• Data Management
• Health Assessment and Instrumentation 
• Health Economics and Medical Decision Making
• Health Outcomes Management Software
• Research Consulting
• Research Study Design and Project Planning

​In the age of instant global communication, multi-center studies are becoming increasingly common as technology helps us address the inherent difficulties common to non-centralized data collection and coordination tasks. The HSRC team has the experience and technical expertise to act as your data coordination center for multi-center studies. This includes experienced personnel such as programmers, data managers and project managers, as well as current technology such as comprehensive communication, online assessment, and database tools. HSRC can provide data entry and management tools for participating centers as well as training in the use of these tools, and can coordinate and track incoming data and provide quality control and feedback to individual centers as required. Web-based, comprehensive reports are available for individual centers or the entire project.

Data Collection Technologies

• Health Outcomes Management System (HOMS): HSRC has developed the Health Outcomes Management System (HOMS) to securely track and report health outcomes data. In addition to providing various reports for program improvement, it acts as a resource for clinicians to monitor individual client progress. Housed at the San Diego Supercomputer Center and supported by our expert HSRC-based help desk, HOMS is equipped with a full-scale user management system to ensure secure data separation on an individual, clinical, or administrative level. HOMS provides users a customizable dynamic experience to meet desired functionality through user-friendly interfaces. This includes the ability to customize input forms with automatic validation for data collection tasks, and obtain a variety of reports of individual and program level data. HOMS can also merge and process data from other medical information system, enabling powerful and meaningful analyses.
  
  
• Computer-Aided Telephone Interviewing (CATI): HSRC has a full-capability call-center where we have conducted thousands of interviews using customizable Computer-Aided Telephone Interviewing software. A powerful call-tracking system lets surveyors know who needs to be called and when, and reports to the mailing system when incentives, thank-you cards, or reminders need to be printed and mailed following a phone session. Our call-projects have included interviews related to quality of life, medication adherence and side-effects, adverse event reporting, health behaviors, patient reported outcomes, tobacco exposure and many others.
  
  
• Interactive Voice Response (IVR): Interactive voice response (IVR) represents a cutting edge technique for collecting data at almost any time and place with a minimum amount of intrusion. Participants in a study using IVR are called on their cell or home phones, and are then asked study questions via an automated electronic ‘surveyor.’ Responses to questions can be verbal, or through the use of the phone key-pad.
  
  
• ​Internet Adaptive Surveying: Administering surveys via the Internet has fast become one of the most popular and cost-efficient means of collecting data. It has multiple advantages over traditional paper and pencil survey methods such as convenience, flexibility, cost effectiveness, control, and reliability. Our Web-based surveying platform can be programmed for logic-based surveys that automatically administer conditional questions and follow complex skip patterns. This can ensure that all relevant questions are displayed, and that the minimum number of questions is administered in order to provide complete data for each subject.
  
  
• ​Alternative Document Transfer: Often a fax or email is the best way to get information from clinical sites to a study center. We can design forms and HTML email layouts that enable researchers to send and receive data collection tools via fax or email. Faxable forms are designed to be quickly and easily scanned or entered into a study database. Email forms have the capability of allowing respondents to include their responses in the reply to a secure email, which is automatically entered into a database.
  
  

Data Analytics

Quantitative analysis is a cornerstone of quality research. Here at HSRC we do a wide variety of routine and custom statistical analysis and reporting. Our experience with the latest statistical techniques allows us to design optimal analytic strategies for each individual project. We also have expertise in qualitative data analysis of data obtained from focus groups and qualitative interviews.

Data Dissemination

Publishing results in a timely manner is a critical activity that challenges many investigators. Researchers at HSRC have extensive experience publishing research in a variety of modalities, with hundreds of peer reviewed publications among them. We can take a paper from any stage of completion to final publication. 

