Health Outcomes for Older People: Questions for the Coming Decade
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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1996-11 edition. Excerpt: ...(e.g., several adult children) and they have differing views of the individual"s preferences. When using proxy responses for outcomes measurement, should any special calibrations or adjustments be made to give them weights different from that of the actual individual"s response? The methodology for making such adjustments with any kind of validity or reliability is very underdeveloped. Practitioners play an important role in helping patients make choices among different treatment options. Practitioners need to be able to communicate with patients objectively, noncoercively, and sensitively and to let them know what the various outcomes are likely to be for them as individuals. Usually with older people this involves having an understanding of multivariate risk analysis or how multiple and competing risks might interact with each other. Better information on the likelihood of various events and their likely outcomes may assist effective decisionmaking, sometimes through the use of formal decision aids such as decision trees. Examples of Needed Research Include questions about expectations and values in national surveys, such as the National Health Interview Survey, Medicare Current Beneficiary Survey, and the National Nursing Home Survey to establish national norms for comparative use. Improve models that portray treatment benefits while taking into account competing risks and the likelihood of various events occurring. Establish methods of measuring patient preferences for various functional outcomes and examine how those preferences might change over time. Advance the use of methods that incorporate individuals" beliefs, values, preferences, and expectations into treatment plans and decisions. Develop methodologies for calibrating or...