William H Rogers

• PhD
• Statistician at Tufts Medical Center

Objective: The aim was to quantify caregiver distress among informal caregivers of individuals with schizophrenia or schizo-affective disorder and identify its correlates. Methods: From December 2014 through April 2015, ads posted with mental health advocates and the media recruited informal caregivers, age $21 years, to complete an online question...

Objective: Although depression is a prevalent and costly health problem exacting a large toll on work productivity, interventions targeting occupational functioning are rare. This article describes the development of the Tufts Be Well at Work intervention, a brief telephonic program designed to improve occupational functioning among employees with...

Background: Excellent adherence to HIV antiretroviral therapy (ART) remains a cornerstone of HIV care. A three-item adherence self-report scale was recently developed and validated, but the scale has not been previously tested in a nationally representative sample. Design: We administered the adherence scale to participants in the CDC's Medical...

Objective: To describe caregiving work outcomes and related indirect (i.e., productivity) and direct (i.e., caregiving hours and expenses) costs. Methods: A national, population-based survey to identify employed caregivers assisting a person with treatment-resistant depression (TRD) and a comparison group of employed caregivers assisting others...

Importance Thousands of working-age veterans with depression experience impaired occupational functioning. Objectives To test whether the Veterans Health Administration (VHA) integrated care (IC) program combined with telephonic work-focused counseling, known as Be Well at Work (BWAW), is superior to IC alone for improving occupational functioning...

Objective: While Anti-Retroviral Therapy (ART) is essential to patients with HIV, there is substantial variation in adherence nationally. We assess how provider and practice factors contribute to successful HIV ART adherence. Design: We used Medicaid Analytic Extract claims from 2008-2012. We attributed patients with HIV to the provider that pro...

This literature review analyzes 418 articles from 2 periods (2000-2010 and 2011-2017) to provide interpretative guidelines for the change in physical (PCS) and mental component summaries (MCS) of well-established patient-reported measures (MOS SF-36 V1, HOS SF-12, VR-36, and VR-12). The magnitude of the intervention effects was calculated using bas...

Objective: Methods for assessing the costs and benefits of administering vaccines to international business/occupational travelers, assignees and expatriates have neglected the impact of health and treatment on work productivity. The research objective is to evaluate the benefit to cost ratio of the Japanese Encephalitis (JE) vaccine for internati...

Purpose: To develop bridging algorithms to score the Veterans Rand-12 (VR-12) scales for comparability to those of the SF-36® for facilitating multi-cohort studies using data from the National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER) linked to Medicare Health Outcomes Survey (MHOS), and to provide a model for min...

While some studies have assessed patient recall of important information from ambulatory care visits, none has done so recently. Furthermore, little is known about features of clinical interactions which are associated with patient understanding and recall, without which shared decision making, a widely shared ideal for patient care, cannot occur....

We conducted a randomized trial comparing the effect of two different levels of motivational interviewing training on clinician communication behaviors and patient experiences. We enrolled 12 HIV clinicians who attended a one-day MI workshop focusing on behavior change counseling skills. We then randomized clinicians to receive (or not) 3-5 rounds...

Objective: The aim was to quantify caregiver distress among informal caregivers of individuals with schizophrenia or schizoaffective disorder and identify its correlates. Methods: From December 2014 through April 2015, ads posted with mental health advocates and the media recruited informal caregivers, age ≥21 years, to complete an online questi...

Objective: The aim of this study was to test the reliability, validity, and responsiveness of the Caregiver Work Limitations Questionnaire (WLQ) for employed caregivers of individuals with schizophrenia and/or schizoaffective disorder. Methods: A cross-sectional web-based survey with test/retest and responsiveness test components was administere...

Though many workers carry the double burden of a limiting illness and work stress, their problems are neglected in services settings and intervention research. Despite vulnerability to adverse health and work outcomes, workers with concurrent depression and/or work stress are a neglected group. A novel workplace intervention, aimed at improving the...

Few self-report measures of medication adherence have been rigorously developed and validated against electronic drug monitoring (EDM). Assess the validity of the 3-item self-report scale by comparing it with a contemporaneous EDM measure. We conducted an observational study in which adherence assessments were done monthly for up to 4 months for 81...

