Browsing by Subject "Information Systems"

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    ItemOpen Access
    An Information Systems Strategy for the Environmental Conservation Community
    (2008-04-25T20:55:48Z) Barker, Kristin
    As the cause of environmental conservation emerges as a global priority, the need for a practical information systems strategy shared among conservation organizations becomes imperative. Historically, researchers and practitioners in conservation have met their own information management and analysis needs with inevitable variation in methodology, semantics, data formats and quality. Consequently, conservation organizations have been unable to systematically assess conditions and set informed priorities at various scales, measure performance of their projects and improve practices through adaptive management. Moreover, the demands on conservation are changing such that the bottom-up approach to information systems will become an increasing constraint to effective environmental problem solving. Where we have historically focused on the protection of “important” places and species and more recently “biodiversity,” conservation is moving to a systems view, specifically ecosystem-based management, where relationships and process are as important as the individual elements. In parallel, awareness of the human dependency on functioning natural systems is on the rise and with it the need to explicitly value ecosystem services and inform tradeoffs. Climate change requires conservation to develop dynamic adaptation scenarios at multiple spatial and temporal scales. Finally, the business of conservation is under increased pressure to account for its spending and objectively measure outcomes of its strategies. All of these changes translate to growing, not shrinking, demands on information and information systems. In response to these challenges, this research presents an information systems strategy for the environmental conservation community. It proposes the development of a distributed systems infrastructure with end-user tools and shared services that support standardized datasets. Key strategies include removing the barriers to information sharing, providing valuable tools to data producers and directly supporting heterogeneity in conservation datasets. The strategy concludes with a call for high-level management involvement in information systems strategy and collaborative investment in implementation by the conservation community, partners in government and donors. Without these steps, conservation as an industry may find itself ill-equipped to meet the changing needs of people and nature.
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    Measuring social health in the patient-reported outcomes measurement information system (PROMIS): item bank development and testing.
    (Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2010-09) Hahn, Elizabeth A; Devellis, Robert F; Bode, Rita K; Garcia, Sofia F; Castel, Liana D; Eisen, Susan V; Bosworth, Hayden B; Heinemann, Allen W; Rothrock, Nan; Cella, David; PROMIS Cooperative Group

    Purpose

    To develop a social health measurement framework, to test items in diverse populations and to develop item response theory (IRT) item banks.

    Methods

    A literature review guided framework development of Social Function and Social Relationships sub-domains. Items were revised based on patient feedback, and Social Function items were field-tested. Analyses included exploratory factor analysis (EFA), confirmatory factor analysis (CFA), two-parameter IRT modeling and evaluation of differential item functioning (DIF).

    Results

    The analytic sample included 956 general population respondents who answered 56 Ability to Participate and 56 Satisfaction with Participation items. EFA and CFA identified three Ability to Participate sub-domains. However, because of positive and negative wording, and content redundancy, many items did not fit the IRT model, so item banks do not yet exist. EFA, CFA and IRT identified two preliminary Satisfaction item banks. One item exhibited trivial age DIF.

    Conclusion

    After extensive item preparation and review, EFA-, CFA- and IRT-guided item banks help provide increased measurement precision and flexibility. Two Satisfaction short forms are available for use in research and clinical practice. This initial validation study resulted in revised item pools that are currently undergoing testing in new clinical samples and populations.
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    Use of Patient-Reported Outcomes Measurement Information System (PROMIS) measures to characterise health status for patients seeking care from an orthopaedic provider: a retrospective cohort study.
    (BMJ open, 2021-09-02) Horn, Maggie E; Reinke, Emily K; Yan, Xiaofang; Luo, Sheng; Bolognesi, Michael; Reeve, Bryce B; George, Steven Z; Comprehensive Outcomes in Orthopaedics and Rehabilitation Data System (COORDS) group

    Objectives

    Characterise the health status of patients newly consulting an orthopaedic specialist across eight clinical subspecialties.

    Design

    Retrospective cohort.

    Setting

    18 orthopaedic clinics, including 8 subspecialties (14 ambulatory and 4 hospital based) within an academic health system.

    Participants

    14 910 patients consulting an orthopaedic specialist for a new patient consultation who completed baseline Patient-Reported Outcomes Measurement Information System (PROMIS) measures associated with their appointment from 17 November 2017 to 13 May 2019. Patients were aged 55.72±5.8 years old, and 61.3% were female and 79.3% were Caucasian and 13.4% were black or African American. Patients who did not complete PROMIS measures or cancelled their appointment were excluded from the study.

    Primary outcome

    PROMIS domains of physical function, pain interference, pain intensity, depression, anxiety, fatigue, sleep disturbance and the ability to participate in social roles.

    Results

    Mean PROMIS scores for physical function were (38.1±9.2), pain interference (58.9±8.1), pain intensity (4.6±2.5), depression (47.9±8.9), anxiety (49.9±9.5), fatigue (50.5±10.3), sleep disturbance (51.1±9.8) and ability to participate in social roles (49.1±10.3) for the entire cohort. Across the clinical subspecialties, neurosurgery, spine and trauma patients were most profoundly affected across almost all domains and patients consulting with a hand specialist reported the least limitations or symptoms across domains. There was a moderate, negative correlation between pain interference and physical functioning (r=-0.59) and low correlations between pain interference with anxiety (r=0.36), depression (r=0.39) as well as physical function and anxiety (r=-0.32) and depression(r=-0.30) and sleep (r=-0.31).

    Conclusions

    We directly compared clinically meaningful PROMIS domains across eight orthopaedic subspecialties, which would not have been possible with legacy measures alone. These results support PROMIS's utility as a common metric to assess and compare patient health status across multiple orthopaedic subspecialties.