Ronald D Hays

Ronald D Hays
University of California, Los Angeles | UCLA · Department of Medicine

Doctor of Philosophy

About

872
Publications
262,201
Reads
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87,433
Citations
Citations since 2017
177 Research Items
29065 Citations
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Introduction
patient-reported measures including behaviors (e.g., adherence to medical recommendations, substance use, exercise), reports and ratings of healthcare, and patient-reported outcomes (health-related quality of life).
Additional affiliations
June 1997 - present
University of California, Los Angeles
Position
  • Professor

Publications

Publications (872)
Article
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Objective Our objective was to gauge adherence to nationally endorsed protocols in implementation of pulse oximetry (POx) screening for critical congenital heart disease (CCHD) in infants after mandate by all states and to assess associated characteristics. Study Design Between March and October 2019, an online questionnaire was administered to nur...
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Purpose To (1) Compare vision-related quality of life (VRQOL) in adolescent and young adult (AYA) unilateral versus bilateral retinoblastoma (RB) survivors using a vision-targeted measure and a generic health-related quality of life (HRQOL) measure and (2) Assess associations among VRQOL and generic HRQOL domains and overall QOL and estimate associ...
Article
Objective: Receipt of follow-up care after Emergency Department (ED) visits for chronic ambulatory care sensitive conditions (ACSCs) - asthma, chronic obstructive pulmonary disease, heart failure, diabetes, and/or hypertension - is crucial. We assessed Veterans' follow-up care knowledge, perceptions, and receipt of care after visits to Veterans He...
Article
Introduction: Shadow coaching improves provider-patient interactions, as measured by CG-CAHPS® overall provider rating (OPR) and provider communication (PC). However, these improvements erode over time. Aim: Examine whether a second coaching session (re-coaching) improves and sustains patient experience. Setting: Large, urban Federally Qualifi...
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Objectives: To assess the relationship between self-rated mental health (SRMH) and infrequent routine care among Medicare beneficiaries and to investigate the roles of managed care and having a personal doctor. Study design: Cross-sectional analysis of data from the 2018 Medicare Consumer Assessment of Healthcare Providers and Systems survey. M...
Article
Purpose Burnout among nurses negatively impacts patient care experiences and safety. Inpatient pediatric nurses are high-risk for burnout due to high patient volumes, inadequate staffing, and needing to balance the demands of patients, families and team members. We examined the associations of inpatient pediatric nurse burnout with their perspectiv...
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Adjuvant chemotherapy improves breast cancer survival but is associated with bothersome short- and long-term toxicity. Factors associated with toxicity, especially subacute toxicity up to 2 years following chemotherapy, have not been fully elucidated. The NRG Oncology/NSABP B-30 clinical trial compared 3 different doxorubicin-, cyclophosphamide-, a...
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Background: Data from surveys of patient care experiences are a cornerstone of public reporting and pay-for-performance initiatives. Recently, increasing concerns have been raised about survey response rates and how to promote equity by ensuring that responses represent the perspectives of all patients. Objective: Review evidence on survey admin...
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Purpose Efficient analytical methods are necessary to make reproducible inferences on single-item longitudinal ordinal patient-reported outcome (PRO) data. A thorough simulation study was performed to compare the performance of the semiparametric probabilistic index models (PIM) with a longitudinal analysis using parametric cumulative logit mixed m...
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Objective: In this study, we examined the impact of a range of methods to improve data quality on the demographic and health status representativeness of Amazon Mechanical Turk (MTurk) samples. Methods: We developed and field-tested a general survey of health on MTurk in 2017 among 5755 participants and 2021 among 6752 participants. We collected...
Article
Patient-centered medical home takes years to attain. Fifteen-to-eighteen percent of US primary care practices in 2008-2017 sought or maintained patient-centered medical home recognition. We conducted interviews with a stratified-random sample of 105 of these practices to determine why patient experience surveys were chosen. Fifty-one were using a C...
Article
Among those with low back pain (LBP), individuals with chronic LBP (CLBP) face different treatment recommendations and incur the majority of suffering and costs. However, the way CLBP has been defined varies greatly. This study used a scoping review and qualitative and quantitative analyses of data from LBP patients to explore this variation. CLBP...
