Faculty of Medicine, School of Physical and Occupational Therapy, 3654 Prom Sir-William-Osler, Montreal, QC H3G 1Y5, Canada.
Expert Rev Pharmacoecon Outcomes Res. 2008 Oct;8(5):479-89. doi: 10.1586/14737167.8.5.479.
The aims of this paper are to review the theoretical history of response shift and selected methodological approaches used to assess response shift, and to highlight the important next steps for research in this field. Patient-reported outcomes (PRO), such as health-related quality of life, play a central role in evaluating the impact of illness and healthcare interventions. As individuals experience changes in health or adapt to illness, their perspective and standards of well-being often fluctuate over time. Evaluations of change in PRO that do not account for this response shift effect may result in misleading conclusions about the effectiveness of interventions or clinical care. Despite important advances in response shift research over the past 10 years further work is needed to address challenges in the field that have hindered assessments of the clinical significance of response shift. This will include testing and comparison of methodological approaches that have yielded contradictory results, and triangulation of methodological approaches using quantitative and qualitative assessments. Identifying an approach that can evaluate response shift at the individual level will enrich the information derived from PRO assessments used for monitoring the impact of clinical care, tailoring individual treatments, and evaluating the effectiveness of healthcare interventions.
本文旨在回顾反应转移的理论历史和用于评估反应转移的选定方法，并强调该领域研究的重要下一步。患者报告的结果（PRO），如健康相关生活质量，在评估疾病和医疗保健干预的影响方面发挥着核心作用。随着个人健康状况的变化或对疾病的适应，他们的观点和幸福感标准往往会随时间波动。如果不考虑这种反应转移效应，对 PRO 变化的评估可能会导致对干预措施或临床护理效果的误导性结论。尽管在过去 10 年中反应转移研究取得了重要进展，但仍需要进一步解决该领域的挑战，这些挑战阻碍了对反应转移临床意义的评估。这将包括测试和比较产生矛盾结果的方法，并使用定量和定性评估对方法进行三角测量。确定一种能够在个体水平上评估反应转移的方法将丰富用于监测临床护理影响、定制个体治疗和评估医疗保健干预效果的 PRO 评估所获得的信息。
