This three-year study will consist of four phases: 1) refinement and testing of a multimedia preference assessment instrument; 2) assessing utilities for ADL dependencies from 1,200 elderly persons drawn from the Kaiser-Permanente Medical Care Program (KPMCP); 3) analyzing the relationships between utilities and respondents' characteristics; and 4) performing the cost-effectiveness analysis (CEA) and cost-benefit analysis of GEM. The investigators plan to assess utilities using a multimedia based computer software program called FLAIR. FLAIR consists of pictures, movies, voice recordings, and text to describe hypothetical health states to study participants. Following pilot testing, the investigators will obtain standard gamble and willingness-to-pay utilities for current health, dependency in each of seven ADLs, dependency in all seven ADLs, and dependency in each of six combinations of ADLs drawn from a factorial grid. Those health states encompass 98 percent of prevalent health states in the elderly. Utilities for the other two percent will be imputed using a regression model. Utilities will be incorporated with survival and direct medical costs into the CEA of GEM. In addition, the willingness-to-pay data will be used in a cost-benefit analysis. Effectiveness data for the economic analyses will come from one or more ongoing randomized trials of GEM.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
1R01AG015110-01
Application #
2460887
Study Section
Special Emphasis Panel (HCT)
Project Start
1997-09-30
Project End
2000-08-31
Budget Start
1997-09-30
Budget End
1998-08-31
Support Year
1
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
800771545
City
Stanford
State
CA
Country
United States
Zip Code
94305
Seidler, Anne M; Bayoumi, Ahmed M; Goldstein, Mary K et al. (2012) Willingness to pay in dermatology: assessment of the burden of skin diseases. J Invest Dermatol 132:1785-90
Sims, Tamara; Holmes, Tyson H; Bravata, Dena M et al. (2008) Simple counts of ADL dependencies do not adequately reflect older adults'preferences toward states of functional impairment. J Clin Epidemiol 61:1261-70
Gerson, Lauren B; Ullah, Nighat; Hastie, Trevor et al. (2007) Does cancer risk affect health-related quality of life in patients with Barrett's esophagus? Gastrointest Endosc 65:16-25
Das, Amar K; Ahmed, Bilal A; Garten, Yael et al. (2006) Knowledge-based method for building patient decision-analytic tools. AMIA Annu Symp Proc :175-9
Phibbs, Ciaran S; Holty, Jon-Erik C; Goldstein, Mary K et al. (2006) The effect of geriatrics evaluation and management on nursing home use and health care costs: results from a randomized trial. Med Care 44:91-5
Gerson, Lauren B; Ullah, Nighat; Hastie, Trevor et al. (2005) Patient-derived health state utilities for gastroesophageal reflux disease. Am J Gastroenterol 100:524-33
Bravata, Dena M; Nelson, Lorene M; Garber, Alan M et al. (2005) Invariance and inconsistency in utility ratings. Med Decis Making 25:158-67
Sims, T L; Garber, A M; Miller, D E et al. (2005) Multimedia quality of life assessment: advances with FLAIR. AMIA Annu Symp Proc :694-8
Wagner, Todd H; Goldstein, Mary K (2004) Behavioral interventions and cost-effectiveness analysis. Prev Med 39:1208-14
Chen, Suephy C; Bayoumi, Ahmed M; Soon, Seaver L et al. (2004) A catalog of dermatology utilities: a measure of the burden of skin diseases. J Investig Dermatol Symp Proc 9:160-8

Showing the most recent 10 out of 11 publications