in HRQOL. Another area for future research concerns the development of utilities associated with these different measures of domains, that can potentially be used to provide a common metric of the impact of AIDS. Other research can assess the potential utility of item response theory approaches ( Nunnally & Bernstein, 1994) to select scale items that are more sensitive to extremes of QOL, and that can improve scale performance.
The modular approach of the GHAC modules also points to a more general strategy for QOL studies: Relatively inexpensive but comprehensive QOL measures like the GHAC can be supplemented by more in-depth and precise measures for domains that are a major focus of interest in a particular study. For example, as a supplement to the BPI (28 items), we could have used the larger CBCL (150 items), and/or versions of the CBCL for teachers or the subject.
One of the more important questions for the clinical AIDS researcher concerns what domains of QOL are expected to be affected by treatments, and hence what supplemental measures might be desirable. The GHAC modules provide an inexpensive approach in that researchers can utilize the entire battery, and include additional more extensive measures for specific domains of interest. Symptom scales can be altered to reflect the chronic health condition being studied. Other measures of QOL domains discussed in other chapters in this book can also be utilized to measure aspects of QOL, and supplemental scales added as needed.
Preparation of this chapter was supported in part by the Statistical and Data Analysis Center of the AIDS Clinical Trials Group, under the National Institute of Allergy and Infectious Diseases Contract NO 1-AI-95030.
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