Epidemiology and Biostatistics at the NIH Clinical Center conduct collaborative clinical research. Examples of current ongoing research are:
Analyzing the SSA Disability Evaluation Process
In the U.S., the safety net for individuals with disabilities includes important federal programs administered by the Social Security Administration (SSA) including Supplemental Security Income (SSI) and Social Security Disability Income (SSDI). For more than a decade, the SSA has faced challenges in managing its workload of 2-3 million initial applications per year along with appeals and continuing disability reviews. In addition, SSA’s own workforce is aging and retiring, leading to greater case workloads to be handles by fewer staff. These administrative challenges can have a profound effect on the lives of individuals with disabilities. In response to these system pressures, in 2007, the SSA sought advice from the NIH on new technologies, diagnostic tools, and novel assessments that might inform their adjudication process. Since that time, the NIH Rehabilitation Medicine Department (RMD) and SSA have worked closely to execute yearly inter-agency agreements that supports NIH-conducted research with two broad objectives: 1) analysis of SSA data to develop data-driven approaches that inform SSA’s decision making processes; and, 2) development of the Work Disability Functional Assessment Battery (WD-FAB). Both of these objectives aim to address the accuracy, consistency, and timeliness of SSA’s disability determination processes. The overarching goal of analytics is to develop key capabilities in cutting-edge areas of data science such as information retrieval, natural language processing, and machine learning to work with data collected and generated by SSA as part of their business process for disability determination. These capabilities are adapted and applied to the real-world problems confronted by the SSA to generate helpful tools and products for SSA’s use. Development of these capabilities, and their application in the SSA context, represents a cross-cutting principle of our analytic work. Concurrently, NIH and researchers from several academic institutions developed and are testing the WD-FAB. The objective of this area of work is to develop new ways to collect, structure, and interpret functional data for use by SSA. This includes development and testing of the WD-FAB as well as methods to assist in interpreting WD-FAB results. Contemporary models of disability suggest that, in order to assess work disability, what individuals can do and what they are expected to do for work must both be assessed. The WD-FAB is intended to assess what individuals can do. The WD-FAB is a 15-20-minute individualized assessment of functional activity that uses Item Response Theory (IRT), along with computer adaptive technology (CAT) to select the most relevant test items from a large pool of items to measure self-reported functional ability. Item-based scoring means respondents do not need to answer all items or the same items to obtain comparative scores and scores are obtained in a highly efficient manner.