RC-MDM will support the OAIC's effort to establish a comprehensive program to conduct research on older patients with serious illness and train leaders in geriatric palliative care research by providing measurement evaluation and selection and data management for core projects. Among the challenges associated with research in this patient population is the difficulty of fielding lengthy surveys and other examinations on study subjects who are seriously ill, frail, and/or cognitively impaired and family members who are highly burdened. Furthermore, it is unclear whether observed racial/ethnic differences in health outcomes reflect true differences or cultural bias in the measures. In accordance with the Patient Reported Outcomes Measurement Information System (PROMIS) initiative to improve the quality of patient-reported outcomes in geriatric palliative care research, the RC-MDM will address existing measurement challenges in the field through the use of item response theory (IRT) to provide information that could be used to a) construct short-form surveys, b) item banks and c) computerized adaptive tests (CATs) and determine differential item functioning (DIF) to assess the extent to which individuals of different race/ethnicities with the same level of an attribute have a different probability of giving a certain response. Therefore, building on our previous work in data management, item banking, and experience working with PROMIS measures, the Core will (a) assist investigators from the Mount Sinai OAIC and other Pepper centers in evaluating measures, and, where appropriate, in the selection and use of IRT-derived measures; (b) apply psychometric techniques to items on geriatric palliative care domains from identified data sets of older adults with advanced illness; and (c) provide data management for studies (including clinical trials) supported by the other cores. Additionally, through a Developmental Project (DP), the RC-MDM will aim to broaden the availability of IRT-derived measures for geriatric palliative care domains of interest not currently included in the PROMIS initiative. We will perform psychometric analyses of measures obtained in ongoing studies of older adults with serious illness in the areas of family satisfaction and doctor-patient communication among Latino caregivers, symptom burden and quality of life. Finally, we will disseminate measurement information to researchers interested in geriatric palliative care through: a) publications, b) cooperation with the Mount Sinai OAIC Information and Dissemination Core (IDC) and the measurement cores from other OAICs and other groups using item banks, and c) continuation of the RC-MDM web site with links to key sites for measurement research.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Center Core Grants (P30)
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Icahn School of Medicine at Mount Sinai
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