Marilyn Bergner

Bio: Marilyn Bergner is an academic researcher from Johns Hopkins University. The author has contributed to research in topics: Health care & Population. The author has an hindex of 26, co-authored 49 publications receiving 12938 citations. Previous affiliations of Marilyn Bergner include Washington University in St. Louis & University of Washington.

The Sickness Impact Profile: development and final revision of a health status measure.

Abstract: The final development of the Sickness Impact Profile (SIP), a behaviorally based measure of health status, is presented. A large field trial on a random sample of prepaid group practice enrollees and smaller trials on samples of patients with hyperthyroidism, rheumatoid arthritis and hip replacements were undertaken to assess reliability and validity of the SIP and provide data for category and item analyses. Test-retest reliability (r = 0.92) and internal consistency (r - 0.94) were high. Convergent and discriminant validity was evaluated using the multitrait--multimethod technique. Clinical validity was assessed by determining the relationship between clinical measures of disease and the SIP scores. The relationship between the SIP and criterion measures were moderate to high and in the direction hypothesized. A technique for describing and assessing similarities and differences among groups was developed using profile and pattern analysis. The final SIP contains 136 items in 12 categories. Overall, category, and dimension scores may be calculated.

The sickness impact profile: validation of a health status measure.

Abstract: The Sickness Impact Profile (SIP), a measure of health status, is being developed as an outcome measure of health care. A preliminary study of the validity of the SIP was conducted on a sample of 278 subjects who were grouped into four subsamples differing in land and severity of sickness. Selfasses

The Sickness Impact Profile: Conceptual Formulation and Methodology for the Development of a Health Status Measure:

Abstract: The development of a health status measure, the Sickness Impact Profile (SIP), is described in terms of both its conceptualization and methodology. The need for a health status measure that is sensitive and appropriate, based on sickness-related behavior, and culturally unbiased, is discussed. A model of sickness behavior is presented as a guide for methodological development. The description of the initial developmental stage of the SIP includeds detailed discussion and documentation of the collection, sorting and grouping of items that comprise the SIP, scaling of the items, scoring of the instrument, and testing and revision of the prototype instrument. Results of preliminary tests of reliability, validity, and administrative feasibility are presented. Subsequent steps in revision and finalization, now under way, are outlined.

The sickness impact profile. Development of an outcome measure of health care.

Abstract: Dr. Betty Gilson is Associate Professor and Associate Dean, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington 98195. Dr. John Gilson is Director of Medical Education, Group Health Cooperative of Puget Sound, Seattle, Washington. Dr. Bergner is Assistant Professor, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington. Dr. Bobbitt is Research Professor, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington. Ms. Kressel is Senior Administrative Analyst, Health Policy Program, San Francisco, California. Dr. Pollard is a postdoctoral fellow, Department of Psychology, Northwestern University, Evanston, Illinois. Dr. Vesselago's address is: 2012 Tenth Avenue East, Seattle, Washington. This investigation was supported by the HMO Service of the Health Services and Mental Health Administration, Contract HSM 110-72-420. This paper was presented, in abbreviated form, at the American Public Health Association Annual Meeting, San Francisco, 1974. It was accepted for publication July 21, 1975. costly services. The proliferation of innovative organizational patterns for providing health services makes it necessary to obtain data demonstrating the relative benefits of available alternatives. Evaluators use three types of measures to assess health care services: measures of structure, measures of process, and measures of outcome. 1 2 Measures of structure or process assess factors that are presumably directly related to outcome. Measures of outcome are designed to assess the effects of the health care services on the population served. Often, structure or process measures are used because no adequate or efficient measure of outcome is available. While it has been assumed that these three types of evaluation measures are highly related and that structure and process measures can serve as proxies for outcome measures, the substitution will be legitimate only when the relationship between structure or process and outcome has been established. For example, one can assess the outcome of a program such as polio immunization by examining the number of immunizations administered (a process measure), since it has been demonstrated that such immunization leads to less polio (an outcome measure). On the other hand, since it is not known whether the number of clinician visits decreases illness, measuring numbers of visits does not provide knowledge of outcome.

The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.

Abstract: A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.

Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.

Abstract: Background Traditional approaches to mechanical ventilation use tidal volumes of 10 to 15 ml per kilogram of body weight and may cause stretch-induced lung injury in patients with acute lung injury and the acute respiratory distress syndrome. We therefore conducted a trial to determine whether ventilation with lower tidal volumes would improve the clinical outcomes in these patients. Methods Patients with acute lung injury and the acute respiratory distress syndrome were enrolled in a multicenter, randomized trial. The trial compared traditional ventilation treatment, which involved an initial tidal volume of 12 ml per kilogram of predicted body weight and an airway pressure measured after a 0.5-second pause at the end of inspiration (plateau pressure) of 50 cm of water or less, with ventilation with a lower tidal volume, which involved an initial tidal volume of 6 ml per kilogram of predicted body weight and a plateau pressure of 30 cm of water or less. The primary outcomes were death before a patient was discharged home and was breathing without assistance and the number of days without ventilator use from day 1 to day 28. Results The trial was stopped after the enrollment of 861 patients because mortality was lower in the group treated with lower tidal volumes than in the group treated with traditional tidal volumes (31.0 percent vs. 39.8 percent, P=0.007), and the number of days without ventilator use during the first 28 days after randomization was greater in this group (mean [+/-SD], 12+/-11 vs. 10+/-11; P=0.007). The mean tidal volumes on days 1 to 3 were 6.2+/-0.8 and 11.8+/-0.8 ml per kilogram of predicted body weight (P Conclusions In patients with acute lung injury and the acute respiratory distress syndrome, mechanical ventilation with a lower tidal volume than is traditionally used results in decreased mortality and increases the number of days without ventilator use.