Toward mindfulness in quality-of-life research: perspectives on how to avoid rigor becoming rigidity

Abstract

BackgroundThe field of quality-of-life (QOL) research has matured into a discipline with scientific rigor, sophisticated methods, and guidelines. While this maturation is laudable and needed, it can result in a limiting rigidity. We aim to highlight examples of practices that are based on shared research values and principles that, when dogmatically applied, may limit the potential impact of QOL research.MethodsBy juxtaposing rigorous standards with their rigid application for different stages of the research cycle, we suggest more balanced approaches.ResultsRigidity in cultivating a research question relates to constraining our thinking, leading to ‘safe’ research focusing on small variations of similar studies. Rigidity in operationalizing key constructs focuses on problems with validation practices that hinder further innovations, the use of static questionnaires when a more flexible approach is needed, dismissing rarely endorsed items that are clinically relevant, use of insensitive generic measures when specific measures are required, and a rigid emphasis on short questionnaires. Rigidity in data analysis relates to an undue emphasis on delineating primary and secondary outcomes and an unquestioned insistence on reducing Type 1 errors regardless of the research context. Rigidity in research infrastructure focuses on the unquestioned validity of patient input on scientific matters, and increasingly rigid guidelines and checklists that end up driving grant applications.DiscussionIt is hoped that this overview will lead to a reconsideration of a more flexible application of research principles while retaining scientific rigor.

A Comparison of Short Forms of the Screener and Opioid Assessment for Patients With Pain – Revised (SOAPP-R)

“…Moreover, respondent burden may not always be an issue when administering the longer version of a questionnaire. Indeed, participants might view a questionnaire as a signal of interest in important elements of their lives, and lengthy questionnaires have been used successfully especially in settings in which the participants are interested in the content at hand (Sprangers & Schwartz, 2017). It is for these reasons that we emphasize that the shorter versions of the SOAPP-R are not intended to replace the longer versions for all participants and scenarios.…”

Some recommendations for developing multidimensional computerized adaptive tests for patient-reported outcomes

“…Furthermore, in some cases, it may not be feasible to satisfy some of the criteria; here, we encourage authors to explain why certain steps were omitted. As recently suggested by Sprangers and Schwartz [ 77 ], QoL research has developed a broad, rigorous, and diverse set of methods which allow for a comprehensive investigation of relevant phenomena. Nevertheless, they also note “[w]hile this maturation is laudable and needed, it can result in a limiting rigidity.” [ 77 , p. 1387] In the spirit of their article, we do not wish this commentary to be seen as yet another addition to an ever expanding collection of rules that potentially hinder the discovery process.…”

“…As recently suggested by Sprangers and Schwartz [ 77 ], QoL research has developed a broad, rigorous, and diverse set of methods which allow for a comprehensive investigation of relevant phenomena. Nevertheless, they also note “[w]hile this maturation is laudable and needed, it can result in a limiting rigidity.” [ 77 , p. 1387] In the spirit of their article, we do not wish this commentary to be seen as yet another addition to an ever expanding collection of rules that potentially hinder the discovery process. On the contrary, we hope that our discussion adds to the pioneering papers in an area that is in our opinion likely to become a key methodological building block of quality of life research.…”