Smooth individual level covariates adjustment in disease mapping.

Spatial models for disease mapping should ideally account for covariates measured both at individual and area levels. The newly available "indiCAR" model fits the popular conditional autoregresssive (CAR) model by accommodating both individual and group level covariates while adjusting for spatial correlation in the disease rates. This algorithm has been shown to be effective but assumes log-linear associations between individual level covariates and outcome.

Development and validation of the Psychological Adaptation Scale (PAS): use in six studies of adaptation to a health condition or risk.

Objective: We introduce The Psychological Adaptation Scale (PAS) for assessing adaptation to a chronic condition or risk and present validity data from six studies of genetic conditions.

Methods: Informed by theory, we identified four domains of adaptation: effective coping, self-esteem, social integration, and spiritual/existential meaning. Items were selected from the PROMIS "positive illness impact" item bank and adapted from the Rosenberg self-esteem scale to create a 20-item scale.

Process, cost, and clinical quality: the initial oral contraceptive visit.

Objectives: To demonstrate how the analysis of clinical process, cost, and outcomes can identify healthcare improvements that reduce cost without sacrificing quality, using the example of the initial visit associated with oral contraceptive pill use.

Study Design: Cross-sectional study using data collected by HealthMETRICS between 1996 and 2009.

Methods: Using data collected from 106 sites in 24 states, the unintended pregnancy (UIP) rate, effectiveness of patient education, and unit visit cost were calculated.

Modelling decisions to undergo genetic testing for susceptibility to common health conditions: an ancillary study of the Multiplex Initiative.

New genetic tests reveal risks for multiple conditions simultaneously, although little is understood about the psychological factors that affect testing uptake. We assessed a conceptual model called the multiplex genetic testing model (MGTM) using structural equation modelling. The MGTM delineates worry, perceived severity, perceived risk, response efficacy and attitudes towards testing as predictors of intentions and behaviour.

Clinical process variation: effect on quality and cost of care.

Objective: To identify optimal transferable practice processes for provision of a clinical service by studying the relationships among unit cost, clinical outcome, patient satisfaction, and staff satisfaction observed for a discreet service performed at multiple sites in a well-defined patient population.

Study Design: Cross-sectional study using data collected by HealthMETRICS from 1996 to 2007.

Methods: Data from 165 US clinics in 29 states, totaling 8835 patients and 1583 clinic staff, were reviewed.