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$6.9M initiative aims to improve health measurement tools

Dennis G. Fryback

Dennis G. Fryback (large image)

With $6.9 million in funding from the National Institute on Aging of the National Institutes of Health, Industrial and Systems Engineering and Population Health Sciences Professor Dennis Fryback will lead an international initiative that could give researchers and policy makers a more accurate picture of U.S. residents' overall health.

Increasingly, says Fryback, those groups want measures of citizens' overall health. "They need to do so to determine whether and how much health in the United States is improving over time-given the huge national investment we make in health care," he says.

But while tracking changes in life expectancy, for example, involves noting only the age at which people die, measuring overall health is much more complicated. "To do this, we have to measure a sum of all the physical, mental and social abilities of people, as well as how they view their own health and well-being," says Fryback.

Researchers gather that information via health questionnaires. But one problem, he says, is that hundreds of different surveys exist, with about a half-dozen among the most widely used. "These are administered to thousands — even hundreds of thousands — of people worldwide each day," he says.

While they all measure "health," the individual questionnaires do so in different ways. Consequently, researchers can't compare the results accurately. In addition, health averages for U.S. citizens as measured by the surveys don't exist, and questionnaire answers vary depending on the method — phone or pen and paper — with which they're administered. "These have been big problems impeding use of existing health measures and data to solve important policy problems," says Fryback.

Using the half-dozen questionnaires, he and his collaborators will survey nearly 3,000 U.S. older adults via telephone and follow an additional 1,000 patients who undergo medical treatments expected to make big changes in their functional abilities and quality of life. With the data, they will develop parallels, or "crosswalks," among the different questionnaires so their future results will be comparable.

The group also will use the data to determine national health averages for adults by age and sex — both for the population as a whole and for African-American citizens. "Having averages on all the questionnaires simultaneously lets researchers and policy makers look for disparities in health and well-being in much more precise ways than now available," says Fryback.

And to study the psychology of people's responses to various methods of questionnaire delivery, the group will systematically administer the questionnaire both as a self-completed paper-and-pencil document and via telephone. With the results, the researchers will establish national standards for health measures regardless of which way they are administered.

Ultimately, the group hopes to improve considerably the toolbox of general health measures available to researchers and policy makers worldwide.

At UW-Madison, Fryback's collaborators include Sociology Professor Robert Hauser, Social Work Associate Professor Stephanie Robert and Assistant Professor Sherril Sellers, UW Survey Center Researcher John Stevenson and Professor Nora Cate Schaefer, Population Health Sciences Professor Mari Palta, Associate Professor of Medicine James Sosman, and population health sciences graduate students Janel Hanmer and Shani Herrington. Collaborators also hail from University of California-Los Angeles and RAND Health, the University of California-San Diego, the University of Alberta in Canada, and the University of York in England.