Measurement in veterans affairs health services research: veterans as a special population

Health Services Research, Oct, 2005 by Robert O. Morgan, Cayla R. Teal, Siddharta G. Reddy, Marvella E. Ford, Carol M. Ashton

In the seventh and final article, "Dynamic Assessment of Health Outcomes: Time to Let the CAT Out of the Bag?" Cook, O'Malley, and Roddey discuss CAT in the assessment of patient reported outcomes. CAT-based measures are "dynamic" in that the set of items presented to a patient is individualized based on continually updated estimations of the patient's level of the trait being measured. This tailored approach to assessment returns increased measurement precision without increased response burden. The article by Cook, O'Malley, and Roddey describes what CAT is (and is not) and discusses its promise and its problems.

SUMMARY

Measurement is the foundation on which health decisions are made, both inside and outside of the VA system. Poor measurement quality can affect the quality of health care decisions, contributing to over- or undertreatment of medical conditions, and, at a system level, can affect decisions about health care policy. While there are numerous measurement issues that deserve consideration (e.g., Rasch approaches to measurement, the linkage or comparison of data from different administrative databases), the accompanying articles highlight a subset of measurement issues that have applicability to the broad community of health services research. It is our hope that they stimulate a broad discussion of the measurement challenges posed by conducting "state-of-the-art" health services research.

ACKNOWLEDGMENT

This material is based upon work supported by the Health Services Research and Development (HSR&D) Service of the Office of Research and Development, Department of Veterans Affairs.

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