Issues in Health Disparities Research in the
Dr. Teresi was the leader of the session of the conference that focused on quantitative approaches to study psychometric adequacy and invariance.
Dr. Teresi is an active member of the Advisory Group of the Veterans Administration — Measurement Excellence and Training Resource Information Center (METRIC), which is a scientific arm devoted to the advancement of measurement methodologies. A recent special issue of HSR, co-edited by Dr. Kuykendall of the VA and Dr. Siu focused on measurement challenges in health services research. Drs Ramirez and Teresi were contributors of an article on measurement equivalence.
Dr. Teresi is on the External Advisory Board to the Cornell Institute for Translational Research on Aging (CITRA)
. In that capacity, she has advised three CITRA pilot investigators regarding measurement issues. Of relevance, one junior investigator (Lisa Honkanen, MD) performed a study of hip protectors at the HHAR; study goals were to examine whether a reduction in hip fractures and hospitalizations would result from use of these devices. CITRA has performed a review of 22 randomized control trials (RCTs) described in the falls prevention literature. They found that interventions that include an exercise component (e.g., walking, muscle strengthening, balance training) are most effective. For those with a known risk for falling, interventions that include home hazard modification were also found to be effective. Several reviews of the literature, including one meta-analysis of 40 RCTs, showed that multifactorial interventions are the most effective for falls prevention (CITRA) Roybal Center
Symposium on Measurement of Pain Among Elderly Chronic Care Populations:
In November 2003, Dr. Teresi was the discussant to a symposium related to measurement of pain among older persons, including those with dementing illness. Other participants included an interdisciplinary group of researchers who have contributed to the measurement of pain and discomfort. The conclusions, based on the symposium were that the set of presentations and papers addressed one of the most challenging areas of measurement research, and that the following issues required addressing:
- How do we assess a latent construct that could be different conceptually across groups?
- How do we assure that the pain measures are culturally invariant? and invariant across different age, gender, caregiver groups?
- How do we converge on valid assessment when the gold standard of self-report is often not measurable?
- How do we address issues such as protection of human subjects, proxy informed consent, and ability to provide informed consent?
- What are the modalities, dimensions, sources of information that must be obtained?
- How do we tackle latent structural equation models when there are selection effects involved?
Hopefully, the scientific development aspects of the proposed effort will begin to address these issues.
State of the Science Conference on End-of-Life Care:
Dr. Teresi and Dr. Magaziner were both subpanel co-chairs of the December, 2004 State of Science Conference on End of Life Care. Dr. Morrison presented state-of-science evidence. One question dealt with measurement of symptoms and states at the end-of-life, an area that was identified as requiring further research.
State of the Science Conference on Item Response Theory
In June, 2004, a State of the Science Conference on IRT, sponsored by the National Cancer Institute was held in
. Dr. Celia was one of the organizers of the conference, and both Drs. Teresi and Cella gave presentations. Dr. Cella contributed data on emotional distress and functional impairment IRT and DIF analyses were conducted by Teresi, Ocepek-Welikson and Kleinman. A paper is in preparation describing these results. Washington