Browsing by Subject "Utility"

Now showing 1 - 3 of 3
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    An Improved Utility Driven Approach Towards K-Anonymity Using Data Constraint Rules
    (2013-08-14) Morton, Stuart Michael; Mahoui, Malika; Palakal, Mathew J.; Gibson, P. Joseph; Kharrazi, Hadi
    As medical data continues to transition to electronic formats, opportunities arise for researchers to use this microdata to discover patterns and increase knowledge that can improve patient care. Now more than ever, it is critical to protect the identities of the patients contained in these databases. Even after removing obvious “identifier” attributes, such as social security numbers or first and last names, that clearly identify a specific person, it is possible to join “quasi-identifier” attributes from two or more publicly available databases to identify individuals. K-anonymity is an approach that has been used to ensure that no one individual can be distinguished within a group of at least k individuals. However, the majority of the proposed approaches implementing k-anonymity have focused on improving the efficiency of algorithms implementing k-anonymity; less emphasis has been put towards ensuring the “utility” of anonymized data from a researchers’ perspective. We propose a new data utility measurement, called the research value (RV), which extends existing utility measurements by employing data constraints rules that are designed to improve the effectiveness of queries against the anonymized data. To anonymize a given raw dataset, two algorithms are proposed that use predefined generalizations provided by the data content expert and their corresponding research values to assess an attribute’s data utility as it is generalizing the data to ensure k-anonymity. In addition, an automated algorithm is presented that uses clustering and the RV to anonymize the dataset. All of the proposed algorithms scale efficiently when the number of attributes in a dataset is large.
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    Pragmatic characteristics of patient-reported outcome measures are important for use in clinical practice
    (Elsevier, 2015-09) Kroenke, Kurt; Monahan, Patrick O.; Kean, Jacob; Department of Medicine, IU School of Medicine
    OBJECTIVES: Measures for assessing patient-reported outcomes (PROs) that may have initially been developed for research are increasingly being recommended for use in clinical practice as well. Although psychometric rigor is essential, this article focuses on pragmatic characteristics of PROs that may enhance uptake into clinical practice. STUDY DESIGN AND SETTING: Three sources were drawn on in identifying pragmatic criteria for PROs: (1) selected literature review including recommendations by other expert groups; (2) key features of several model public domain PROs; and (3) the authors' experience in developing practical PROs. RESULTS: Eight characteristics of a practical PRO include: (1) actionability (i.e., scores guide diagnostic or therapeutic actions/decision making); (2) appropriateness for the relevant clinical setting; (3) universality (i.e., for screening, severity assessment, and monitoring across multiple conditions); (4) self-administration; (5) item features (number of items and bundling issues); (6) response options (option number and dimensions, uniform vs. varying options, time frame, intervals between options); (7) scoring (simplicity and interpretability); and (8) accessibility (nonproprietary, downloadable, available in different languages and for vulnerable groups, and incorporated into electronic health records). CONCLUSION: Balancing psychometric and pragmatic factors in the development of PROs is important for accelerating the incorporation of PROs into clinical practice.
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    Quality of Life and Health State Utilities in Bladder Cancer
    (IOS Press, 2022-03-11) Smith, Angela B.; McCabe, Sean; Deal, Allison M.; Guo, Amy; Gessner, Kathryn H.; Lipman, Robert; Chisolm, Stephanie; Ahlschlager, Lauren; Gore, John L.; Urology, School of Medicine
    Background: Bladder cancer treatments may variably impact health-related quality of life (QOL). Objective: To characterize the quality of life of patients with bladder cancer at various time points across the continuum of bladder cancer care from non-muscle-invasive disease to metastatic bladder cancer and develop utility scores to inform cost-effective analyses. Methods: We performed a cross-sectional survey of bladder cancer patients in the Bladder Cancer Advocacy Network Patient Survey Network. Participants were classified into mutually exclusive health states based upon non-muscle invasive (NMIBC), muscle-invasive (MIBC), or metastatic bladder cancer and completed surveys of generic cancer and bladder cancer-specific quality of life, financial toxicity, and work impairment. We constructed generalized linear mixed models to identify patient, clinical, and treatment factors associated with quality of life over time and derived health state utilities. Results: Among 911 self-identified patients with bladder cancer, overall QOL scores and function domains were worse among those with advanced cancer. Financial toxicity was similar among non-metastatic disease states. Work and activity impairment increased with advancing disease (13%and 12%among non-recurrent NMIBC to 63%and 31%for metastatic disease respectively; p < 0.01). On multivariable analysis, bowel-related QOL was diminished among patients with MIBC, with urinary symptoms and physical function most diminished among patients with metastatic disease. Patients with metastatic and MIBC experienced worse emotional functioning (p = 0.04; p = 0.048). Health state utilities were calculated, highest among those with non-recurrent NMIBC and lowest among those with metastatic disease. Conclusion: Generic and bladder cancer-specific QOL diminishes with advancing disease. Health state utility estimates derived from this study can inform shared decision making with patients and may be used to inform future cost-effective analyses.