Showing papers by "Colleen A. McHorney published in 2000"
TL;DR: Although a majority of patients prefer to delegate decision making to physicians, preferences vary significantly by patient characteristics, and approaches to enhancing patient involvement will need to be flexible and accommodating to individual preferences in order to maximize the benefits of patient participation on health outcomes.
Abstract: Objectives.To identify the determinants of patient preferences for participation in medical decision making.Methods.Data were analyzed for 2,197 patients from the Medical Outcomes Study, a 4-year observational study of patients with chronic disease (hypertension, diabetes, myocardial infarction, con
583 citations
TL;DR: This work presents the conceptual foundation and item generation process for the SWAL-QOL, a quality of life and quality of care outcomes tool under development for dysphagia researchers and clinicians.
Abstract: In the past two decades, noteworthy advances have been made in measuring the physiologic outcomes of dysphagia, including measurement of duration of structure and bolus movements, stasis, and penetration–aspiration. However, there is a paucity of data on health outcomes from the patients' perspective, such as quality of life and patient satisfaction. A patient-based, dysphagia-specific outcomes tool is needed to enhance information on treatment variations and treatment effectiveness. We present the conceptual foundation and item generation process for the SWAL-QOL, a quality of life and quality of care outcomes tool under development for dysphagia researchers and clinicians.
306 citations
TL;DR: The pretest of the SWAL-QOL afforded us the opportunity to select items for the ongoing validation study which optimally met a priori psychometric criteria of high data quality, normal item distributions, and robust evidence of item convergent validity.
Abstract: The SWAL-QOL outcomes tool was constructed for use in clinical research for patients with oropharyngeal dysphagia. The SWAL-QOL was constructed a priori to enable preliminary psychometric analyses of items and scales before its final validation. This article describes data analysis from a pretest of the SWAL-QOL. We evaluated the different domains of the SWAL-QOL for respondent burden, data quality, item variability, item convergent validity, internal consistency reliability as measured by Cronbach's alpha, and range and skewness of scale scores upon aggregation and floor and ceiling effects. The item reduction techniques outlined reduced the SWAL-QOL from 185 to 93 items. The pretest of the SWAL-QOL afforded us the opportunity to select items for the ongoing validation study which optimally met our a priori psychometric criteria of high data quality, normal item distributions, and robust evidence of item convergent validity.
255 citations
TL;DR: Overweight and obesity have the largest association with physical function measures and patients who are more likely to have clinically significant reductions in HRQOL and functional impairment are identified.
Abstract: OBJECTIVE: To determine the association between over-weight and obesity and health-related quality of life (HRQOL) in patients with chronic conditions typical of those seen in general medical practice, after accounting for the effects of depression and medical comorbidities. DESIGN: Cross-sectional analysis of data from the Medical Outcomes Study. SETTING: Offices of physicians practicing family medicine, internal medicine, endocrinology, cardiology, and psychiatry in three U.S. cities. PATIENTS: We surveyed 2,931 patients with chronic medical and psychiatric conditions. The patients completed a self-administered questionnaire at enrollment and had complete data on height and weight. MEASUREMENTS AND MAIN RESULTS: Body mass index (BMI), chronic medical conditions, and depression were obtained by structured interview. Health-related quality of life was measured by the SF-36 Health Survey. Patients who were over-weight (BMI 25.0–29.9 kg/m2), patients with class I obesity (BMI 30.0–34.9 kg/m2), and patients with class II–III obesity (BMI ≥ 35 kg/m2) had significantly lower adjusted physical function scores (by 3.4, 7.8, and 13.8 points, respectively) compared with nonoverweight patients. Patients with class I and class II–III obesity also had significantly lower adjusted general health perceptions scores (by 2.8 and 4.4 points, respectively) and lower adjusted vitality scores (by 4.0 and 7.1 points, respectively), compared with nonoverweight patients. No significant differences between nonoverweight, overweight, and obese patients were observed for the mental health scale. Women with elevated BMI had significantly lower HRQOL scores compared with the scores of obese men in several domains. Additionally, blacks with elevated BMI had significantly lower scores than whites in several domains of HRQOL. CONCLUSIONS: Overweight and obesity have the largest association with physical function measures. Recent national standards, which have lowered the threshold for defining overweight, identify patients who are more likely to have clinically significant reductions in HRQOL and functional impairment.
249 citations
TL;DR: By using item response theory to equate and calibrate a large number of activities of daily living on the same scale, this work was able to better understand the structure and order of domain-specific items to each other, as well as the interrelations among items across the ability continuum.
Abstract: BackgroundMore than 75 instruments have been developed to measure functional status These measures differ in number of items, type of rating scale, and item difficulty Such variations render it impossible to compare data across different measures One way to overcome such test dependency is test
196 citations