Dr. Testa and colleagues are developing quantitative and health information technology methods and processes relating to the measurement and analysis of expanded patient outcomes (quality of life, cost-effectiveness and risk-benefit) for clinical, pharmacoeconomic, pharmacoepidemiologic, quality of care and comparative effectiveness research studies with particular application to primary care, cardiovascular disease, HIV, and diabetes.
Quality of Life, Patient Satisfaction, Clinical Decision Making and Comparative Effectiveness Research
Dr. Testa is working on analytical, statistical and health information methods for conducting health outcomes and comparative effectivness research for pharmaceutical drug development, disease management, quality of care programs and primary care and physician subspecialty practice management. As part of this methodologic work, she is analyzing a comprehensive database of patients who have participated in large-scale clinical trials of antihypertensive and diabetes therapies to evaluate differential treatment effects on quality-of-life outcomes including mood, vitality, sleep, cognitive functioning, sexual dysfunctioning, work/social role functioning and physical symptoms. Dr. Testa is exploring the relationships between treatment satisfaction, glycemic control, hypo and hyperglycemic symptomatology, quality of life and health care utilization during the treatment of patients with type 1 and type 2 diabetes. For the past five years she also has worked on designing Web 2.0 and Health 2.0 home health monitoring health information systems involving the use of telemedicine and telehealth (e-Health) strategies for diabetes management.
Pharmacoeconomics and Pharmacoepidemiology
As part of the AIDS Clinical Trials Group, Dr. Testa and colleagues have evaluated the quality-of-life impact of treatment for HIV in medication adherence models. Adherence to HIV therapy has implications for the cost-effectiveness of new treatments. Dr. Testa is also currently developing database systems and electronic reporting devices (e-diaries) for monitoring health outcomes, expanding observational databases for longitudinal research and surveying resource utilization and costs for inclusion into pharmacoeconomic, pharmacoepidemiological and cost-effectivness models. She has guided doctoral research in the areas of health outcomes research and pharmacoepidemiology evaluating patient compliance, physician practice patterns and patient functional health status and quality of life using large patient information systems.
Statistical Methods for Quality-of-Life Outcomes Research
Dr. Testa and colleagues are developing more sophisticated methods for dealing with the analysis of expanded patient outcomes. The statistical and analytical issues involve applications of item response theory, causal modeling, latent variables and structural equation modeling to the analysis of quality-of-life and patient satisfaction data. Other topics of research interest include:
measurement, involving the response structure of multi-dimensional constructs, intervention and non-intervention based validities, and respondent variability;
hypothesis testing, including estimation of power, simultaneous test procedures, global hypothesis testing, longitudinal models, and the effects of missing data, early withdrawal, length bias and confounding; and
overall effectiveness models, specifically quality-adjustment measures, and health state transition and utility models.