​Several validated measurement instruments developed by HSRC researchers are widely used to study 

physical and mental health outcomes. HSRC offers expertise in:

• Measurement Design and Validation
• Creation, Selection and Validation of Patient Reported Outcomes (PROs) 
• Content, Construct and Structural Validation of Patient Reported Outcomes (PROs) 
• Scaling and Scoring Algorithms 
• Responsiveness Testing and Clinically Important Differences 
• Validation in New Clinical Populations  
• Linguistic/Cultural Validation  
• Literature and Instrument Reviews 
  
  

QWB-SA

One of the criticisms of the original, interview driven QWB is that it is more expensive and difficult to administer than competing measures, such as the SF-36. The original QWB is relatively long and complex because it has some branching and probe questions and requires a trained interviewer. We developed a self-administered QWB; referred to  as the Quality of Well-Being scale, Self-Administered (QWB-SA) that addresses some of these issues (Kaplan, Ganiats, and Sieber, 1996).

The particular strengths of the QWB-SA are:

• It includes assessment of symptoms in addition to various areas of functioning.
• The expanded list of symptoms now includes additional mental health items.
• To reduce recall bias, the QWB-SA assesses only the 3 days prior to completion of the questionnaire.
• The scoring of the instrument utilizes population-derived preference weights.

Use of the QWB-SA is growing rapidly. HSRC is conducting a strong and diverse research program toward establishing the psychometric properties of this new measure. Current studies are addressing the ability of the QWB-SA to detect changes in samples of migraineurs, cataract surgery patients, people with severe mental illness, and arthritis patients, as well as validating the sensitivity of this measure translated in Spanish, German, Italian, Swedish, French-Canadian, and Dutch.

To learn more about the QWB-SA, visit: https://hoap.ucsd.edu/qwb-info/

Contact Information:
For specific questions regarding the QWB-SA, contact: qwb@ucsd.edu

Effectiveness Assessment: 

Researchers at HSRC have an extensive background in studying, assessing, and utilizing health valuation techniques. We have developed and validated the QWB-SA, a widely used preference-based measure of health-related quality of life.

We have participated in numerous methodological and theoretical studies of the comparability of various economic utility-based and preference-based measures, the assessment of health values (ceiling and floor effects, ordering effects), partial questionnaire sampling, time preference for health, the strengths and limitations of the QALY concept, the calculation of QALYs, and others.

Cost Assessment: 

When a health intervention has been shown to be effective at improving health, it is important to also gauge the resources required to provide that health benefit. HSRC researchers have measured intervention and utilization costs in a variety of medical settings, using multiple techniques for estimating costs of retail services, personnel and benefits, and materials and equipment. Healthcare utilization is assessed via chart review,  administrative data review or patient self-report, depending on the study.

Utilization cost estimates are generated using data from the Centers for Medicare and Medicaid Services CMS or other organizations, as appropriate for the study. Once an appropriate utilization assessment is completed, costs can be assigned based on the perspective of the analysis.

Cost-Effectiveness Analysis: 

Evaluating the cost-effectiveness of medical treatments or health interventions is increasingly important for advancing medical science, informing public policy, and positioning medical products. Our expertise includes conducting cost-effectiveness analysis using advanced decision modeling techniques both with and without data from prospective, longitudinal trials.

We work closely with clients to design the optimal study specifications including costing methodologies, effectiveness measures, study perspective, comparators, and time horizons as well as using sophisticated sensitivity analyses to thoroughly assess the robustness of findings. In addition to having extensive experience measuring QALYs in the cost-utility framework, we also work with other tangible outcomes such as cases prevented, cases diagnosed, and mortality.

Modeling the Impact of Attitudes and Decisions on Health Behaviors and Clinical Outcomes: 

Health related attitudes and medical decision making are key variables in explaining health behaviors and clinical outcomes. Health service related processes and dynamics such as diagnostic screening and assessment, clinician-patient relationship, and treatment compliance/adherence, among others can affect outcomes.