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Background In 2014, the National Institute of Health Pain Consortium’s research task force on research standards for chronic low back pain (CLBP) proposed a measure that could be used to stratify patients by the impact CLBP has on their lives, namely the Impact Stratification Score (ISS). This study examines the dimensionality of the ISS and suppor...
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Background Level of symptom burden for cancer patients can be summarized using simple-summated scoring of multiple patient-reported symptoms. The Toxicity Index (TI) is an alternative that has been used primarily to summarize clinician-reported toxicities. Objective To compare the TI with simple-summated scoring of 28 patient-reported symptoms. M...
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Background: In 2014, the National Institutes of Health Pain Consortium Research Task Force recommended that patients with chronic low back pain (CLBP) be stratified by its impact on their lives. They proposed the Impact Stratification Score (ISS) to help guide therapy and facilitate study comparability. The ISS has been evaluated as a continuous m...
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This paper estimates differences in walking and associations of walking with neighborhood perceptions among older adults in California. We analyzed the restricted-use California Health Interview Survey data merged with the American Community Survey data. Walking at least 10 minutes for leisure in the last 7 days and number of minutes walked were re...
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Purpose Individual change on a patient-reported outcome (PRO) measure can be assessed by statistical significance and meaningfulness to patients. We explored the relationship between these two criteria by varying the confidence levels of the coefficient of repeatability (CR) on the Patient-Reported Outcomes Measurement Information System (R) Physic...
Article
Introduction Hypoactive Sexual Desire Disorder (HSDD) significantly impacts a woman's daily functioning and well-being (health-related quality of life, HRQoL) and is often undetected by the medical profession and dismissed by society. As a result, the profound and extensive impact of HSDD on the lives of women and their partners is underappreciated...
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David Cella,1 Ron D Hays2 1Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA; 2Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USACorrespondence: David Cella, Email d-cella@northwestern.eduAbstract: We briefly review the history of measuring perceptions of health and quality of life, fo...
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Objective : To crosswalk the National Institutes of Health (MIH) Pain Consortium's Research Task Force proposed Impact Stratification Scale (ISS) to the PEG (Pain intensity, interference with Enjoyment of life, interference with General activity) scale. Design Cross-sectional data collected in 2021. Ordinary least squares regression analyses of IS...
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The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys collect standardized information about patient experiences of care from nationally representative samples of people with Medicare to support consumers’ enrollment choices and enable the Centers for Medicare & Medicaid Services to monitor care quality and incentivi...
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Patient health literacy is vital to clinical trial engagement. Knowledge and beliefs about clinical trials may contribute to patient literacy of clinical trials, influencing engagement, enrollment and retention. We developed and assessed a survey that measures clinical trial health knowledge and beliefs, known as the Clinical trial HEalth Knowledge...
Article
Background: Retinoblastoma (RB) is a malignant intraocular tumor diagnosed in early childhood that requires extensive medical and surgical treatment at a young age. Health-related quality of life (HRQOL) is thought to be diminished due to visual impairment, facial deformities, and fear of recurrence or secondary cancer. However, few studies have id...
Article
Objective: The purpose of this study was to compare the crowdsourcing platform Amazon Mechanical Turk (MTurk) with in-person recruitment and web-based surveys as a method to (1) recruit study participants and (2) obtain low-cost data quickly from chiropractic patients with chronic low back pain in the United States. Methods: In this 2-arm quasi-...
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Objective The purpose of this study was to estimate the significance of individual change using 5 statistical indicators in 2 samples of patients treated for low back pain. Methods This secondary analysis used observational and clinical trial data from 2 samples of patients with low back pain to compare 5 ways of estimating significant individual...
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Background: There has been limited evaluation of health-related quality of life (HRQOL) in rectal cancer patients receiving neoadjuvant chemoradiotherapy. HRQOL outcomes in the National Surgical Adjuvant Breast and Bowel Project R-04 trial are examined in this article. Methods: Between 2004 and 2010, R-04 patients were invited to enroll in the H...
Article
It is challenging to synthesize findings across studies of pain impact. This study develops a link to estimate the Patient-Reported Outcomes Measurement Information System (PROMIS®) global health measure from the 3-item PEG (Pain intensity, interference with Enjoyment of life, interference with General activity) scale, The PROMIS and PEG items were...
