Distinguished Professor of Psychiatry Arthur A. Stone, PhD, co-edited a special issue of the journal Psychosomatic Medicine
devoted to ambulatory monitoring of biobehavioral processes in health
and disease. The issue included an article by Dr. Stone and his
colleagues from the Applied Behavioral Medicine Research Institute on
Expanding Options for Developing Outcome Measures from Momentary
Assessment Data. Thomas Kubiak, PhD, of the Johannes Gutenberg
University in Mainz, Germany, co-edited the special issue with Dr.
Stone.
In their editorial, Drs. Stone and Kubiak point out that
ambulatory monitoring — which includes various techniques of self-report
and physiological monitoring — has significantly advanced during the
past decade. Researchers have developed new techniques for measuring a
broad range of physiological parameters; for performing sophisticated
statistical analyses; and for integrating biological, psychological,
behavioral and environmental information. The authors expect that these
advances “will lead to new theories in psychosomatic medicine and other
areas where the behavioral and social sciences interact with biomedical
research.”
In the article on expanding options for developing
outcome measures, Dr. Stone and his Stony Brook colleagues discussed the
feasibility of using summary measures other than a simple average of
multiple moments over time to characterize the experience of pain and
other self-reported outcomes. Using data from two studies of pain
reported by patients with rheumatic disease, they described eight
possible measures — including the proportion of ratings of no or minimal
pain, the proportion of ratings of moderate to severe pain, and
indicators of the maximum levels of pain experienced — that might
represent the individual’s experience of pain in clinically meaningful
ways.
For the first study, they created histograms representing
variations in pain intensity within individuals over time using each of
the eight measures. They found that the histograms showed distinctively
different patterns in the distribution of pain intensity scores,
suggesting that the measures could provide novel information by
revealing different facets of the pain experience.
In their
second study, they used the eight measures to describe the outcomes of
clinical interventions intended to reduce pain by comparing before and
after scores of patients who received pain-reducing interventions to the
scores of a comparison group of patients whose treatment was not
changed. They found that the measures they described in the first study
reflected improvement in pain control and corresponded with patients’
global impression of improvement. They concluded that “evaluation of
clinical outcomes could be potentially more informative and refined by
adopting more than one way of characterizing change.”
Professors
Joan E. Broderick, PhD, Stefan Schneider, PhD, and Joseph E. Schwartz,
PhD, all from the Department of Psychiatry and Behavioral Science at
Stony Brook University were coauthors of the paper.
