Untitled

Abstract

A lack of clarity exists about the definition and adequate approach for evaluating responsiveness. An overview is presented of different categories of definitions and methods used for calculating responsiveness identified through a literature search. Twenty-five definitions and 31 measures were found. When applied to a general and a disease-specific quality of life questionnaire large variation in results was observed, partly explained by different goals of existing methods. Four major issues are considered to claim the usefulness of an evaluative health-related quality of life (HRQL) instrument. Their relation with responsiveness is discussed. The confusion about responsiveness arises mostly from a lack of distinction between cross-sectional and longitudinal validity and from a lack of distinction between responsiveness defined as the effect of treatment and responsiveness defined as the correlation of changes in the instrument with changes in other measures. All measures of what is currently called responsiveness can be looked at as measures of longitudinal validity or as measures of treatment effect. The latter ones tell us little about how well the instrument serves its purpose and are only of use in interpreting score changes. We therefore argue that the concept of responsiveness can be rejected as a separate measurement property of an evaluative instrument.

Responsiveness of the Canadian Occupational Performance Measure

“…Inappropriate measures of responsiveness are the use of effect sizes and related measures such as standardized response mean and relative efficacy statistics [33]. A suitable method to assess responsiveness is calculating change scores for clients whose health is expected to have changed and to examine the correlation with corresponding changes in a reference measure or transition indices [30][31][32].…”

“…Various approaches exist for measuring responsiveness [28][29][30][31][32]. Inappropriate measures of responsiveness are the use of effect sizes and related measures such as standardized response mean and relative efficacy statistics [33].…”

Interpretation of the Skin Cancer Quality of Life Score: A Validated Quality of Life Questionnaire for Non-Melanoma Skin Cancer

“…Responsiveness has been defined as the extent to which the score of an instrument reflects changes in the patient's condition over time [3,27,28]. No agreement has been made in the literature for a preferred statistical measure [29].…”

Development and Validation of a Simplified Chinese Version of EORTC QLQ-CR38 to Measure the Quality of Life of Patients with Colorectal Cancer

“…Responsiveness was assessed by comparing the mean difference between the first and third assessments (pretreatment and posttreatment) with the effect size (ES), standardized response mean (SRM), and change ratio (CR) being computed [16,20,21]. The ES is the difference divided by the baseline standard deviation (SD), the SRM is the difference divided by its SD, and the CR is the ratio of difference over the baseline mean score (pretreatment), reflecting the degree of score change after treatment:…”