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Despite poor sleep among older adults, little is known about the sleep habits of older immigrants living in the United States. The current pragmatic qualitative descriptive study explored sleep among older Korean immigrants, using a focus group with six participants and individual phone interviews with 22 Korean immigrants aged ≥60 years. Transcrip...
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Background: The Agency for Healthcare Research and Quality held a research meeting on using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data for quality improvement (QI) and evaluating such efforts. Topics covered.: Meeting addressed: 1)What has been learned about organizational factors/environment needed to improve patient...
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This study reports the results of focus groups with school nurses and teachers from elementary, middle, and high schools to explore their perceptions of child and adolescent oral health. Participants included 14 school nurses and 15 teachers (83% female; 31% Hispanic; 21% White; 21% Asian; 14% African American; and 13% Others). Respondents were rec...
Article
Background Understanding the long-term sequelae of severe COVID-19 remains limited, particularly in the United States. Objective To examine long-term outcomes of patients who required intensive care unit (ICU) admission for severe COVID-19. Design, Patients, and Main Measures This is a prospective cohort study of patients who had severe COVID-19...
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Poor sleep is common among older adults, affecting a wide range of health outcomes. However, little is known about sleep issues among older Korean immigrants, the fastest growing Asian American subgroup in the United States. We aimed to explore multiple factors associated with sleep among this group. We analyzed cross-sectional survey data from 43...
Article
Patient-reported outcomes are recognized as essential for the evaluation of medical and public health interventions. Over the last 50 years, health-related quality of life (HRQoL) research has grown exponentially from 0 to more than 17,000 papers published annually. We provide an overview of generic HRQoL measures used widely in epidemiological stu...
Preprint
This study reports results of focus groups with school nurses and teachers from elementary, middle, and high schools to explore their perceptions of child and adolescent oral health. Participants included 14 school nurses and 15 teachers (83% Female; 31% Hispanic, 21% White, 21% Asian, 14% African American, and 13% Others). Respondents were recruit...
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Background and objectives: Health care organizations track patient experience data, identify areas of improvement, monitor provider performance, and assist providers in improving their interactions with patients. Some practices use one-on-one provider counseling ("shadow coaching") to identify and modify provider behaviors. A recent evaluation of...
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Black men who have sex with men and women (BMSMW) experience pressure to fill hypermasculine ideals and may not identify with “gay” cultural norms. Existing measures of gender role expectations and internalized homophobia are not culturally appropriate for BMSMW. Researchers generally measure categorical identification with race, gender, and sexual...
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Objective This study examines Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v1.0 outcomes of chiropractic care in a multi-site, pragmatic clinical trial and compares the PROMIS measures to: 1) worst pain intensity from a numerical pain rating 0–10 scale, 2) 24-item Roland-Morris Disability Questionnaire (RMDQ); and 3) global...
Article
Background Information about telehealth versus in-office visits and how patient experience before compared to during the COVID-19 pandemic is important for healthcare planning.Objective To compare patient experience by visit type and before and during the pandemic.DesignSurvey of patients assessing ambulatory care before and during the pandemic.Par...
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Little is known about sleep disturbance among older Korean immigrants living in the United States. In this exploratory study, we conducted focus groups with 6 and phone interviews with 22 older Korean immigrants to explore and understand their sleep experiences. Three members of the research team fluent in Korean independently coded each focus grou...
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Background Differences in experiences of care reported by Asian Americans (Asians) compared to non-Hispanic Whites (Whites) may be due to lack of measurement invariance. Methods We evaluated the three-factor structure and the equivalence of responses to the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinical and Group (CG-CAH...
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Background: Dental caries is the most common chronic childhood infectious disease and is a serious public health problem affecting both developing and industrialized countries, yet it is preventable in most cases. This study evaluated the potential of screening for dental caries among children using a machine learning algorithm applied to parent p...
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Background: Pilot studies test the feasibility of methods and procedures to be used in larger-scale studies. Although numerous articles describe guidelines for the conduct of pilot studies, few have included specific feasibility indicators or strategies for evaluating multiple aspects of feasibility. In addition, using pilot studies to estimate ef...
