Knowledge Item:
CA-Medical Outcomes-27
More Complex Hierarchical Linear
Models Showing Differential Change in Karnofsky Severity Ratings for Groups Formed by
Demographic Categories and Drug Abuse Status
Hierarchical Linear Modeling (or
HLM)
methods are used to study change in Karnofsky
Severity Ratings over time. For each
person, an individual trend is line fit to that patient's quality of
life scores over time. The method uses all observations for individual
patients and takes into account the fact that patients received the
assessments at different times in their treatment histories. After
fitting "individual" curves for each patient, overall trends
in the "average curves" or "trajectories" are
studied and related to other factors. HLM modeling
can be considered the "definitive" method for studying change
in the kinds of naturally-occurring treatment assessment data from these
projects.
The hierarchical models show that on
the average patients experience decreasing Karnofsky Severity Ratings over the
course of their involvement with the programs represented here. This
Knowledge Item studies the rate of change as a function of different
service needs and vulnerabilities of the patient. A
number of service needs-vulnerabilities are related to both the
initial Karnofsky Severity Rating of the patient at the time of enrollment
into the program and to the rate of change throughout the program.
On Average,
-
There
is a statistically significant decrease in Karnofsky Ratings over
time, but it is relatively tiny in magnitude over a year. Clients are seen by their clinicians as
slightly more ill.
-
There is
no statistically significant differential change in Karnofsky
Severity Ratings over time by
Gender.
-
There is
no statistically significant differential change in Karnofsky
Severity Ratings over time by
Project Type.
-
There is
no statistically significant differential change by the
Gender by Project Type interaction.
-
Degree
of change in Karnofsky Ratings over time is related to the patient
demographic factor of race-ethnicity but not to drug abuse status.
This difference
is not statistically significant.
This difference
is not statistically significant.
This difference
is not statistically significant.
More Information:
CHAID and CHAID Diagram
Knowledge Item Citation: Huba, G. J., Melchior, L. A., Panter, A. T., and the HRSA/HAB SPNS Cooperative Agreement Steering Committee (1998-2001). Knowledge Item:
CA-Medical Outcomes-27 from
HRSA/HAB's SPNS Cooperative Agreements on Innovative Models of Care, The Measurement Group Knowledge Base on HIV/AIDS Care, Online at www.TheMeasurementGroup.com.
Last Updated:
March 25, 2005; data through June 15,
1999; analyses conducted March - May 2000.
|