Purpose: The objective of this study was to determine the fraction of variance in patient-level medication adherence accounted for by prescribers and pharmacies. Methods: We used prescription drug claims paid between January 2010 and July 2011 to a national pharmacy benefits manager to define implementation during persistent episodes. Patients i...

Objectives: The study tested an intervention aimed at improving work functioning among middle-aged and older adults with depression and work limitations. Methods: A randomized clinical trial allocated an initial sample of 431 eligible employed adults (age ≥45) to a work-focused intervention (WFI) or usual care. Inclusion criteria were depression...

Motivational Interviewing (MI) consistent talk by a counselor is thought to produce "change talk" in clients. However, it is possible that client resistance to behavior change can produce MI inconsistent counselor behavior. We applied a coding scheme which identifies all of the behavioral counseling about a given issue during a visit ("episodes"),...

To determine the cost of back and/or neck (B/N) pain among predominantly rural employees insured through an employee benefits trust. Eligible employees had 1 year or more of medical coverage and completed a survey subsequently linked to their claims data. B/N pain costs consisted of medical and pharmacy claims, over-the-counter expenses, and presen...

Objective: To assess the cost outcomes of treatment approaches to care for back problems in a major self-insured workforce, using published guidelines to focus on low back pain. Methods: Longitudinally tracked episodes of three types of International Classification of Diseases, Ninth Revision diagnosis code-identified back problems (n=14,787) du...

The objectives of this study were to understand how different types of barriers to adherence to antiretroviral therapy (ART) were related and their differential impact on objectively measured adherence over time. Data from 151 patients taking ART were used to describe four sub-types of self-reported adherence barriers: medication and health concern...

Disparities in HIV care and outcomes negatively affect Black and Hispanic patients. Features of clinical communication may be a factor. This study is based on coding transcripts of 404 routine outpatient visits by people with HIV at four sites, using a validated system. In models adjusting for site and patient characteristics, with provider as a ra...

Abstract Providers do not predict reliably which of their HIV-positive patients are having difficulty adhering to antiretroviral therapy (ART). The transtheoretical, or stages of change model, may be a useful tool to help providers identify patients who are having difficulty with ART adherence. The objective of the current study was to determine th...

We conducted four rounds of cognitive testing of self-report items that included 66 sociodemographically diverse participants, then field tested the three best items from the cognitive testing in a clinic waiting room (N = 351) and in an online social networking site for men who have sex with men (N = 6,485). As part of the online survey we conduct...

Background: Depression goes often unrecognised and untreated in non-psychiatric medical settings. Screening has recently gained acceptance as a first step towards improving depression recognition and management. The Primary Care Screener for Affective Disorders (PC-SAD) is a self-administered questionnaire to screen for Major Depressive Dis-order (...

Background: Depression goes often unrecognised and untreated in non-psychiatric medical settings. Screening has recently gained acceptance as a first step towards improving depression recognition and management. The Primary Care Screener for Affective Disorders (PC-SAD) is a self-administered questionnaire to screen for Major Depressive Dis-order (...

To use an empirical Bayesian approach, blending practice, and group quality data with physician results to increase the accuracy of quality of care measures. Performance data on diabetes glycemic screening for 8,357 physicians collected from multiple payers as part of a statewide physician performance reporting initiative. A variance components ana...

Objective: The purpose of this study was to develop a cystic fibrosis (CF)-specific patient and family experience of care survey that CF care centers could use to inform quality improvement efforts. Methods: A literature search and query of CF care centers was conducted to identify existing surveys. Individuals with CF, their families, and healt...

Objectives: To evaluate variation in the prescription of guideline-recommended medications across Medicare Advantage (MA) plans and to determine whether such variation is associated with increased mortality. Methods: Observational study of 111,667 patients aged 65 years or older receiving care in 203 MA plans. We linked data from the Medicare He...

Objective: To assess the evidence regarding the economic impact of worker health promotion programs. Objective: Peer-reviewed research articles were identified from a database search. Included articles were published between January 2000 and May 2010, described a study conducted in the United States that used an experimental or quasi-experimenta...

Background: Depression goes often unrecognised and untreated in non-psychiatric medical settings. Screening has recently gained acceptance as a first step towards improving depression recognition and management. The Primary Care Screener for Affective Disorders (PC-SAD) is a self-administered questionnaire to screen for Major Depressive Dis-order (...

