Dr. Ware presented an invited lecture covering noteworthy milestones in the history of patient-reported outcomes (PRO) including a new generation of standardized disease-specific PROs, the QOL Disease-specific Impact Scale (QDIS®), that fill the gap between widely-used disease-specific measures that do not measure quality of life (QOL) and generic QOL measures that do not measure disease-specific outcomes. In his workshop, Dr. Ware showed how both the content and scoring of condition-specific QOL impact measures, including measures of the QOL impact attributed to smoking, can be standardized across conditions using QDIS and how norm-based scoring can make interpretation much easier. Dr. Ware also presented examples of how to test whether survey respondents who have multiple conditions such as arthritis and asthma are able to make valid ratings of the QOL impact of each condition using QDIS. Another consideration of particular importance in smoking research that focuses on otherwise well smokers (free of chronic health problems) is the range of PRO measurement and whether the measurement “ceiling” is high enough to detect improvements with decreased tobacco exposure. The ceiling effect observed for the SF-36® Physical Functioning scale (59%) was lowered using JWRG’s new QGEN® Physical Functioning alternative scale (35%), enabling detection of a more favorable functional outcome with reduced toxicant prototype exposure that would otherwise have been missed in a recent clinical trial.
Support for this lecture and workshop was provided by an unrestricted research grant to John Ware Research Group (JWRG) from British American Tobacco (Investments) Ltd. A journal article evaluating generic and smoking-specific measures among healthy current and former smokers and examining the effects of switching to a reduced toxicant prototype cigarette is forthcoming in Nicotine and Tobacco Research.