The purpose of this project is to develop a new patient-centered outcomes methodology for chronic neurologic diseases which will eventually be used to develop practice guidelines for cost-effective and efficacious preventive treatment. This project will use multiple sclerosis (MS) as a model, and will apply a utility-based approach which integrates patient preferences, neurologic function, and societal cost in its evaluation of treatment trade-offs. This methodology requires validating a set of sensitive, reliable, and valid neurologic and patient-preference assessment tools, considering a series of societal cost models, and integrating them in the evaluation of clinical research on pharmaco- and rehabilitation therapies. The investigation will proceed in two phases. First, psychometric analyses will be done on preliminary versions of the proposed tools using available cross-sectional and longitudinal data. Second, data will be collected for two years from 230 MS patients undergoing pharmaco or rehabilitation therapies. Several health state models of societal cost will be used to evaluate the cost-effectiveness and -efficacy of these interventions. Future work will extend this -work to practice guidelines and to other chronic neurologic diseases.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Project (R01)
Project #
3R01HS008582-01A1S1
Application #
2237063
Study Section
VA Health Services Research and Development Scientific Merit Review Board (HSRD)
Project Start
1995-09-30
Project End
1998-09-29
Budget Start
1995-09-30
Budget End
1996-09-29
Support Year
1
Fiscal Year
1996
Total Cost
Indirect Cost
Name
Frontier Science & Tech Research Fdn,Inc
Department
Type
DUNS #
City
Newton
State
MA
Country
United States
Zip Code
02467
Schwartz, C E; Foley, F W; Rao, S M et al. (1999) Stress and course of disease in multiple sclerosis. Behav Med 25:110-6
Schwartz, C E; Daltroy, L H (1999) Learning from unreliability: the importance of inconsistency in coping dynamics. Soc Sci Med 48:619-31
Schwartz, C E; Peng, C K; Lester, N et al. (1998) Self-reported coping behavior in health and disease: assessment with a card sort game. Behav Med 24:41-4
Schwartz, C E; Chesney, M A; Irvine, M J et al. (1997) The control group dilemma in clinical research: applications for psychosocial and behavioral medicine trials. Psychosom Med 59:362-71