence and use of complementary health approaches among women with chronic pelvic pain in a prospective cohort study.
The aim of this study was to examine the prevalence of and factors associated with use of complementary health approaches among women with chronic pelvic pain (CPP). It found that just over 51 percent of the women with CPP who used complementary health approaches had more optimal health-related quality of life, as measured by the Pelvic Problem Impact Questionnaire.
AHRQ-funded; HS011657; HS07373; HS09478.
Citation: Chao MT, Abercrombie PD, Nakagawa S .
Prevalence and use of complementary health approaches among women with chronic pelvic pain in a prospective cohort study.
Pain Med 2015 Feb;16(2):328-40. doi: 10.1111/pme.12585..
Keywords: Chronic Conditions, Women, Complementary and Alternative Medicine, Quality of Life
Prosser LA, Lamarand K, Gebremariam A
Measuring family HRQoL spillover effects using direct health utility assessment.
The researchers evaluated the loss in health-related quality of life of having a family member with a chronic illness by condition and relationship type. They found that the effects of illness extend beyond the individual patient to include effects on caregivers of patients, parents of ill children, spouses, and other close family and household members. They recommended that cost-effectiveness analyses consider the inclusion of health-related quality of life spillover effects in addition to caregiving time costs incurred by family members of ill individuals.
AHRQ-funded; HS014010.
Citation: Prosser LA, Lamarand K, Gebremariam A .
Measuring family HRQoL spillover effects using direct health utility assessment.
Med Decis Making 2015 Jan;35(1):81-93. doi: 10.1177/0272989x14541328.
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Keywords: Caregiving, Chronic Conditions, Family Health and History, Healthcare Costs, Quality of Life