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Purpose Estimates of the minimally important change (MIC) can be used to evaluate whether group-level differences are large enough to be important. But responders to treatment have been based upon group-level MIC thresholds, resulting in inaccurate classification of change over time. This article reviews options and provides suggestions about indiv...
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PURPOSE The US National Cancer Institute Moonshot initiative calls for improving analysis and reporting of toxicity to inform treatment tolerability. We used existing clinician-reported adverse event (AE) and patient-reported outcome (PRO) questionnaire data from the randomized, double-blind NSABP B-35 clinical trial to explore reasons for anastroz...
Article
Objectives: Quality improvement (QI) requires data, indicators, and national benchmarks. Knowledge about the usefulness of Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) data are lacking. We examined quality leader and frontline staff perceptions about patient experience measurement and use of Child HCAHPS da...
Article
Background Prior studies using aggregated data suggest that better care coordination is associated with higher performance on measures of clinical care process; it is unclear whether this relationship reflects care coordination activities of health plans or physician practices.Objective Estimate within-plan relationships between beneficiary-reporte...
Article
Introduction Hypoactive Sexual Desire Disorder (HSDD) / Female Sexual Interest/Arousal Disorder (FSIAD) impacts health-related quality of life (HRQoL) of women and their partners, yet existing measures fail to adequately capture relevant concepts (ie, what is essential to measure including symptoms/impacts) important to women with HSDD/FSIAD. Obje...
Article
Objectives: To examine how primary care practices use the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and its patient-centered medical home (PCMH) items during their PCMH transition. Study design: Qualitative study of practices' use of patient experience data during PCMH transformation, based on a random sample of prim...
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Objectives: Knowing which patient-centered medical home (PCMH) care delivery changes and quality improvement (QI) practices further PCMH implementation is essential. Study design: We used the 2008-2017 National Committee of Quality Assurance (NCQA) PCMH directory of 15,188 primary care practices that received Level 1, 2, or 3 NCQA PCMH recogniti...
Article
Introduction The Impact Stratification Score (ISS) is a measure of the impact of chronic low back pain (LBP) consisting of nine Patient-Reported Outcomes Measurement Information System (PROMIS-29) items, but no studies have examined the ISS or its association with psychological symptoms in military samples. This study examines longitudinal associat...
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Objectives To (1) develop a survey to assess the patient experience of care in hospital-based emergency departments (ED) and (2) evaluate the reliability and validity of composite measures of patient experience using data collected through the experimental implementation of the newly developed Emergency Department Patient Experience of Care (EDPEC)...
Article
Background: Health care organizations strive to improve patient care experiences. Some use one-on-one provider counseling (shadow coaching) to identify and target modifiable provider behaviors. Objective: We examined whether shadow coaching improves patient experience across 44 primary care practices in a large urban Federally Qualified Health C...
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The National Children's Study (NCS) statistics and item response theory group was tasked with promoting the quality of study measures and analysis. This paper provides an overview of six measurement and statistical considerations for the NCS: (1) Conceptual and Measurement Model; (2) Reliability; (3) Validity; (4) Measurement Invariance; (5) Interp...
Article
Background and Objectives A preference-based health utility score (PROPr) can be calculated using Patient-Reported Outcomes Measurement Information System domain scores. We assessed the construct validity of PROPr among patients treated with kidney replacement therapy (hemodialysis or kidney transplant). Design, setting, participants and measuremen...
Article
Objective and objective: Obstructive Sleep Apnea (OSA) is a highly prevalent disorder that disparately affects racial/ethnic minorities. OSA functional health literacy can contribute to health disparities. Documenting poor OSA functional health literacy is needed to inform research agendas, policy, and advocacy efforts. The objective of this study...
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The reliable change index has been used to evaluate the significance of individual change in health-related quality of life. We estimate reliable change for two measures (physical function and emotional distress) in the Patient-Reported Outcomes Measurement Information System (PROMIS®) 29-item health-related quality of life measure (PROMIS-29 v2.1)...
Article
Purpose: The toxicity index (TI) is a summary index that accounts for toxicity grades associated with cancer symptoms that is more sensitive than other toxicity systems to treatment differences. The TI can be used with patient-reported symptoms but requires that scores for different items represent equivalent severity. The purpose of this article...
