Detection of response shift in health-related quality of life studies: a systematic review

Abstract

Background Response Shift (RS) refers to the idea that an individual may undergo changes in its health-related quality of life (HRQOL). If internal standard, values, or reconceptualization of HRQOL change over time, then answer to the same items by the same individuals may not be comparable over time. Traditional measures to evaluate RS is prone to bias and strong methodologies to study the existence of this phenomenon is required. The objective is to systematically identify, analyze, and synthesize the existing and recent evidence of statistical methods used for RS detection in HRQOL studies. Methods The analysis of selected studies between January 2010 and July 2020 was performed through a systematic review in MEDLINE/PubMed, Scopus, Web of Science, PsycINFO and Google Scholar databases. The search strategy used the terms “Health-Related Quality of Life” and “Response Shift” using the filters “Humans”, “Journal Article”, “English” and “2010/01/01–2020/07/31”. The search was made in August 2020. Results After considering the inclusion and exclusion criteria, from the total selected articles (675), 107 (15.9%) of the publications were included in the analysis. From these, 79 (71.0%) detected the existence of RS and 86 (80.4%) only used one detection method. The most used methods were Then Test (n = 41) and Oort’s Structural Equation Models (SEM) (n = 35). Other method used were Multiple Lineal Regression (n = 7), Mixed-Effect Regression (n = 6), Latent Trajectory Analysis (n = 6), Item Response Theory (n = 6), Logistics Regression (n = 5), Regression and Classification Trees (n = 4) and Relative Importance Method (n = 4). Most of these detected recalibration, including Then Test (n = 27), followed by Oort’s SEM that detected the higher combination of RS types: recalibration (n = 24), reprioritization (n = 13) and reconceptualization (n = 7). Conclusions There is a continuous interest of studying RS detection. Oort’s SEM becomes the most versatile method in its capability for detecting RS in all different types. Despite results from previous systematic reviews, same methods have been used during the last years. We observed the need to explore other alternative methods allowing same detection capacity with robust and highly precise methodology. The investigation on RS detection and types requires more study, therefore new opportunity grows to continue attending this phenomenon through a multidisciplinary perspective.

Response shift results of quantitative research using patient-reported outcome measures: a descriptive systematic review

“…To further find the field of response shift research, this study described variation in prevalence of response shift results and where possible, magnitude of response shift effects for quantitative studies using PROM data. Consistent with earlier reviews [ 7 , 10 ], the most frequently applied response shift method was the then-test, followed by SEM, other design-based methods, regression methods without classification, individualized methods, regression methods with classification, IRT/Rasch, and other study-specific methods. Most studies reported detection of one or more response shift effects.…”

“…Of these studies, 82 (85.4%) detected recalibration response shift, 20 studies (20.8%) detected reprioritization response shift, four studies (4.2%) detected reconceptualization response shift, and seven studies (7.3%) reported a general response shift effect without indicating a particular pathway. A more recent systematic review of 107 studies, also using quantitative methods, which were published between 2010 and 2020 [ 10 ] found that only 91 studies (70.5%) had detected response shift. Less than half of the studies (51 studies) overlapped with the former review by Sajobi et al [ 7 ].…”

Relationship of life expectancy with quality of life and health-related hope among Japanese patients receiving home medical care: The Zaitaku Evaluative Initiatives and Outcome Study

“…Alternative explanations include improved patient satisfaction through interactions with home medical care providers and improved QOL caused by reduced pain and other symptoms through appropriate palliation [ 5 , 31 ]. A further alternative explanation is a response shift to QOL-HC due to changes in internal standards and values accompanying repeated reflections on their lives [ 32 ]. In applying the results of this study to clinical practice, physicians should keep in mind that the patients might have lost their sense of purpose in life and hope for health.…”

Health Care for Older Adults with Kidney Failure

“…As patients and families become familiar with dialysis tasks and schedules, there is a shift in expectation, potentially leading to QoL improvements that overstate the benefits. This adaptation or response shift is well described and common in longitudinal studies of patients with chronic disease (7,8). In brief, response shift theory, as applied to longitudinal QoL assessment, describes changes that occur over time as patients re-evaluate the meaningfulness of their lives.…”