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Determinants of Successful Aging: Developing an Integrated Research Agenda for the 21st Century |

Ten Recommendations for Advancing Patient-Centered Outcomes Measurement for Older Persons

Colleen A. McHorney, PhD
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From Richard L. Roudebush Veterans Affairs Medical Center; Indiana University School of Medicine; Regenstrief Institute; and Indiana University Center for Aging Research, Indianapolis, Indiana.

Grant Support: In part by the Department of Veterans Affairs (grants RR&D C-2488-R and RCS 02-066-1).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Colleen A. McHorney, PhD, Regenstrief Institute, RHC 6th Floor, 1050 Wishard Boulevard, Indianapolis, IN 46202; e-mail, cmchorney@regenstrief.org.

Ann Intern Med. 2003;139(5_Part_2):403-409. doi:10.7326/0003-4819-139-5_Part_2-200309021-00005
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In the past 50 years, great progress has been made in the measurement of patient-based outcomes for older populations. More than 85 tools now measure basic and instrumental activities of daily living (1). Myriad depression measures exist (2), some of which are specific to older persons (3). Numerous measures of cognitive function (4) and almost two dozen generic quality-of-life instruments (5) have been developed, and hundreds of disease-specific instruments exist (67). For patients with cancer alone, more than 75 quality-of-life measures are available. Generic and disease-specific quality-of-life measures have been widely used in older populations. Although such advances in measurement have served many useful purposes, a crucial drawback is that the various assessment tools cannot speak to one another. Data from one study cannot be compared with data from another study that assesses the same trait by using a different set of items. This state of affairs is called test dependency. Thus, despite five decades of measurement proliferation, each measure is still a separate yardstick—the measures are on different planes rather than at different spots on an underlying common continuum.

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