nach oben

Quality of Life Research

Erschienen in:

01.11.2013

Changing values, changing outcomes: the influence of reprioritization response shift on outcome assessment after spine surgery

verfasst von: Carolyn E. Schwartz, Tolulope T. Sajobi, Lisa M. Lix, Brian R. Quaranto, Joel A. Finkelstein

Erschienen in: Quality of Life Research | Ausgabe 9/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

When patients experience a substantial health state change, they may undergo changes in the underlying meaning of their self-report to standardized outcome measures. These response shifts can reflect changes in the patient’s internal standards, values or conceptualization of quality of life. We investigated the presence of changing values (reprioritization response shift) in a longitudinal cohort of spine surgery patients.

Methods

Spinal decompression surgery patients (mean age 52 years; 39 % female, 36 % working) provided visual analogue scale (VAS) back and leg pain items, the Short-Form-36 (SF-36v1), and the Oswestry Disability Index (ODI) data pre- and post-surgery (n _pre = 169; n _6weeks = 102; n _3months = 106; n _6months = 68). Improved and No-Effect patient groups were compared using the VAS minimally important difference (±15 points) as a cutoff. Reprioritization response shift detection was based on change in the relative importance of the SF-36 domains for group discrimination pre- and post-surgery.

Results

The Improved group evidenced significant post-surgery differences from the No-Effect group on bodily pain, general health, physical functioning, social functioning, vitality, and the ODI. The relative importance analysis showed a differential effect with bodily pain (p < 0.01) and physical functioning (p < 0.05) becoming more important, and role physical (p < 0.01) becoming less important post-surgery in distinguishing the Improved group as compared to the No-Effect group. The Improved patients also evidenced stronger associations between bodily pain and physical functioning, vitality and general health (p < 0.05). The No-Effect group evidenced increased inter-correlations of bodily pain with social functioning, mental health, and general health (p < 0.05).

Conclusions

Patients who report clinically significant change in leg and back pain post-surgery using VAS pain scores are also distinguished by increased importance of bodily pain and physical functioning, and decreased importance of role physical. Bodily pain is primarily reflective of physical item response post-surgery among Improved patients, but reflects physical, social, and emotional item response among No-Effect patients. These changes in values may reflect a “moving goal post” in outcome assessment that complicates the interpretation of mean differences over time on standard spine outcome measures.

Nur mit Berechtigung zugänglich

Embretson, S. E., & Reise, S. P. (2000). Item response theory for psychologists. Mahwah, NJ: Lawrence Erlbaum Associates.

Snyder, C. F., Aaronson, N. K., Choucair, A. K., Elliott, T. E., Greenhalgh, J., Halyard, M. Y., et al. (2011). Implementing patient-reported outcomes assessment in clinical practice: A review of the options and considerations. Quality of Life Research. doi:10.1007/s11136-011-0054-x.

Cella, D., Riley, W., Stone, A., Rothrock, N., Reeve, B., Yount, S., et al. (2010). The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. Journal of Clinical Epidemiology, 63(11), 1179–1194.PubMedCrossRef

FDA. (2009). Guidance for industry. Patient-reported outcome measures: Use in medical product development to support labeling claims. In F. A. D. Administration (Ed.). Washington, DC: U.S. Dept. of Health and Human Services.

Sloan, J. A., Halyard, M. Y., Frost, M. H., Dueck, A. C., Teschendorf, B., & Rothman, M. L. (2007). The mayo clinic manuscript series relative to the discussion, dissemination, and operationalization of the Food and Drug Administration guidance on patient-reported outcomes. Value Health, 10(Suppl 2), S59–S63. doi:10.1111/j.1524-4733.2007.00267.x.PubMedCrossRef

Cleeland, C. S., & Sloan, J. A. (2010). Assessing the symptoms of cancer using patient-reported outcomes (ASCPRO): Searching for standards. Journal of Pain and Symptom Management, 39(6), 1077–1085. doi:10.1016/j.jpainsymman.2009.05.025.PubMedCrossRef

Bombardier, C. (2000). Outcome assessments in the evaluation of treatment of spinal disorders: Summary and general recommendations. SPINE, 25(24), 3100–3103.PubMedCrossRef

Deyo, R. A., Battie, M., Beurskens, A. J., Bombardier, C., Croft, P., Koes, B., et al. (1998). Outcome measures for low back pain research. A proposal for standardized use. Spine (Phila Pa 1976), 23(18), 2003–2013.

Sloan, J. A., Cella, D., & Hays, R. D. (2005). Clinical significance of patient-reported questionnaire data: another step toward consensus. (Editorial). Journal Clinical Epidemiology, 58, 1217–1219.CrossRef

10.

