YEARS

2007-2013

AUTHORS

Philip D. Harvey

TITLE

Validation of Measures of real-world outcome

ABSTRACT

DESCRIPTION (provided by applicant): This collaborative study (the P.I. of whose companion application is Dr. Thomas Patterson) aims to validate assessments of real-world (RW) functional outcomes in people with schizophrenia. Schizophrenia patients are often impaired in their social and occupational functioning, their self-care, and their ability to live independently. Not only do these impairments worsen the patient's quality of life, they also increase the societal cost of his or her illness. While these impairments are evident in most patients, surprisingly little attention has been paid to the validity of assessments of these outcomes. Since the current tool of choice in predicting functional disability in schizophrenia is neuropsychological (NP) testing, proposals to reduce disability have tended to focus on short-term treatment of cognitive impairments. However, such trials are not well suited either to induce or identify improvements in real-world functioning. Some researchers have proposed switching to measures of functional capacity instead, but, recent evidence suggests that the correlations obtained between functional-capacity measures, NP test results, and real-world outcomes are largely a function of the real-world rating scale that is used. Thus systematic studies are needed to determine the optimal means for measuring real-world disability and its response to treatment. The present proposal has three distinct goals. It aims to determine: (1) the most accurate and practical scale for rating real-world outcomes in schizophrenia;(2) the optimal user of the scale;and (3) the factors that may impair the validity of self-reports of real-world outcomes on the part of schizophrenia patients. We adopt a construct-validation approach, using NP testing and functional-capacity measures as indicators of the construct and examining the convergence of various real-world outcome measures with these two indicators. Sophisticated data analysis will be performed to determine the convergences, and retesting will be performed to determine the test-retest stability of the candidate measures. The overall goal is to identify improved strategies for measuring real-world disability in schizophrenia and to inform the coming generation of treatment trials aimed at cognitive and functional enhancement through pharmacology and cognitive remediation in terms of the most suitable outcomes measures.

FUNDED PUBLICATIONS

  • The course of neuropsychological performance and functional capacity in older patients with schizophrenia: influences of previous history of long-term institutional stay.
  • Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder.
  • Communication abnormalities predict functional outcomes in chronic schizophrenia: differential associations with social and adaptive functions.
  • Impairment in functional capacity as an endophenotype candidate in severe mental illness.
  • Social competence versus negative symptoms as predictors of real world social functioning in schizophrenia.
  • Absence of bias in clinician ratings of everyday functioning among African American, Hispanic and Caucasian patients with schizophrenia.
  • Association of obesity and treated hypertension and diabetes with cognitive ability in bipolar disorder and schizophrenia.
  • Meta-analysis of the association between cognitive abilities and everyday functioning in bipolar disorder.
  • Psychometric properties of performance-based measurements of functional capacity: test-retest reliability, practice effects, and potential sensitivity to change.
  • Social competence and observer-rated social functioning in bipolar disorder.
  • Diagnosis of schizophrenia: consistency across information sources and stability of the condition.
  • Cognition in schizophrenia: Past, present, and future.
  • Self-assessment in schizophrenia: Accuracy of evaluation of cognition and everyday functioning.
  • Relationship of the Brief UCSD Performance-based Skills Assessment (UPSA-B) to multiple indicators of functioning in people with schizophrenia and bipolar disorder.
  • Heartache and heartbreak—the link between depression and cardiovascular disease
  • Factors influencing self-assessment of cognition and functioning in bipolar disorder: a preliminary study.
  • Performance-based measurement of functional disability in schizophrenia: a cross-national study in the United States and Sweden.
  • Determinants of different aspects of everyday outcome in schizophrenia: The roles of negative symptoms, cognition, and functional capacity.
  • Heartache and heartbreak--the link between depression and cardiovascular disease.
  • Performance-based assessment of functional skills in severe mental illness: results of a large-scale study in China.
  • Schizophrenia in later life.
  • Age-associated differences in cognitive performance in older patients with schizophrenia: a comparison with healthy older adults.
  • Virtual Reality Functional Capacity Assessment In Schizophrenia: Preliminary Data Regarding Feasibility and Correlations with Cognitive and Functional Capacity Performance.
  • Depression in schizophrenia: methodological artifact or distinct feature of the illness?
  • Subscale structure for the Positive and Negative Syndrome Scale (PANSS): a proposed solution focused on clinical validity.
  • Self-assessment of functional ability in schizophrenia: milestone achievement and its relationship to accuracy of self-evaluation.
  • Cognitive enhancement in schizophrenia: pharmacological and cognitive remediation approaches.
  • Factor structure of the MATRICS Consensus Cognitive Battery (MCCB) in schizophrenia.
  • Validating measures of real-world outcome: the results of the VALERO expert survey and RAND panel.
  • APOE: a risk factor for multiple disorders.
  • Sensitivity and specificity of the UCSD Performance-based Skills Assessment (UPSA-B) for identifying functional milestones in schizophrenia.
  • Cognition and disability in bipolar disorder: lessons from schizophrenia research.
  • Functional outcomes, functional capacity, and cognitive impairment in schizotypal personality disorder.
  • Correction of murine hemophilia A and immunological differences of factor VIII variants delivered by helper-dependent adenoviral vectors.
  • Determinants of everyday outcomes in schizophrenia: the influences of cognitive impairment, functional capacity, and symptoms.
  • Factor structure of neurocognition and functional capacity in schizophrenia: a multidimensional examination of temporal stability.
  • Predicting schizophrenia patients' real-world behavior with specific neuropsychological and functional capacity measures.
  • Determinants of occupational and residential functioning in bipolar disorder.
  • Functional milestones and clinician ratings of everyday functioning in people with schizophrenia: overlap between milestones and specificity of ratings.
  • Hospitalization and psychosis: influences on the course of cognition and everyday functioning in people with schizophrenia.
  • A review of instruments for measuring functional recovery in those diagnosed with psychosis.
  • Functional implications of neuropsychological normality and symptom remission in older outpatients diagnosed with schizophrenia: A cross-sectional study.
  • Functional impairment in people with schizophrenia: focus on employability and eligibility for disability compensation.
  • Validating the measurement of real-world functional outcomes: phase I results of the VALERO study.
  • The course of vocational functioning in patients with schizophrenia: Re-examining social drift.
  • Assessing everyday functioning in schizophrenia: not all informants seem equally informative.
  • Assessment of everyday functioning in schizophrenia: implications for treatments aimed at negative symptoms.
  • Age-associated differences in cognitive performance in older community dwelling schizophrenia patients: differential sensitivity of clinical neuropsychological and experimental information processing tests.
  • Factors influencing self-assessment of cognition and functioning in schizophrenia: implications for treatment studies.
  • The Course and Correlates of Everyday Functioning in Schizophrenia.
  • Predictors of the accuracy of self assessment of everyday functioning in people with schizophrenia.
  • Toward a terminology for functional recovery in schizophrenia: is functional remission a viable concept?
  • The convergence between self-reports and observer ratings of financial skills and direct assessment of financial capabilities in patients with schizophrenia: more detail is not always better.
  • Abbreviated neuropsychological assessment in schizophrenia: prediction of different aspects of outcome.
  • Current smoking is associated with worse cognitive and adaptive functioning in serious mental illness.
  • Systemic hypotheses for generalized cognitive deficits in schizophrenia: a new take on an old problem.
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