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Exploring the Response Shift Effect on the Quality of Life of Patients with Schizophrenia

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Listed:
  • Mohamed Boucekine
  • Laurent Boyer
  • Karine Baumstarck
  • Aurelie Millier
  • Badih Ghattas
  • Pascal Auquier
  • Mondher Toumi

Abstract

Background. Interpretation of quality of life (QoL) scores over time can be difficult because of possible changes in internal standards, values, and conceptualization of QoL by individuals. This effect is called a response shift (RS). The purpose of this study was to examine whether an RS effect occurred over a 24-mo period in patients who were suffering from schizophrenia. Methods. The random forest method was applied to detect any RS reprioritization in a multicenter cohort study. QoL was recorded using a generic questionnaire (SF36) at baseline (T0), 12 mo (T12), and 24 mo (T24). Patients were categorized into 3 groups based on psychotic symptoms and relapse (stable, improved, and worsened groups) from their clinical profiles. The random forest method was performed to predict the General Health score of the SF36 from the other QoL domain scores of the SF36. We estimated the average variable importance of the QoL domain for each of the 3 groups. Results. A total of 124 (53.2%) patients were defined as stable, 59 (25.3%) as improved, and 50 (21.5%) as worsened. Among the stable group, the Social Functioning domain became more important over time. Of those classified as improved, the Mental Health domain became more important over time, while the Vitality domain became less important. Among those in the group who worsened, the Mental Health domain became less important while the Vitality and Bodily Pain domains became more important. Conclusions. Our study identified differential RS reprioritization among patients with different clinical profiles. Further work is needed to determine whether RS should be interpreted as a measurement bias or as an effect integrated in a true change.

Suggested Citation

  • Mohamed Boucekine & Laurent Boyer & Karine Baumstarck & Aurelie Millier & Badih Ghattas & Pascal Auquier & Mondher Toumi, 2015. "Exploring the Response Shift Effect on the Quality of Life of Patients with Schizophrenia," Medical Decision Making, , vol. 35(3), pages 388-397, April.
    • Handle: RePEc:sae:medema:v:35:y:2015:i:3:p:388-397
    DOI: 10.1177/0272989X14559273
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    References listed on IDEAS

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    1. Schwartz, Carolyn E. & Sprangers, Mirjam A. G., 1999. "Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research," Social Science & Medicine, Elsevier, vol. 48(11), pages 1531-1548, June.
    2. Greenhalgh, Joanne & Long, Andrew F & Flynn, Rob, 2005. "The use of patient reported outcome measures in routine clinical practice: lack of impact or lack of theory?," Social Science & Medicine, Elsevier, vol. 60(4), pages 833-843, February.
    3. Sprangers, Mirjam A. G. & Schwartz, Carolyn E., 1999. "Integrating response shift into health-related quality of life research: a theoretical model," Social Science & Medicine, Elsevier, vol. 48(11), pages 1507-1515, June.
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