New Findings from Tufts University in the Area of Managed Care Reported (Assessing Reliability and Validity of Sipat and Opportunities for Improvement: a Single-center Cohort Study): Managed Care

2024 JAN 01 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Researchers detail new data in Managed Care. According to news reporting out of Medford, Massachusetts, by NewsRx editors, research stated, “Psychosocial assessment is a standard component of patient evaluations for transplant candidacy. The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a widely used measure to assess psychosocial risk for transplant.”

Financial supporters for this research include Greenwall Foundation “Faculty Scholars Program” grant (PI: Keren Ladin), National Institutes of Health (NIH) - USA, NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK), Paul Teschan Research Fund, Dialysis Clinics Inc. (DCI), Greenwall Foundation, Patient-Centered Outcomes Research Institute - PCORI.

Our news journalists obtained a quote from the research from Tufts University, “However, there are questions regarding the SIPAT’s reliability and validity. We examined the SIPAT’s psychometric performance and its impact on equitable access to transplant in a diverse cohort of 2825 patients seeking liver transplantation between 2014 and 2021 at an urban transplant center. The SIPAT demonstrated good internal consistency reliability at the overall score [Cronbach’s alpha = 0.85, 95% CI (0.83, 0.86)] and domain levels (0.80 > alpha > 0.70). There was mixed support for structural validity, with poor overall model fit in confirmatory factor analysis and 50% of questions achieving the 0.70-factor loadings threshold. Adjusting for sociodemographic variables, the odds of not being waitlisted for psychosocial reasons were three times higher for patients with Medicaid insurance than patients with private insurance [OR 3.24, 95% CI (2.09, 4.99)] or Medicare [OR 2.89, 95% CI (1.84, 4.53)], mediated by higher SIPAT scores. Black patients had nearly twice the odds of White patients [OR 1.88, 95% CI (1.20, 2.91)], partially mediated by higher social support domain scores. Patients with Medicaid, non-White patients, and those without a college degree scored significantly higher on collinear questions, disproportionately contributing to higher SIPAT scores. The SIPAT did not perform equally across insurance type, race/ethnicity, and education groups, with the lowest subgroup validity associated with patient readiness and psychopathology domains. The SIPAT should be interpreted with caution, especially as a composite score.”

According to the news editors, the research concluded: “Future studies should examine validity in other populations.”

This research has been peer-reviewed.

For more information on this research see: Assessing Reliability and Validity of Sipat and Opportunities for Improvement: a Single-center Cohort Study. Liver Transplantation, 2023. Liver Transplantation can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Wiley-Blackwell - http://www.wiley.com/; Liver Transplantation - http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1527-6473)

Our news journalists report that additional information may be obtained by contacting Keren Ladin, Tufts University, Dept. of Community Health, Medford, MA, United States. Additional authors for this research include Jennifer M. Perry, Elizabeth Marfeo, Sasha Deutsch-Link and Marina Serper.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/LVT.0000000000000299. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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