Response shift and adaptation in chronically ill patients
Response shift and adaptation in chronically ill patients
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DOI：
10.1177/0272989x0002000204
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发表时间：
2000-04-01
影响因子：
3.6
通讯作者：
Adang, EMM
中科院分区：
文献类型：
--
作者：
Postulart, D;Adang, EMM
目的是探讨反应转移对生活质量测量的影响，从而对成本效益分析。这是通过使用早期研究的数据完成的。对疾病的适应为反应转变的发生提供了可能的解释。对于代理受访者来说，很可能不存在适应效应。因此，检验了两个假设：1）回顾性生活质量测量与代理人给出的评级没有差异; 2）代理人评级与前瞻性评估的治疗前生活质量评分不同。采用视觉模拟量表（VAS）、时间权衡（TTO）和标准赌博（SG）评估生活质量。分析显示，这两个假设都不能被拒绝，表明前瞻性评估的治疗前生活质量的提高，适应不完善的健康状态在治疗前期间。因此，与使用目前患病患者的生活质量评估相比，使用治疗前生活质量的替代措施或回顾性评估时的成本-效果比是不同的。
The purpose was to explore the impact of response shift on quality-of-life measurement and consequently on cost-effectiveness analysis. This was done by using data from an earlier study. Adaptation to illness provides a probable explanation for the occurrence of response shift. In the case of proxy respondents, it is likely that the adaptation effect is absent. Therefore, two hypotheses were tested: 1) retrospective quality-of-life measurement does not differ from ratings given by proxies; and 2) proxy ratings differ from prospectively assessed pretreatment quality-of-life scores. Quality of life was assessed using a visual analog scale (VAS), time tradeoff (TTO), and the standard gamble (SG). Analyses revealed that neither hypothesis could be rejected, indicating that prospectively assessed pretreatment quality of life is enhanced by adaptation to the imperfect health state during the pretreatment period. Consequently, the cost-effectiveness ratio is different when using proxy measures or retrospective assessments of pretreatment quality of life, compared with using assessments of the quality of life in currently ill patients.