Method, system and medium for assessing the impact of various ailments on health related quality of life

• US 8,340,982 B2
• Filed: 09/10/2010
• Issued: 12/25/2012
• Est. Priority Date: 06/02/2000
• Status: Active Grant

• Current Assignee: QuarterMaster Newco, LLC (UnitedHealth Group Incorporated)
• Original Assignee: Optuminsight Life Sciences, Inc. (UnitedHealth Group Incorporated)
• Inventors: Bjorner, Jakob B., Ware, John E., Kosinski, Mark R., Sardinha, Barbara, Dewey, James E.
• Primary Examiner(s): Le, Michelle
• Application Number:
  US12/879,267
• Publication Number:
  US 20110208533A1
• Time in Patent Office: 837 Days
• Field of Search: 434/236, 434/322
• US Class Current: 705/3
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 70/60 relating to pathologies

Abstract

The present invention relates to a system and method for assessing the impact of an ailment on a health related quality of life domain of a patient using a standardized common metric. The standardized common metric of the present invention enables the impact of various ailments to be compared.

Claims

1. A computer based system for assessing the impact of one or more ailments on a health related quality of life (HRQOL) domain of a patient, wherein said HRQOL domain comprises a plurality of indicators of functional health and well being, comprising:

a microprocessor configured to;

generate a customized test having a plurality of questions for said patient to determine the impact of said one or more ailments on said HRQOL domain, wherein each question comprises an indicator of functional health and well being as a result of said one or more ailments, wherein said indicator is stably scaled across ailments whose impact is to be assessed to establish a standardized common metric for comparing the impact of various ailments;

administer said test by providing one question at a time to said patient;

evaluate, after each question, answers provided by said patient to estimate an ailment impact score and a confidence level in the accuracy of said estimated ailment impact score for each of the one or more ailments;

vary a threshold, after each question, as a function of said estimated aliment impact scores during administration of said test to said patient; and

dynamically modify said test if said estimated confidence level is outside said threshold for each of the one or more ailments;

an interface associated with said microprocessor to present said test to said patient and to receive said answers provided by said patient; and

a database associated with said processor to store said test, said plurality of questions, said answers provided by said patient, and said estimated ailment impact scores.

2. The system of claim 1, wherein said microprocessor generates said test to determine the impact of said one or more ailments on at least one of the following indicators of functional health and well being:

restrict recreational activities, lie down and rest, feel frustrated, difficult to focus attention, restrict performing daily activities, feel irritable, limit ability to do activities, difficulty in performing daily activities, keep from enjoying social activities, limit ability to concentrate, keep you from socializing, afraid of letting others down, avoid social or family activities, place stress on your relationships, feel like a burden on others, avoid traveling, feel desperate, cancel work or daily activities, need help in routine daily tasks, and keep you in bed.

3. The system of claim 1, wherein said microprocessor generates said test to determine the impact of at least one of the following ailments:

headache, hernia, rhinitis, asthma, overweight, osteoarthritis, diabetes, chronic obstructive pulmonary disease, depression, congestive heart failure, and rheumatoid arthritis.

4. The system of claim 1, wherein said microprocessor is further configured to generate a report regarding said estimated ailment impact scores of said patient, and to compare said answers provided by said patient with answers provided by other patients in said domain stored in said database.

5. The system of claim 4, wherein said report compares the estimated impact scores calculated for each of the one or more ailments on a uni-dimensional scale.

6. The system of claim 1, wherein said microprocessor is further configured to rank said plurality of questions in accordance with said estimated ailment impact scores, and to select a highest ranked question that has not been administered to said patient from said plurality of questions stored in said database based on said ranking.

7. The system of claim 1, wherein said microprocessor is further configured to terminate said administration of said test if it is determined that said estimated confidence level is within said threshold.

8. The system of claim 1, wherein said microprocessor generates said test having said plurality of questions to determine the impact of said one or more ailments on a plurality of HRQOL domains.

9. The system of claim 1, wherein said microprocessor is configured to repeat the generating, administering, evaluating, varying, and dynamically modifying steps for each of the one or more ailments.

10. The system of claim 1, wherein said microprocessor is configured to statistically analyze said answers provided by said patient for errors, consistency, or estimating non-responsive answers to said test.

11. The system of claim 1, wherein said microprocessor is configured to generate said standardized common metric of the impact of an ailment on said HRQOL domain across a plurality of ailments or age groups.

12. The system of claim 11, wherein said microprocessor is further configured to:

perform a uni-dimensionality evaluation on a plurality of indicators of functional health and well-being impacted by said plurality of ailments to provide a first set of candidate indicators;

perform a differential item functioning analyses on said plurality of indicators of functional health and well-being impacted by said plurality of ailments to provide a second set of candidate indicators;

build an item bank of said plurality of indicators of functional health and well-being impacted by said plurality of ailments from said indicators that are members of both said first and second sets of candidate indicators to provide indicators that are stably scaled across said plurality of ailments or age groups; and

order said indicators of functional health and well-being impacted by said plurality of ailments that are stably scaled across said plurality of ailments or age groups in accordance with the relative level of ailment impact defined by each to form said standardized common metric of the impact of an ailment on said HRQOL domain of said at least one patient across said plurality of ailments or age groups.

