Page 40 - The Importance of Common Metrics for Advacing Social Science Theory and Research

The Importance of Common Metrics for Advancing Social Science Theory and Research: A Workshop Summary
http://www.nap.edu/catalog/13034.html

28 THE IMPORTANCE OF COMMON METRICS

PROMIS. Other challenges include difficulty agreeing on a common set of
metrics and the need to create or demonstrate valid and reliable measures
across population groups. There is also the challenge of assessing change
that involves not only aging but also the perception of the change with
age, taking into account individual abilities to adapt. Another challenge is
the tension between the needs of large-scale survey enterprises and clinical
settings. Measures that have emerged in a clinical setting have a different
set of goals (to augment clinical decision making) than those in population
surveys (to more broadly inform social science and policy), and, in that
sense, they may not be robust in a larger social survey setting. Fryback also
had observed that rankings seem to mobilize the American psyche. Cagney
remarked on the importance of thinking about policy-related goals when
using HRQoL measures.
Cagney closed with a summary of opportunities. She saw HRQoL
measures as potentially providing insight into geographic variation. These
measures also instill a greater appreciation for the role of subjective as-
sessments, as Willis noted in his presentation. She endorsed the idea of
potentially triangulating survey data resources with clinical assessments
that come from the hospital or from a physician’s office. There is also op-
portunity to focus on a framework for the study of cultural comparisons, to
consider the larger social context and the bridging of mental and physical
components, and to operationalize the social component for inclusion in
social surveys. Cagney cautioned that even a very simple notion of walk-
ing across a small room, which is used as a robust indicator of disability
status, is not necessarily translatable. Another opportunity is to think about
HRQoL measures in concert with biomarkers. She saw an opportunity
for the social sciences to improve the understanding of health, pointing
again to the potential of PROMIS and other data sources to augment this
understanding.

OPEN DISCUSSION
David Grusky (Stanford University) picked up on the comment that one
of the major obstacles to adoption or standardization of HRQoL measures
is that there is debate about whether or not to allow respondents to score
some states worse than dead. According to Fryback, some measures do
not allow for states worse than dead, despite the fact that there is always
a small segment of the population that identifies certain conditions (such
as chronic unremitting pain, inability to do self-care activities, dependence
on others for toileting, dressing, etc.) as worse than dead. Pollak raised
two other points that support the reality of states worse than dead: (1) in
estate planning, the use of living wills and advanced directives reflect an

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