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Health Serv Res. 1999 December; 34(5 Pt 1): 1033–1045.
PMCID: PMC1089071

Clustering and the design of preference-assessment surveys in healthcare.

Abstract

OBJECTIVE: To show cluster analysis as a potentially useful tool in defining common outcomes empirically and in facilitating the assessment of preferences for health states. DATA SOURCES: A survey of 224 patients with ventricular arrhythmias treated at Kaiser Permanente of Northern California. STUDY DESIGN/METHODS: Physical functioning was measured using the Duke Activity Status Index (DASI), and mental status and vitality using the Medical Outcomes Study Short Form-36 items (SF-36). A "k-means" clustering algorithm was used to identify prototypical health states, in which patients in the same cluster shared similar responses to items in the survey. PRINCIPAL FINDINGS: The clustering algorithm yielded four prototypical health states. Cluster 1 (21 percent of patients) was characterized by high scores on physical functioning, vitality, and mental health. Cluster 2 (33 percent of patients) had low physical function but high scores on vitality and mental health. Cluster 3 (29 percent of patients) had low physical function and low vitality but preserved mental health. Cluster 4 (17 percent of patients) had low scores on all scales. These clusters served as the basis of written descriptions of the health states. CONCLUSIONS: Employing a clustering algorithm to analyze health status survey data enables researchers to gain a data-driven, concise summary of the experiences of patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Barry MJ, Fowler FJ, Jr, Mulley AG, Jr, Henderson JV, Jr, Wennberg JE. Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Med Care. 1995 Aug;33(8):771–782. [PubMed]
  • Hlatky MA. Patient preferences and clinical guidelines. JAMA. 1995 Apr 19;273(15):1219–1220. [PubMed]
  • Hlatky MA, Boineau RE, Higginbotham MB, Lee KL, Mark DB, Califf RM, Cobb FR, Pryor DB. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol. 1989 Sep 15;64(10):651–654. [PubMed]
  • Hornberger JC, Redelmeier DA, Petersen J. Variability among methods to assess patients' well-being and consequent effect on a cost-effectiveness analysis. J Clin Epidemiol. 1992 May;45(5):505–512. [PubMed]
  • Hornberger JC, Habraken H, Bloch DA. Minimum data needed on patient preferences for accurate, efficient medical decision making. Med Care. 1995 Mar;33(3):297–310. [PubMed]
  • Lenert LA, Treadwell JR, Schwartz CE. Associations between health status and utilities implications for policy. Med Care. 1999 May;37(5):479–489. [PubMed]
  • McNeil BJ, Weichselbaum R, Pauker SG. Speech and survival: tradeoffs between quality and quantity of life in laryngeal cancer. N Engl J Med. 1981 Oct 22;305(17):982–987. [PubMed]
  • Nease RF, Jr, Bonduelle Y. Solid recommendations from soft numbers: the test/treatment decision. Med Decis Making. 1987 Oct-Dec;7(4):220–233. [PubMed]
  • Nelson CL, Herndon JE, Mark DB, Pryor DB, Califf RM, Hlatky MA. Relation of clinical and angiographic factors to functional capacity as measured by the Duke Activity Status Index. Am J Cardiol. 1991 Oct 1;68(9):973–975. [PubMed]
  • Stewart AL, Hays RD, Ware JE., Jr The MOS short-form general health survey. Reliability and validity in a patient population. Med Care. 1988 Jul;26(7):724–735. [PubMed]
  • Ware JE, Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473–483. [PubMed]
  • Willund I, Gorkin L, Pawitan Y, Schron E, Schoenberger J, Jared LL, Shumaker S. Methods for assessing quality of life in the cardiac arrhythmia suppression trial (CAST). Qual Life Res. 1992 Jun;1(3):187–201. [PubMed]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust