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

健康相关的生活质量已成为临床实践和研究的重要结果标准。作为治疗益处证据的生活质量的变化通常被计算为治疗后和治疗前的差值。这里出现的问题是，评估标准可能在前测和后测之间发生了变化。分析和纠正这种反应转移效应的一种方法是Test。受访者被要求在事后对情况进行回顾评估，就像以前一样。然后，使用原始前测和后测之间的差异来推断这种反应转移效应。然而，这种差异也可能是回忆偏差的影响，即在记忆中系统地存储了更高或更低水平的生活质量。虽然文献中讨论了对这种影响的各种理论上可能的解释，但如何从经验上分离和检验这些解释仍然不清楚。分析这种影响的一种方法是在疾病发作前询问患者对生活质量的评估。文献中的研究表明，这些回溯性判断通常比普通人群的当前判断反映出更好的生活质量。相关研究多以发生事故的人为研究对象，对其他患者群体的相应研究较少。此外，目前尚不清楚这是从回忆偏差的意义上对过去进行的总体更好的评估，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，将使用普通人口的大样本(n&gt；2000)来分析对主观健康的回顾评估在多大程度上系统地超过或低于当时所作的评估。根据四个临床样本(癌症患者和心脏康复患者，各约300人)，将回顾的QOL判断(疾病前的情况评估)与普通人群给出的值进行比较。它将检验是否可以证明系统地高估了回溯性评估的生活质量，它是否以及在多大程度上超过了一般人群的回溯性影响，以及哪些(社会人口学和临床)条件是这种影响的预测因素。经验数据集已经可用，它们是与其他三个项目一起收集的，但尚未进行分析。因此，我们不申请资金用于数据收集，而只申请对现有数据的分析及其发布。

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.