The National Institute on Disability and Rehabilitation Research estimates 253,000 persons presently live with spinal cord injury (SCI) in the U. S. Incidence is approximately 40 per million, or 11,000 new cases per year. SCI affects life expectancy, occupational status, marital status and likelihood, and health-related quality of life. Lifetime costs range from approximately $500,000 for incomplete injury at age 50 to $3 million for high-level injury at age 25, without taking into account lost wages, productivity or informal care giving. Increasing life expectancy for persons with SCI makes improved characterization of health-related quality of life crucial to a full understanding of SCI impact on injured persons, their social circle, the health care system, and society. Judging the effectiveness of rehabilitation to improve independence and quality of life for those with SCI depends on measuring the full range of functional levels across all health aspects targeted by treatment. Current instruments are limited in conceptual clarity, and traditional methods limit their ability to balance measurement precision and acceptability. Therefore, instruments with necessary measurement properties are either too extensive for clinical use or serve a limited patient population. Instruments with a reasonable burden on patients and resources lack the precision required to detect treatment effects, monitor health, judge care quality, provide prognoses, or aid decision-making across the range of patient characteristics. The long-term objective of this project is to develop a superior outcome measurement instrument for SCI than is presently available using contemporary item response theory (IRT) and computer adaptive testing (CAT) methods.
The specific aims of are to: 1) field test the 'item pool', or collection of existing, revised, and newly designed questions to capture SCI status, 2) build the prototype 'SCI-CAT' instrument, and 3) conduct a pilot study of the SCI-CAT in SCI patients with various levels of injury severity. Upon completion, the SCI-CAT and related methods will be available for future clinical and research use. The SCI-CAT will enhance clinical, research, and policy decision-making by providing comprehensive information across the range of limitations affected by SCI while minimizing response burden and resource use.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
5F32HD056763-02
Application #
7547378
Study Section
Special Emphasis Panel (ZRG1-F16-T (20))
Program Officer
Quatrano, Louis A
Project Start
2008-01-02
Project End
2009-09-01
Budget Start
2009-01-01
Budget End
2009-09-01
Support Year
2
Fiscal Year
2009
Total Cost
$49,910
Indirect Cost
Name
Boston University
Department
Other Health Professions
Type
Schools of Public Health
DUNS #
604483045
City
Boston
State
MA
Country
United States
Zip Code
02118
Hazard, Rowland G; Spratt, Kevin F; McDonough, Christine M et al. (2012) Patient-centered evaluation of outcomes from rehabilitation for chronic disabling spinal disorders: the impact of personal goal achievement on patient satisfaction. Spine J 12:1132-7
McDonough, Christine M; Tian, Feng; Ni, Pengsheng et al. (2012) Development of the computer-adaptive version of the Late-Life Function and Disability Instrument. J Gerontol A Biol Sci Med Sci 67:1427-38
McDonough, C M; Grove, M R; Elledge, A D et al. (2012) Predicting EQ-5D-US and SF-6D societal health state values from the Osteoporosis Assessment Questionnaire. Osteoporos Int 23:723-32
Goldstein, Marc S; Scalzitti, David A; Craik, Rebecca L et al. (2011) The revised research agenda for physical therapy. Phys Ther 91:165-74
McDonough, Christine M; Tosteson, Tor D; Tosteson, Anna N A et al. (2011) A longitudinal comparison of 5 preference-weighted health state classification systems in persons with intervertebral disk herniation. Med Decis Making 31:270-80
Carreon, Leah Y; Anderson, Paul A; McDonough, Christine M et al. (2011) Predicting SF-6D utility scores from the neck disability index and numeric rating scales for neck and arm pain. Spine (Phila Pa 1976) 36:490-4
Carreon, Leah Y; Glassman, Steven D; McDonough, Christine M et al. (2009) Predicting SF-6D utility scores from the Oswestry disability index and numeric rating scales for back and leg pain. Spine (Phila Pa 1976) 34:2085-9
Hazard, Rowland G; Spratt, Kevin F; McDonough, Christine M et al. (2009) The impact of personal functional goal achievement on patient satisfaction with progress one year following completion of a functional restoration program for chronic disabling spinal disorders. Spine (Phila Pa 1976) 34:2797-802
Ryder, Hilary F; McDonough, Christine; Tosteson, Anna N A et al. (2009) Decision Analysis and Cost-effectiveness Analysis. Semin Spine Surg 21:216-222
Jette, Alan M; McDonough, Christine M; Haley, Stephen M et al. (2009) A computer-adaptive disability instrument for lower extremity osteoarthritis research demonstrated promising breadth, precision, and reliability. J Clin Epidemiol 62:807-15

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