Article
Objective: Evaluate the Impact Stratification Score (ISS) measure of low back pain impact that assesses physical function, pain interference, and pain intensity. Design: Secondary analyses of a prospective comparative effectiveness trial of active-duty military personnel with low back pain. Setting: A Naval hospital at a military training site...
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Background Healthcare organizations want to improve patient care experiences. Some use ‘shadow coaching’ to improve interactions between providers and patients. A Federally Qualified Health Center (FQHC) implemented a half-day observation of individual primary-care providers by a ‘shadow coach’ during real-time patient visits, including an in-perso...
Article
Background: Clear and complete reporting of the components of complex interventions is required in clinical trials to ensure that research can be reliably replicated and successfully translated into clinical practice. Movement-based mind-body exercises, such as Tai Chi, qigong, and Yoga (TQY), are considered complex interventions and recommended fo...
Article
Purpose To develop a vision-targeted health-related quality-of-life (HRQoL) instrument for patients with glaucoma who are candidates for minimally invasive glaucoma surgery (MIGS). Design Development of a health-related quality-of-life instrument. Participants Twelve practicing ophthalmologists and 41 glaucoma patients. Methods A questionnaire w...
Preprint
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Background: Identifying how many individuals significantly improve (“responders”) provides important supplementary information beyond group mean change about the effects of treatment options. This supplemental information can enhance interpretation of clinical trials and observation studies. This study provides a comparison of five ways of estimati...
Preprint
Full-text available
Bido et al. concluded that the PROMIS Global-10 performed poorly in patients undergoing total shoulder arthroplasty for glenohumeral arthritis compared to legacy measures: The Standardized Shoulder Assessment Form (ASES), Single Assessment Numeric Evaluation (SANE), and the Shoulder Activity Scale (SAS). Bido et al. did not distinguish between chan...
Article
Objective: To link scores from two condition-specific measures for chronic lower back pain (CLBP), the Oswestry Disability Index (ODI) and the Roland-Morris Disability Questionnaire (RMDQ), to Patient Reported Outcomes Measurement Information System (PROMIS®) physical function, pain interference, and pain intensity scores. Design: Ordinary least...
Preprint
Full-text available
Purpose Estimates of the minimally important change (MIC) can be used to evaluate whether group-level differences are large enough to be important. But responders to treatment have been based upon group-level MIC thresholds, resulting in inaccurate classification of change over time. This article reviews options and provides suggestions about indiv...
Article
Background: Patient surveys are the primary tool to measure patient experiences of care. Caution must be taken when analyzing these data, as responses can be influenced by factors that do not reflect the quality of care received. Objectives: To provide a practical overview of adjusting patient experience survey results to address bias related to...
Article
Background/objectives: Briefer measures of symptoms and functional limitations may reduce assessment burden and facilitate monitoring populations of persons with dementia (PWD). Design: Prospective follow-up study. Setting: University-based dementia care management program. Participants: 1,091 PWD. Measurements: We assessed cognition (Mini...
Article
The internal-external locus of control construct, Health-Belief Model, Theory of Reasoned Action, Differential Association-Reinforcement Theory, and Problem Behavior Theory all stem from general value-expectancy theory. Ironically, none of these theories contain a full account of social learning, from developmental process to current personality. I...
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Because depressive symptoms are a part of health-related quality-of-life (HRQOL) measures, measures of depression will be empirically associated with HRQOL. We discuss examples of published research where authors ignored or did not fully account for overlap between depressive symptom and HRQOL measures. Future researchers need to recognize when the...
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Background Substantial investment has gone into research on the efficacy and effectiveness of pharmaceutical and nonpharmacologic interventions for chronic pain. However, synthesizing this extensive literature is challenging because of differences in the outcome measures used in studies of similar or competing interventions. The absence of a common...
Article
Background and objectives: Delivering care as a patient-centered medical home (PCMH) is being widely adopted across the United States by primary care practices to better meet patient needs. A key PCMH element is measuring patient experience for practice improvement. The National Committee for Quality Assurance (NCQA) PCMH recognition program requi...
Article
Study objectives: Person-centered obstructive sleep apnea (OSA) care is a collaborative approach that is respectful of an individual's health priorities. Informed decision-making is essential to person-centered care, especially as patients age. In a feasibility study, we evaluated the effects of a new decision aid (Decide2Rest) on OSA treatment de...