BACKGROUND: Interest in comparative effectiveness research and the rising number of negative or "small effect" trials have stimulated research into differential response to treatment among subgroups of patients. OBJECTIVE: To develop and test the Potential for Benefit Scale (PBS), a composite measure to identify subgroups of patients with differential potential for response to treatment, using diabetes as a model. DESIGN: Cross-sectional and longitudinal cohort study. SUBJECTS AND SETTING: Type 2 diabetes patients (n = 1361) were identified from 7 outpatient clinics serving a diverse population. Of these, 611 completed a 1-year follow-up. MEASURES: To represent patients' health status, we used the Total Illness Burden Index, the Physical Function Index of the SF-36, the Center for Epidemiologic Studies Depression Scale, and the Diabetes Burden Scale. To represent personality characteristics related to health, we used the Provider-Dependent Health Care Orientation scale. We assessed the contribution of these measures to a composite scale of patients' potential for treatment response in terms of self-reported medication adherence and glycemic control. RESULTS: Principal components analysis confirmed associations among these measures. The internal consistency reliability of the PBS was adequate (Cronbach alpha = 0.65). Patients in the lowest versus highest quartile of the PBS reported poorer adherence (18% vs. 55%, P < 0.001) and poorer glycemic control at baseline (mean hemoglobin A1c values: 7.75 vs. 7.39, P < 0.001). Those in the highest quartile of the PBS also were more likely to reach target values for glycemic control (HbA1c <7%) at 1-year follow-up, (adjusted OR = 1.61, P < 0.05). CONCLUSIONS: The PBS, a composite scale, may be helpful in identifying patients with differential potential for response to treatment.
BACKGROUND: Interest in comparative effectiveness research and the rising number of negative or "small effect" trials have stimulated research into differential response to treatment among subgroups of patients. OBJECTIVE: To develop and test the Potential for Benefit Scale (PBS), a composite measure to identify subgroups of patients with differential potential for response to treatment, using diabetes as a model. DESIGN: Cross-sectional and longitudinal cohort study. SUBJECTS AND SETTING:Type 2 diabetespatients (n = 1361) were identified from 7 outpatient clinics serving a diverse population. Of these, 611 completed a 1-year follow-up. MEASURES: To represent patients' health status, we used the Total Illness Burden Index, the Physical Function Index of the SF-36, the Center for Epidemiologic Studies Depression Scale, and the Diabetes Burden Scale. To represent personality characteristics related to health, we used the Provider-Dependent Health Care Orientation scale. We assessed the contribution of these measures to a composite scale of patients' potential for treatment response in terms of self-reported medication adherence and glycemic control. RESULTS: Principal components analysis confirmed associations among these measures. The internal consistency reliability of the PBS was adequate (Cronbach alpha = 0.65). Patients in the lowest versus highest quartile of the PBS reported poorer adherence (18% vs. 55%, P < 0.001) and poorer glycemic control at baseline (mean hemoglobin A1c values: 7.75 vs. 7.39, P < 0.001). Those in the highest quartile of the PBS also were more likely to reach target values for glycemic control (HbA1c <7%) at 1-year follow-up, (adjusted OR = 1.61, P < 0.05). CONCLUSIONS: The PBS, a composite scale, may be helpful in identifying patients with differential potential for response to treatment.
Authors: Mark S Litwin; Sheldon Greenfield; Eric P Elkin; Deborah P Lubeck; Jeanette M Broering; Sherrie H Kaplan Journal: Cancer Date: 2007-05-01 Impact factor: 6.860
Authors: Sheldon Greenfield; John Billimek; Fabio Pellegrini; Monica Franciosi; Giorgia De Berardis; Antonio Nicolucci; Sherrie H Kaplan Journal: Ann Intern Med Date: 2009-12-15 Impact factor: 25.391
Authors: S Greenfield; S H Kaplan; R A Silliman; L Sullivan; W Manning; R D'Agostino; D E Singer; D M Nathan Journal: Diabetes Care Date: 1994-06 Impact factor: 19.112
Authors: Sarah E Choi; Quyen Ngo-Metzger; John Billimek; Sheldon Greenfield; Sherrie H Kaplan; Dara H Sorkin Journal: J Immigr Minor Health Date: 2016-04
Authors: Daniel A Barocas; Vivien Chen; Matthew Cooperberg; Michael Goodman; John J Graff; Sheldon Greenfield; Ann Hamilton; Karen Hoffman; Sherrie Kaplan; Tatsuki Koyama; Alicia Morgans; Lisa E Paddock; Sharon Phillips; Matthew J Resnick; Antoinette Stroup; Xiao-Cheng Wu; David F Penson Journal: J Comp Eff Res Date: 2013-07 Impact factor: 1.744
Authors: Shaista Malik; John Billimek; Sheldon Greenfield; Dara H Sorkin; Quyen Ngo-Metzger; Sherrie H Kaplan Journal: Med Care Date: 2013-02 Impact factor: 2.983
Authors: Sherrie H Kaplan; John Billimek; Dara H Sorkin; Quyen Ngo-Metzger; Sheldon Greenfield Journal: J Gen Intern Med Date: 2013-10 Impact factor: 5.128