We have been involved in a variety of research studies that captured these attitudes and decisions through our capabilities in questionnaire and program design, teleform data scanning, data management, data analysis, and call center management:

• Evaluating the impact of tuberculosis diagnosis on physician medical decision making
• Designing a program to verify accuracy of diagnostic screening and assessment 
• Determining the importance of clinician-patient relationship through questionnaire design in mental health studies
• Observing the level of treatment compliance/adherence of patients in prescription niacin trials

The Health Outcomes Management System (HOMS) is a secure, integrated web-based system for managing and tracking a wide range of health outcomes. Developed and maintained by a team of clinicians and health outcomes researchers at the University of California, San Diego Health Services Research Center (HSRC), HOMS can be used in a variety of settings, from single office environments to large, multi-site health systems engaged in medical practice, clinical research, or program evaluation and quality improvement. For more information, please see the Introduction to HOMS Manual.

​HSRC can assist your organization in all aspects of your research or evaluation project, from initial planning to design, implementation, analysis and reporting. ​To discuss your project’s needs please contact:

Andrew Sarkin, PhD
858-622-1771
asarkin@health.ucsd.edu 

Comprehensive Study Design:  

Poorly designed studies collect poor quality information. A quality study collects quality information, and this is what HSRC does best. The HSRC team has the knowledge and experience required to properly design a wide variety of studies. In addition to our work on many randomized, multi-arm, controlled trials, we have expertise in wait-list control, uncontrolled, and quasi-experimental designs, as well as qualitative and multi-method study designs.

Project Management:  

Effective project management is the key to a successful and valid study. The HSRC team has the experience, knowledge and expertise to successfully guide your project from design to implementation to analysis, interpretation, and dissemination of results.

Participant Recruitment, Tracking, and Management:  

The identification of recruitment strategies that will produce representative samples, ensure retention and compliance, all while protecting patient safety is crucial to a successful study. Accurate participant tracking and reporting is also critical to successful data collection. The tracking and reporting system developed by HSRC programmers generates automatic alerts when a participant is due for any desired action such as a mailing, telephone call or visit, providing project managers with a powerful tool to efficiently track projects. The system also generates statistics on recruitment, attrition, response rate, and allows this information, along with estimated completion dates, to be viewed on a secure webpage.

International and Multicultural Studies:  

As our world and healthcare becomes more globalized, the ability to conduct research and promote health innovation internationally and across cultures is increasingly important. The HSRC team has experience managing international research trials, translating and validating questionnaires, and assessing cultural competency. Personnel are sensitive to the needs of clients, researchers, and participants from other countries and cultures.

Measurement Design and Validation:  

The design and development of self-report assessments must meet high psychometric, econometric and clinometric standards, standards that are embodied within PRO/HRQL guidance of regulatory, academic, health policy and clinical decision-makers around the world. In addition to application of state-of-the-art psychometric technologies, HSRC researchers have expertise in refining both qualitative and quantitative methodologies used to design new PRO measures. Our work is evidenced by numerous research initiatives and the publication of their results in leading journals.

Clinical Sample and Sampling Methods: 

We provide clinical investigator support, data collection and analysis, and project management for projects involving a wide variety of healthcare settings and patient populations, including:

• Cardiopulmonary disease
• Chronic renal failure 
• Upper and lower GI 
• Metabolic disorders (diabetes)  
• Rheumatoid disease (gout, arthritis) 
• Infectious disease 
• Oncology 
• Mental Health disorders 
• Health promotion and disease prevention  
• Patient, family, and clinical focus groups 
• Inpatient and Outpatient illness panel studies  
• Complementary and Alternative Medicine
  
  

Literature and Instrument Reviews: 

Background literature reviews provide a conceptual basis for optimizing study design within outcomes research, lending credibility to research initiatives and publication strategies, and providing summary evidence to support filing and promotional materials; similarly, psychometric reviews permit selection of targeted PRO/HRQL measures which are responsive to the known effects of specific treatments and interventions.

The HSRC Team has demonstrated psychometric, clinometric, and economic expertise across a wide variety of patient populations and healthcare settings. This diversity allows for the production of high quality, in-depth technical reviews.