Sloan, J. A., Aaronson, N., Cappelleri, J. C., Fairclough, D. L., & Varricchio, C. (2002). Assessing the clinical significance of single items relative to summated scores. Mayo Clinic Proceedings, 77(5), 479–487.PubMed

11.

Sloan, J. A., Cella, D., Frost, M., Guyatt, G. H., Sprangers, M., & Symonds, T. (2002). Assessing clinical significance in measuring oncology patient quality of life: Introduction to the symposium, content overview, and definition of terms. Mayo Clinic Proceedings, 77(4), 367–370.PubMedCrossRef

12.

Ostelo, R. W., Deyo, R. A., Stratford, P., Waddell, G., Croft, P., Von Korff, M., et al. (2008). Interpreting change scores for pain and functional status in low back pain: Towards international consensus regarding minimal important change. Spine (Phila Pa 1976), 33(1), 90–94. doi:10.1097/BRS.0b013e31815e3a10.

13.

Freeman, M. D. (2010). Clinical practice guidelines versus systematic reviews; which serve as the best basis for evidence-based spine medicine? The Spine Journal, 10(6), 512–513. doi:10.1016/j.spinee.2010.04.006.PubMedCrossRef

14.

Fisher, C. G., Vaccaro, A. R., Mulpuri, K., Angevine, P. D., Thomas, K. C., Patel, A. A., et al. (2011). Evidence-based recommendations for spine surgery. Spine (Phila Pa 1976). doi:10.1097/BRS.0b013e31823dccc0.

15.

Vaccaro, A. R., Fisher, C. G., Whang, P. G., Patel, A. A., Prasad, S. K., Angevine, P. D., et al. (2010). Evidence-based recommendations for spine surgery. Spine (Phila Pa 1976). doi:10.1097/BRS.0b013e3181d9391d.

16.

Drum, C. E., Horner-Johnson, W., & Krahn, G. L. (2008). Self-rated health and healthy days: examining the “disability paradox”. Disability and Health Journal, 1(2), 71–78. doi:10.1016/j.dhjo.2008.01.002.PubMedCrossRef

17.

Kutner, J. S., Nowels, D. E., Kassner, C. T., Houser, J., Bryant, L. L., & Main, D. S. (2003). Confirmation of the “disability paradox” among hospice patients: Preservation of quality of life despite physical ailments and psychosocial concerns. Palliative and Supportive Care, 1(3), 231–237.PubMed

18.

Albrecht, G. L., & Devlieger, P. J. (1999). The disability paradox: High quality of life against all odds. Social Science and Medicine, 48(8), 977–988.PubMedCrossRef

19.

Kagawa-Singer, M. (1993). Redefining health: Living with cancer. Social Science and Medicine, 37, 295–304.PubMedCrossRef

20.

Padilla, G. V., Mishel, M. H., & Grant, M. M. (1992). Uncertainty, appraisal and quality of life. Quality of Life Research, 1(3), 155–165.PubMedCrossRef

21.

Wilson, I. B. (1999). Clinical understanding and clinical implications of response shift. Social Science and Medicine, 48(11), 1577–1588.PubMedCrossRef

22.

Aristotle (384-322 BC). Nicomachean Ethics.

23.

Sprangers, M. A., & Schwartz, C. E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science and Medicine, 48(11), 1507–1515.PubMedCrossRef

24.

Schwartz, C. E., & Sprangers, M. A. (1999). Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research. Social Science and Medicine, 48(11), 1531–1548.PubMedCrossRef

25.

Schwartz, C. E., & Rapkin, B. D. (2004). Reconsidering the psychometrics of quality of life assessment in light of response shift and appraisal. Health and Quality of Life Outcomes, 2, 16.PubMedCrossRef

26.

Andrews, F. M., & Withey, S. B. (1976). Social indicators of well-being: Americans’ perceptions of life quality. New York: Plenum Press.CrossRef

27.

Diener, E. (1984). Subjective well-being. Psychological Bulletin, 95(3), 542–575.PubMedCrossRef

28.

George, L. K. (1979). The happiness syndrome: Methodological and substantive issues in the study of social-psychological well-being in adulthood. The Gerontologist, 19, 210–216.PubMedCrossRef

29.

George, L. K., & Bearon, L. B. (1980). Quality of life in older persons: Meaning and measurement. New York: Human Sciences Press.

30.

Campbell, A., Converse, P. E., & Rodgers, W. L. (1976). The quality of American life. New York: Russell Sage Foundation.

31.

Lawton, M. P. (1975). The Philadelphia geriatric center morale scale: A revision. Journal of Gerontology, 30, 85–89.PubMedCrossRef

32.

Neugarten, B. L., Havighurst, R. J., & Tobin, S. S. (1968). Personality patterns of aging. In B. L. Neugarten (Ed.), Middle age and aging (pp. 173–177). Chicago: University of Chicago Press.

33.

Finkelstein, J. A., Razmjou, H., & Schwartz, C. E. (2009). Response shift and outcome assessment in orthopedic surgery: Is there is a difference between complete vs. partial treatment? Journal of Clinical Epidemiology, 82, 1189–1190.CrossRef

34.

Lix, L. M., Sajobi, T. T., Sawatzky, R., Liu, J., Mayo, N. E., Huang, Y., et al. (2012). Relative importance measures for reprioritization response shift. Quality of Life Research. doi:10.1007/s11136-012-0198-3.

35.

Sajobi, T. T., Lix, L. M., Clara, I., Walker, J., Graff, L. A., Rawsthorne, P., et al. (2012). Measures of relative importance for health-related quality of life. Quality of Life Research, 21, 1–11. doi:10.1007/s11136-011-9914-7.PubMedCrossRef

36.

Hagg, O., Fritzell, P., & Nordwall, A. (2003). The clinical importance of changes in outcome scores after treatment for chronic low back pain. European Spine Journal, 12(1), 12–20. doi:10.1007/s00586-002-0464-0.PubMed

37.

Gudex, C., Dolan, P., Kind, P., & Williams, A. (1996). Health state valuations from the general public using the visual analogue scale. Quality of Life Research, 5(6), 521–531.PubMedCrossRef

38.

Little, R. J. A., & Rubin, D. B. (2002). Statistical analysis with missing data (2nd ed.). New Jersey: Wiley.

39.

Zhou, G. Y. (2007). Toward using confidence intervals to compare correlations. Psychological Methods, 12(4), 399–413.CrossRef

40.

Huberty, C. J., & Wisenbaker, J. M. (1992). Variable importance in multivariate group comparisons. Journal of Educational Statistics, 17, 75–91.CrossRef

41.

Thomas, D. R. (1992). Interpreting discriminant functions: A data analytic approach. Multivariate Behavioral Research, 27, 335–362.CrossRef

42.

Thomas, D. R., & Zumbo, B. D. (1996). Using a measure of variable importance to investigate the standardization of discriminant coefficients. Journal of Educational and Behavioral Statistics, 21, 110–130.

43.

Agresti, A. (1996). An introduction to categorical data analysis. New York: Wiley.

44.

Menard, S. (2004). Six approaches to calculating standardized logistic regression coefficients. The American Statistician, 58, 218–223.CrossRef

45.

Pratt, J. W. (1987). Dividing the indivisible: Using simple symmetry to partition variance explained. In T. Pukkila & S. Puntanen (Eds.), Second international conference in statistics (pp. 245–260). Tampere, Finland: University of Tampere.

46.

Thomas, D. R., Hughes, E., & Zumbo, B. D. (1998). On variable importance in linear regression. Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, 45, 253–275.

47.

Thomas, D. R., Zumbo, B. D., Zhu, P., & Dutta, S. (2008). On measuring the relative importance of explanatory variables in a logistic regression. Journal of Modern Applied Statistical Methods, 7, 21–38.

48.

Schwartz, C. E., Bode, R. K., & Vollmer, T. (2012). The symptom inventory disability-specific short-forms for multiple sclerosis: Reliability and factor structure. Archives of Physical Medicine and Rehabilitation. doi:10.1016/j.apmr.2012.03.006.

Titel: Changing values, changing outcomes: the influence of reprioritization response shift on outcome assessment after spine surgery
verfasst von: Carolyn E. Schwartz
Tolulope T. Sajobi
Lisa M. Lix
Brian R. Quaranto
Joel A. Finkelstein
Publikationsdatum: 01.11.2013
Verlag: Springer Netherlands
Erschienen in: Quality of Life Research / Ausgabe 9/2013
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-013-0377-x

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2013

Commentary on strengthening the assessment of factorial invariance across population subgroups: a commentary on Varni et al. (2013)

Comparison of the responsiveness of the SF-36, the Oxford Knee Score, and the Knee Society Clinical Rating System in patients undergoing total knee replacement

Integrating health-related quality of life with sickness leave days for return-to-work assessment in traumatic limb injuries

Pitfalls in subgroup analysis based on growth mixture models: a commentary on van Leeuwen et al. (2012)

Health status and (health-related) quality of life during the recovery of distal radius fractures: a systematic review

Validation of a Dutch version of the Neurological Fatigue Index (NFI-MS) for patients with multiple sclerosis in the Netherlands