13. The system of claim 1, wherein said microprocessor is further configured to develop clinical benchmarks for interpretation of said estimated ailment impact scores.

14. A method of assessing the impact of one or more ailments on a health related quality of life (HRQOL) domain of a patient, wherein said HRQOL domain comprises a plurality of indicators of functional health and well being, comprising the steps of:

generating a customized test from a database comprising questions for a plurality of HRQOL domains, said test having a plurality of questions for said patient to determine the impact of said one or more ailments on said HRQOL domain by a microprocessor, wherein each question comprises an indicator of functional health and well being as a result of said one or more ailments, wherein said indicator is stably scaled across ailments whose impact is to be assessed to establish a standardized common metric for comparing the impact of various ailments;

administering said test by said microprocessor by providing one question at a time to said patient via an interface associated with said microprocessor;

evaluating by said microprocessor, after each question, answers provided by said patient to estimate an ailment impact score and a confidence level in the accuracy of said estimated ailment impact score;

varying a threshold by said microprocessor, after each question, as a function of said estimated aliment impact score during administration of said test to said patient for each of the one or more ailments;

storing said test, said answers provided by said patient, and said estimated ailment impact score in said database; and

dynamically modifying said test by said microprocessor if said estimated confidence level is outside said threshold.

15. The method of claim 14, further comprising the step of generating said test by said microprocessor to determine the impact of said one or more ailments on at least one of the following indicator of functional health and well being:

restrict recreational activities, lie down and rest, feel frustrated, difficult to focus attention, restrict performing daily activities, feel irritable, limit ability to do activities, difficulty in performing daily activities, keep from enjoying social activities, limit ability to concentrate, keep you from socializing, afraid of letting others down, avoid social or family activities, place stress on your relationships, feel like a burden on others, avoid traveling, feel desperate, cancel work or daily activities, need help in routine daily tasks, and keep you in bed.

16. The method of claim 14, further comprising the step of generating said test by said microprocessor to determine the impact of at least one of the following ailments on said patient:

headache, hernia, rhinitis, asthma, overweight, osteoarthritis, diabetes, chronic obstructive pulmonary disease, depression, congestive heart failure, and rheumatoid arthritis.

17. The method of claim 14, further comprising the steps of generating by said microprocessor a report regarding said estimated ailment impact scores of said patient and comparing by said microprocessor said answers provided by said patient with answers provided by other patients in said domain stored in said database.

18. The method of claim 17, wherein said report compares the estimated impact scores calculated for each of the one or more ailments on a uni-dimensional scale.

19. The method of claim 14, further comprising the steps of ranking said plurality of questions by said microprocessor in accordance with said estimated ailment impact scores;

selecting a higher ranked question by said microprocessor that has not been administered to said patient from said plurality of questions stored in said database based on said ranking.

20. The method of claim 14, further comprising the step of terminating said administration of said test if it is determined that said estimated confidence level is within said threshold.

21. The method of claim 14, further comprising the step of generating by said microprocessor said test having said plurality of questions to determine the impact of said one or more ailments on a plurality of HRQOL domains.

22. The method of claim 14, further comprising repeating the generating, administering, evaluating, varying, and dynamically modifying steps for each of the one or more ailments.

23. The method of claim 14, further comprising the step of statistically analyzing by said microprocessor said answers provided by said patient for errors, consistency, or estimating non-responsive answers to said test.

24. The method of claim 14, further comprising the step of generating by said microprocessor said standardized common metric of the impact of an ailment on said HRQOL domain across a plurality of ailments or age groups.

25. The method of claim 14, further comprising the steps of:

performing by said microprocessor a uni-dimensionality evaluation on a plurality of indicators of functional health and well-being impacted by said plurality of ailments to provide a first set of candidate indicators;

performing by said microprocessor a differential item functioning analyses on said plurality of indicators of functional health and well-being impacted by said plurality of ailments to provide a second set of candidate indicators;

building by said microprocessor an item bank of said plurality of indicators of functional health and well-being impacted by said plurality of ailments from said indicators that are members of both said first and second sets of candidate indicators to provide indicators that are stably scaled across said plurality of ailments or age groups; and

ordering by said microprocessor said indicators of functional health and well-being impacted by said plurality of ailments that are stably scaled across said plurality of ailments or age groups in accordance with the relative level of ailment impact defined by each to form said standardized common metric of the impact of an ailment on said HRQOL domain of said at least one patient across said plurality of ailments or age groups.

26. The method of claim 14, further comprising the step of developing by said microprocessor clinical benchmarks for interpretation of said estimated ailment impact score.