The Veterans RAND 12-Item Health Survey (VR-12) is one of the major patient-reported outcomes for ranking the Medicare Advantage (MA) plans in the Health Outcomes Survey (HOS). Approaches for scoring physical and mental health are given using contemporary norms and regression estimators. A new metric approach for the VR-12 called the "VR-6D" is pre...

: To develop new evidence for advancing a leading employer's capacity to manage the burden of chronic obstructive pulmonary disease (COPD). : Retrospective analyses of an integrated database tracking active employees (n = 19,989) from 2001-2009. Tests on 29 measures of direct/indirect costs and drivers examined unique disease burden and impact over...

To examine total health burden for an employer whose health-related focus is direct and indirect costs. To explore implications for the Final Rule for Accountable Care Organizations recently issued by the Centers for Medicare and Medicaid Services, whose focus includes direct but not indirect costs. Used 42 claims and survey-based measures to track...

: To determine the impact of tapentadol extended release (ER) versus placebo or oxycodone controlled release (CR) on the work productivity of adults with chronic moderate to severe knee osteoarthritis pain. : Using clinical trial data on pain outcomes, a validated methodology imputed treatment group differences in at-work productivity and associate...

To assess the relationship between clinical care metrics and patient experiences of care among patients with chronic disease. Cross-sectional survey and clinical performance data. Eighty-nine medical groups across California caring for patients with chronic disease. Using patient surveys, we identified 51 129 patients with a chronic disease. Using...

To test a new program's effectiveness in reducing depression's work burden. A brief telephonic program to improve work functioning was tested in an early-stage randomized controlled trial involving 79 Maine State Government employees who were screened in for depression and at-work limitations (treatment group = 59; usual care group = 27). Group dif...

Few studies have analyzed physician-patient adherence dialogue about ARV treatment in detail. We comprehensively describe physician-patient visits in HIV care, focusing on ARV-related dialogue, using a system that assigns each utterance both a topic code and a speech act code. Observational study using audio recordings of routine outpatient visits...

Little is known about how the structure of work affects adherence to HIV antiretroviral therapy. We surveyed participants in an adherence intervention study to learn more about job characteristics, including measures of psychological demand and control, and job accommodations. Adherence was assessed using the Medication Event Monitoring System. Of...

Patient centered clinical communication may be associated with longer encounters. We used the General Medical Interaction Analysis System (GMIAS) to code transcripts of routine outpatient visits in HIV care, and create 5 measures of patient-centeredness. We defined visit length as number of utterances. To better understand properties of encounters...

The prevalence of depressive disorders is high among patients with skin disease. The PC-SAD is a 37-item self-administered depression screening questionnaire that has been validated in dermatological patients. The aim of this study was to develop and validate a brief depression severity instrument derived from the PC-SAD that can be used to assess...

Performance reporting is increasingly focused on physician practice sites and individual physicians. To assess the reliability of performance measurement for practice sites and individual physicians. We used data collected across multiple payers as part of a statewide measurement collaborative to evaluate the observed measure reliability and sample...

The Veterans RAND 12-Item Health Survey (VR-12) is currently the major endpoint used in the Medicare managed care outcomes measure in the Healthcare Effectiveness Data and Information Set (HEDIS(®)), referred to as the Health Outcomes Survey (HOS). The purpose of this study is to adapt the Brazier SF-6D utility measure to the VR-12 to generate a si...

Depression, a chronic, episodic condition affecting at least 4.9% of the working age population (Blazer et al.1994), causes substantial functional limitation and social role disability (Wells 1985, 1997; Wells et al. 1991). Since Wells et al. (1989) first reported on the disabling impact of depression in the 1980s, evidence of its human and economi...

To assess the effect of survey distribution protocol (mail versus handout) on data quality and measurement of patient care experiences. Multisite randomized trial of survey distribution protocols. Analytic sample included 2,477 patients of 15 clinicians at three practice sites in New York State. Mail and handout distribution modes were alternated w...

Consensus guidelines in HIV care call for clinicians to provide a brief sexual risk behavioral intervention in each visit. Studies based on participant reports find this occurs infrequently, but studies based on direct observation of clinical encounters are lacking. We conducted a mixed method study that used audio recordings of 116 routine outpati...

