Response shift effects of quality of life assessments in breast cancer survivors
Response shift effects of quality of life assessments in breast cancer survivors
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DOI：
10.1111/ecc.12979
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发表时间：
2019-03-01
影响因子：
2.1
通讯作者：
Hinz, Andreas
中科院分区：
文献类型：
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作者：
Friedrich, Michael;Zenger, Markus;Hinz, Andreas
生活质量（QoL）的测量可能会因受访者适应测量点之间的新情况而扭曲，从而改变了参考框架。为了调查乳腺癌幸存者的这种偏倚，我们将她们的生活质量与一般人群的生活质量进行比较，并使用两种互补的方法来检测这种偏倚。采用欧洲癌症研究与治疗组织生活质量问卷Core 30对乳腺癌幸存者（n = 308，有效率：91%）进行QoL问卷测试。响应位移是通过测试（回顾性判断）和结构方程建模（SEM）方法来检验的。与一般人群相比，乳腺癌幸存者在所有功能量表（Hedges' g: -0.56至-0.93）和症状量表（Hedges' g: 0.28-0.74）中均表现出生活质量受损。测试方法表明，在包括社会功能在内的几个维度上，重新校准效果。扫描电镜方法检测到社会功能在前测到后测和从前测到后测之间存在不均匀的再校准效应，但在前测和后测之间没有效应。乳腺癌幸存者的生活质量明显下降。比较检测响应移位的两种方法表明，将扫描电镜应用于回顾性判断也是有用的，这可以揭示否则会被忽视的响应移位效应。
Measurements of quality of life (QoL) can be distorted by respondents adapting to new situations between measurement points and consequently having a changed frame of reference. To investigate this bias in breast cancer survivors, we compare their QoL with that of the general population and use two complementary methods for detecting this bias. Breast cancer survivors (n = 308, response rate: 91%) were tested with the QoL questionnaire European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Response shift was examined with the thentest (retrospective judgements) and with the structural equation modelling (SEM) approach. Compared with the general population, breast cancer survivors showed impaired QoL in all functioning scales (Hedges' g: -0.56 to -0.93) and symptom scales (Hedges' g: 0.28-0.74).The thentest method indicated recalibration effects in several dimensions including social functioning. The SEM method detected a non-uniform recalibration effect for social functioning from pretest to posttest and from pretest to thentest, but no effect between thentest and posttest. Breast cancer survivors' QoL is clearly diminished. Comparing the two approaches for detecting response shift showed that it is also useful to apply SEM to retrospective judgements and that this can reveal response shift effects that would otherwise be overlooked.