Medical Outcomes Knowledge Item 61: Results from HRSA/HAB's SPNS Innovative Models of Care

Knowledge Item: CA-Medical Outcomes-61
CD4 Outcomes Baseline-Adjusted

This Knowledge Item shows the percentage of patients who have different CD4 change outcomes during the period of their treatment histories. This Knowledge Item examines the relationship of three types of CD4 outcomes studied in various Knowledge Items in this Knowledge Base. The three types of outcomes are defined in the following way.

Variable	Definition
Clinical Outcome	A positive outcome is coded if the CD4 count increased at least 50 points at one time after the baseline assessment; this definition is often used in medical clinics. A negative outcome is coded if the greatest increase in CD4 counts ever observed is less than 50 points from the baseline.
CD4 Maximum Outcome	The highest CD4 count after the baseline is coded as a positive outcome if it is at or above the baseline indicating that positive change occurred at least one time. A negative outcome is coded if the highest CD4 count after the baseline is below the baseline level.
CD4 Change Status	The overall set of CD4 count assessments of the patient is considered. If the last assessment is at or above the baseline, a positive outcome is coded because the CD4 count is increased or maintained at the final assessment. If the last assessment is below the baseline, a negative outcome is coded.

More Information: (Maximum) Outcome vs. Change Status

As can be seen in the results from this Knowledge Item, the three kinds of outcomes are significantly related to one another in a systematic way depending upon the definition of outcome.

47.6 percent of the patients has a clinically significant outcome of a change of 50 CD4 points or more
55.7 percent of the patients had a CD4 count at the last time assessed that was above the baseline level
67.4 percent of the patients had a CD4 count that was observed to be above the baseline level at least one time during the treatment episode

This Knowledge Item further breaks down the results for all patients into groups defined by their CD4 category at the first time a CD4 count was obtained by the projects. While in most cases the initial CD4 category is related to the percentage of patients who have favorable outcomes as defined in one of the three ways above, in general there are fairly consistent results over the different categories.

This Knowledge Item is a direct follow-up to Knowledge Item: CA-Medical Outcomes-59 which did not adjust these results for the baseline CD4 category.

More Information: (Maximum) Outcome vs. Change Status

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-61 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 January 2001.

Knowledge Base Citation: The Knowledge Base and this Knowledge Item were designed and authored by G. J. Huba, Ph.D.; in collaboration with Lisa A. Melchior, Ph.D.; A. T. Panter, Ph.D.; and the staff of The Measurement Group. Cite this work as "Huba, G. J., Melchior, L. A., and Panter, A. T. (1998 - 2001). The Measurement Group Knowledge Base on HIV/AIDS Care. On the World Wide Web: http://www.TheMeasurementGroup.com."

Questions or Comments: Contact The Measurement Group.

Use of Knowledge Base Information: Acceptable Uses and Limitations.

Collaborators from Participating Projects: Cooperative Agreement Steering Committee 1999.

Participating Projects: This Knowledge Base is based on the service delivery experiences of 27 Cooperative Agreement Projects on Innovative Models of HIV/AIDS Care. These projects and the Evaluation and Dissemination Center which produced this Knowledge Base were funded by the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB) as Special Projects of National Significance (SPNS) between 1994 and 1999. Click the Model Programs button above for descriptions of the projects that contributed to this specific Knowledge Item, a list of key staff, and project grant numbers.

Why This Evaluation was Conducted: Editorial.

More Information: Design of this Knowledge Base.

Recommended Citation Format for Web Materials: American Psychological Association Publication Manual Section, Revised 2001.

Work on the Knowledge Base and the cross-cutting evaluation was supported in part by Grant Number 5 U90 HA 00030-05 from the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau's (HAB) Special Projects of National Significance (SPNS). The contents of this Knowledge Base are solely the responsibility of The Measurement Group and do not necessarily represent the official views of HRSA or HRSA/HAB's Special Projects of National Significance nor may they represent the positions of the individual grantees whose projects are included in the cross-cutting evaluation.