To assess the work performance and productivity impact of human papillomavirus (HPV). A cross-sectional study compared 94 employed women with clinically significant HPV-related cervical lesions with 118 healthy controls. Data were collected by self-administered web-based questionnaire. At-work performance limitations and productivity loss (presente...

To compare the Veterans Health Administration (VHA) with the Medicare Advantage (MA) plans with regard to health outcomes. The Medicare Health Outcome Survey, the 1999 Large Health Survey of Veteran Enrollees, and the Ambulatory Care Survey of Healthcare Experiences of Patients (Fiscal Years 2002 and 2003). A retrospective study. Men 65+ receiving...

Chronic pulmonary diseases (CPDs) such as asthma and COPD are associated with particularly high rates of cost-related medication nonadherence (CRN), but the degree to which inhaler costs contribute to this is not known. Here, we examine the relationship between inhaler-specific out-of-pocket costs and CRN in CPD. Using data obtained in 2006 in a na...

Physicians' limited knowledge of patients' antiretroviral adherence may reduce their ability to perform effective adherence counseling. We conducted a randomized, cross-over study of an intervention to improve physicians' knowledge of patients' antiretroviral adherence. The intervention was a report given to the physician before a routine office vi...

Purpose Depressed employees are vulnerable to adverse work outcomes. We hypothesized that work performance is impaired by depression and is worsened by exposure to psychosocial work stressors. Design Longitudinal cohort study with surveys administered at baseline, 6, 12, and 18 months. Setting Recruitment in primary care offices. Subjects A tota...

What are the strengths and weaknesses of computer-based and other automated methods of detecting depression? Two promising technologies make use of the Internet and speech recognition. Whatever technology is used, each method needs to be assessed rigorously using the same high standards that have been applied to pencil-and-paper tests. We are in th...

BACKGROUND Patient experience measures are central to many pay-for-performance (P4P) programs nationally, but the effect of performance-based financial incentives on improving patient care experiences has not been assessed. METHODS The study uses Clinician & Group CAHPS data from commercially insured adult patients (n = 124,021) who had visits with...

In January 2006, 43 million Medicare beneficiaries became eligible for subsidized prescription coverage (Part D) through Medicare. To date, no longitudinal study has afforded information on beneficiaries' prescription coverage transitions and corresponding changes in prescription use and spending. To evaluate changes in Medicare beneficiaries' pres...

Self-management support is an important component of improving chronic care delivery. To validate a new measure of self-management support and to characterize performance, including comparisons across chronic conditions. We incorporated a new question module for self-management support within an existing annual statewide patient survey process in 2...

We compared risk-adjusted mortality rates between Medicaid-eligible patients in the Medicare Advantage plans ("MA dual enrollees") and Medicaid-eligible patients in the Veterans Health Administration ("VHA dual enrollees"). We used the Death Master File to ascertain the vital status of 1912 MA and 2361 VHA dual enrollees. We used Cox regression mod...

To examine the extent to which medical group and market factors are related to individual primary care physician (PCP) performance on patient experience measures. This study employs Clinician and Group CAHPS survey data (n=105,663) from 2,099 adult PCPs belonging to 34 diverse medical groups across California. Medical group directors were interview...

Background: The use of item screeners is viewed as an essential feature of quality survey design because only respondents who are 'qualified' to answer questions that apply to a subset of the sample are directed to answer. However, empirical evidence supporting this view is scant. Objective: This study compares data quality resulting from the ad...

To develop a method for imputing the work performance and productivity impact of illness and treatment from available data. Using data from four studies of musculoskeletal disorders (eg, osteoarthritis) and pain, we modeled the relationships between scores from the Work Limitations Questionnaire (WLQ), a validated measure of health-related limitati...

The purpose of this project was to develop an updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12). We used a well-defined and nationally representative sample of the U.S. population from 52,425 responses to the Medical Expenditure Panel Survey (MEPS) collected between 2000 and 2002. We applied modified regression es...

This study assesses the reliability of patient-reported information about care received by individual specialist physicians. A patient questionnaire that included core composites from the Consumer Assessment of Healthcare Providers and Systems Clinician & Group survey was administered to random samples of patients visiting 1315 physicians from 14 s...

