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Open Access 01-12-2021

Implications of response shift for micro-, meso-, and macro-level healthcare decision-making using results of patient-reported outcome measures

Authors: Richard Sawatzky, Jae-Yung Kwon, Ruth Barclay, Cynthia Chauhan, Lori Frank, Wilbert B. van den Hout, Lene Kongsgaard Nielsen, Sandra Nolte, Mirjam A. G. Sprangers, the Response Shift – in Sync Working Group

Published in: Quality of Life Research | Issue 12/2021

Abstract

Purpose

Results of patient-reported outcome measures (PROMs) are increasingly used to inform healthcare decision-making. Research has shown that response shift can impact PROM results. As part of an international collaboration, our goal is to provide a framework regarding the implications of response shift at the level of patient care (micro), healthcare institute (meso), and healthcare policy (macro).

Methods

Empirical evidence of response shift that can influence patients’ self-reported health and preferences provided the foundation for development of the framework. Measurement validity theory, hermeneutic philosophy, and micro-, meso-, and macro-level healthcare decision-making informed our theoretical analysis.

Results

At the micro-level, patients’ self-reported health needs to be interpreted via dialogue with the clinician to avoid misinterpretation of PROM data due to response shift. It is also important to consider the potential impact of response shift on study results, when these are used to support decisions. At the meso-level, individual-level data should be examined for response shift before aggregating PROM data for decision-making related to quality improvement, performance monitoring, and accreditation. At the macro-level, critical reflection on the conceptualization of health is required to know whether response shift needs to be controlled for when PROM data are used to inform healthcare coverage.

Conclusion

Given empirical evidence of response shift, there is a critical need for guidelines and knowledge translation to avoid potential misinterpretations of PROM results and consequential biases in decision-making. Our framework with guiding questions provides a structure for developing strategies to address potential impacts of response shift at micro-, meso-, and macro-levels.

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Title: Implications of response shift for micro-, meso-, and macro-level healthcare decision-making using results of patient-reported outcome measures
Authors: Richard Sawatzky
Jae-Yung Kwon
Ruth Barclay
Cynthia Chauhan
Lori Frank
Wilbert B. van den Hout
Lene Kongsgaard Nielsen
Sandra Nolte
Mirjam A. G. Sprangers
the Response Shift – in Sync Working Group
Publication date: 01-12-2021
Publisher: Springer International Publishing
Published in: Quality of Life Research / Issue 12/2021
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-021-02766-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Implications of response shift for micro-, meso-, and macro-level healthcare decision-making using results of patient-reported outcome measures

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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