Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, Germany.
Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, Germany.
Qual Life Res. 2020 Aug;29(8):2149-2159. doi: 10.1007/s11136-020-02488-4. Epub 2020 Apr 18.
Asking patients to rate health-related quality of life (HRQoL) of hypothetical individuals described in anchoring vignettes has been proposed to enhance knowledge on how patients understand and respond to HRQoL questionnaires. In this article, we describe the development of anchoring vignettes and explore their utility for measuring response shift in patients' self-reports of HRQoL.
We conducted an explorative mixed-methods study. One hundred patients with multiple sclerosis or psoriasis participated in two interviews at intervals of 3-6 months. During both interviews, patients assessed HRQoL of 16 hypothetical individuals on the SF-12 questionnaire (two vignettes for each of the eight domains of the SF-12). In addition to these quantitative ratings, we used the think-aloud method to explore changes in patients' verbalization of their decision processes during vignette ratings.
Agreement of vignette ratings at baseline and follow-up was low (ICCs < 0.55). In addition, paired sample t-tests revealed no significant directional mean changes in vignette ratings. Thus, ratings changed non-directionally, neither confirming retest reliability nor a systematic change of assessment. Furthermore, patients' verbalization of their decision processes did not indicate whether or not the assessment strategy of individual patients had changed.
Patients' ratings of anchoring vignettes fluctuate non-directionally over time. The think-aloud method appears not to be informative in exploring whether these fluctuations are due to changes in the individual decision process. Overall, vignettes might not be an appropriate approach to explore response shift, at least with regard to the specific target population and the use of the SF-12.
让患者对锚定情境描述的假设个体的健康相关生活质量（HRQoL）进行评分，以增强对患者如何理解和响应 HRQoL 问卷的了解。本文描述了锚定情境的开发，并探讨了其在测量患者对自我报告的 HRQoL 的反应转移中的效用。
我们进行了一项探索性混合方法研究。100 名多发性硬化症或银屑病患者在 3-6 个月的间隔内进行了两次访谈。在两次访谈中，患者使用 SF-12 问卷对 16 个假设个体的 HRQoL 进行评估（SF-12 的 8 个领域中的每个领域有两个情境）。除了这些定量评分外，我们还使用出声思维法来探讨患者在情境评分过程中语言表达的变化。
基线和随访时情境评分的一致性较低（ICC < 0.55）。此外，配对样本 t 检验显示情境评分没有明显的方向性均值变化。因此，评分呈非方向性变化，既不能确认重测信度，也不能系统地改变评估。此外，患者对其决策过程的语言表达并不能表明个体患者的评估策略是否发生了变化。
患者对锚定情境的评分随时间呈非方向性波动。出声思维法似乎无法提供有关这些波动是否是由于个体决策过程的变化引起的信息。总体而言，至少就特定目标人群和 SF-12 的使用而言，情境可能不是探索反应转移的合适方法。