Despite widening efforts to publicly report health care quality data, patients appear to make little use of these data. Several studies indicate patients' interest in physician-level information, but actual use of physician-level data remains unestablished. Using a randomized experimental design, this study evaluates the extent to which use of a We...

Few studies have clarified the mechanisms that contribute to racial and ethnic disparities in primary care quality among comparably-insured patients. To examine relative contribution of "between-" and "within-" physician effects on disparities in patients' experiences of primary care. Regression models using physician fixed effects to account for p...

Background Studies find that primary care physician (PCP) visit continuity is positively associated with care quality. Some of the evidence base, however, relies on patient-reported continuity measures, which may be subject to response bias. Objective To assess the concordance of patient-reported and administratively derived visit continuity measur...

Physicians are increasingly asked to improve the delivery of clinical services and patient experiences of care. We evaluated the association between clinical performance and patient experiences in a statewide sample of physician practice sites and a sample of physicians within a large physician group. We separately identified 373 practice sites and...

In HIV/AIDS, symptoms of depression or post-traumatic stress may interfere with important self-care behaviors such as the ability to adhere to one's medical treatment regimen. However, these problems may frequently go undetected in HIV care settings. The present study used brief self-report screening measures of depression and post-traumatic stress...

We evaluated the patient self-report questions about disease from the Medicare Health Outcomes Survey (HOS), using linked Veterans Health Administration (VA) data for patients who are eligible for both Medicare and Veterans Affairs (VA) care to estimate their utility as measures of illness burden. Patients were classified for 12 diseases on the bas...

Physicians and medical educators have repeatedly acknowledged the inadequacy of communication skills training in the medical school curriculum and opportunities to improve these skills in practice. This study of a controlled intervention evaluates the effect of teaching practicing physicians the skill of "agenda-setting" on patients' experiences wi...

Patient care experience survey data might be useful for managing individual physician malpractice risk, but available evidence is limited. This study assesses whether patients' experiences with individual physicians, as measured by a validated survey, are associated with patient complaints and malpractice lawsuits. Random samples of active patients...

Self-reported measures of antiretroviral adherence vary greatly in recall time periods and response tasks. To determine which time frame is most accurate, we compared 3-, 7-day, and 1-month self-reports with data from medication event monitoring system (MEMS). To determine which response task is most accurate we compared three different 1-month sel...

This presentation provides methodologies for case mix measures using the Veterans RAND 12 Item Health Survey (VR-12) as the outcome. The VR-12 is modified from the Veterans RAND 36 Item Health Survey and the RAND SF-36. This measure of functional status and well being spans the domains of physical to psychological functioning. The VR-12 has recentl...

Despite growing emphasis on public reporting of health care quality data, available data are often ignored. To evaluate the usefulness of web-based physician-level data for patients choosing a new primary care physician (PCP). Patients seeking a new PCP (n = 2225) were invited to view web-based information including PCP credentials, personal charac...

In measuring patients' experiences with individual primary care physicians (PCPs), the reliability and validity of data based on samples of "established" patients of a physician's panel have been shown. However, as large-scale initiatives seek the least costly approach to obtaining these data, little is known about the implications of expanding sam...

Comparing health outcomes with adequate methodology is central to performance assessments of health care systems. We compared the Medicare Advantage Program (MAP) and the Veterans Health Administration (VHA) with regard to changes in health status and mortality. We used the Death-Master-File for vital status and the Short-Form 36 to determine physi...

A national survey in 2006 found that Part D secured drug coverage for most seniors who were without it in 2005, prior to the Medicare drug benefit. Seniors without drug coverage in 2006 generally fell into two groups: those in relatively good health and those potentially difficult to reach. Compared with seniors covered through employer plans or th...

Visit continuity is important to patients and valued by physicians. However, it is virtually impossible for primary care physicians (PCPs) to provide care during every paneled patient visit. It remains unclear whether PCP visit discontinuity can be planned in a way that is least disruptive to patients' experiences with care. This study aims to clar...

Understanding and improving the quality of medication management is particularly important in the context of the Medicare prescription drug benefit that took effect last January 2006. To determine the prevalence of physician-patient dialogue about medication cost and medication adherence among elderly adults nationwide. Cross-sectional survey. Nati...