Comprehensive Management Strategy for GI Disorders

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DESCRIPTION (provided by applicant): Objectives: The proposed project will refine and validate a computerized self-assessment of patient symptoms and health-related quality of life (HRQL) for common gastrointestinal (Gl) disorders. The goals are to improve patient care, to support research, and to ensure the quality of care. Work is being conducted using CarePrep, a Web application for patient self-reporting of health data. RESEARCH PLAN: CarePrep systematically captures data directly entered by the patient regarding symptoms and relevant psychosocial variables, and measures condition-specific HRQL. A prioritized, problem-oriented summary is generated for the clinician. Specific aims are to develop and refine assessment and HRQL content for the targeted Gl disorders {acid reflux, dyspepsia, irritable bowel syndrome, inflammatory bowel disease, colon cancer, and common hepato-biliary and pancreatic diseases); pilot test and perform preliminary psychometric analysis; develop problem management features for clinicians; enhance administrative and research functions; implement revisit functions; perform psychometric validation; assess feasibility and impact on care. In our work thus far, a model-driven assessment strategy has been developed for common Gl disorders, installed in CarePrep, and pilot tested with excellent acceptance from patients and clinicians. METHODOLOGY: Item development will use standard methodology, with review of published instruments and input from experts and patients, the latter using focus groups and cognitive interviews to ensure that issues of relevance for patients are covered. HRQL assessment will use a generic core with condition-specific modules. Pilot testing will gather data for psychometric analysis and item reduction. After necessary revisions, validity and clinical reliability will be tested. The impact of CarePrep on clinician-patient communication and on clinician effectiveness will be compared to usual care. CONCLUSIONS: The refinement and validation of this system will demonstrate the value of an integrated bio-psychosocial instrument for condition-specific assessment of the targeted Gl disorders.