Retrospective judgements on health and quality of life in patients and the general population: Response shift and recall bias

对患者和一般人群健康和生活质量的回顾性判断：反应转变和回忆偏差

• 批准号: 433135196
• 负责人: Professor Dr. Andreas Hinz
• 金额: --
• 依托单位: Abteilung für Medizinische Psychologie und Medizinische Soziologie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2019
• 资助国家: 德国
• 起止时间: 2018-12-31 至 2019-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/433135196?language=en
• 关键词: Retrospective; judgements; health; quality; life

Health-related quality of life (QoL) has become an important outcome criterion in clinical practice and research. Changes in QoL as evidence of therapeutic benefit are often calculated as the difference between a post-value and a pre-value. The problem that arises here is that the assessment criteria may have changed between pretest and posttest. One way to analyze and to correct this response shift effect is the thentest. The respondents are asked at the post-time to assess the situation retrospectively as it was at the pre-time. The difference between the original pretest and the thentest is then used to infer such response shift effects. However, it is also possible that such differences are effects of recall bias, i.e., that in the memory systematically higher or lower levels of QoL are stored. While various theoretically possible explanations of such effects are discussed in the literature, it remains unclear how these can be empirically separated and tested. One approach to analyze such effects is to ask patients about their assessment of QoL before the onset of the disease. Studies in the literature show that these retrospective judgements generally reflect a better QL than the current judgements of the general population. The relevant studies are mostly based on persons who have suffered an accident; corresponding studies on other patient collectives are sparse. In addition, it remains unclear whether this is a general better assessment of the past in the sense of recall bias or a shift in the assessment standard due to the disease. Furthermore, the findings on specific conditions for the occurrence of response shift effects are inconsistent. In the project applied for, a large sample of the general population (n > 2000) will be used to analyze the extent to which retrospective assessments of subjective health systematically exceed or fall short of the assessment made at that time. On the basis of four clinical samples (cancer patients and patients in cardiologic rehabilitation, n about 300 each), the retrospective QoL judgements (evaluation of the situation before the disease) are compared with the values given by the general population. It will be examined whether a systematic overestimation of the retrospectively assessed QoL can be proven, whether and to what extent it exceeds the retrospective effects of the general population, and which (sociodemographic and clinical) conditions are predictive factors for such effects. The empirical data sets are already available, they were collected in connection with three other projects, but have not yet been analyzed. Therefore, we do not apply for funds for data collection, but only for the analysis of the existing data and their publication.

健康相关生活质量（QoL）已成为临床实践和研究中的重要结局标准。作为治疗获益证据的QoL变化通常计算为后值和前值之间的差异。这里出现的问题是，评估标准可能会改变前后测。分析和纠正这种反应转移效应的一种方法是时间检验。要求受访者在事后对情况进行回顾性评估，就像在事前一样。原始的前测和后测之间的差异，然后被用来推断这种反应转移的影响。然而，这种差异也可能是回忆偏差的影响，即，在存储器中系统地存储较高或较低水平的QoL。虽然各种理论上可能的解释，这种影响在文献中进行了讨论，目前还不清楚如何将这些经验分离和测试。 分析这种影响的一种方法是询问患者在疾病发作前对生活质量的评估。文献中的研究表明，这些回顾性判断通常反映了比一般人群当前判断更好的QL。相关的研究大多是基于遭受事故的人;对其他患者群体的相应研究很少。此外，目前尚不清楚这是回忆偏倚意义上的对过去的总体更好评估，还是由于疾病导致评估标准的转变。此外，关于反应转移效应发生的具体条件的研究结果也不一致。 在申请的项目中，将使用大样本的一般人群（n > 2000）来分析主观健康的回顾性评估系统地超过或低于当时所做评估的程度。四个临床样本（癌症患者和心脏病康复患者，n约300）的基础上，回顾性生活质量的判断（评估疾病前的情况）与一般人群给出的值进行了比较。将检查是否可以证明对回顾性评估的QoL的系统性高估，其是否以及在多大程度上超过了一般人群的回顾性效应，以及哪些（社会人口统计学和临床）状况是此类效应的预测因素。 经验数据集已经存在，这些数据集是在其他三个项目中收集的，但尚未进行分析。因此，我们不申请数据收集的资金，而只是为了分析现有数据并公布这些数据。