Peter M Fayers1, Anne L Langston, Clare Robertson. 1. Department of Public Health, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB24 2TN, UK. p.fayers@abdn.ac.uk
Abstract
OBJECTIVES: To explore how patient-reported health-related quality of life (HRQL) and global health status are affected by use of differing personal reference frames. We hypothesized that implicit comparisons against self at an earlier time, against healthy peers, or against ill patients would greatly affect patients' response values. STUDY DESIGN AND SETTING: Patients in a randomized trial for treatment of Paget's disease completed annual HRQL questionnaires. Supplementary questions were appended, asking the patients whether they were aware of having made implicit comparisons. RESULTS: The majority of patients reported considering themselves a year ago (31% at baseline), themselves before becoming ill (23%), or other healthy people (24%), with similar proportions during follow-up. Mean HRQL scores varied substantially according to the declared frame of reference, with differences as big as 19% of the scale score, or a standardized mean effect size of 0.74 standard deviations. CONCLUSION: Reported reference frames were associated with effects of similar magnitude to the differences in HRQL that are regarded as clinically important. This may be of particular concern in trials that randomize patients to management in different settings, such as treatment at home/in hospital, or surgery/chemotherapy and might bias or obscure HRQL differences.
RCT Entities:
OBJECTIVES: To explore how patient-reported health-related quality of life (HRQL) and global health status are affected by use of differing personal reference frames. We hypothesized that implicit comparisons against self at an earlier time, against healthy peers, or against ill patients would greatly affect patients' response values. STUDY DESIGN AND SETTING:Patients in a randomized trial for treatment of Paget's disease completed annual HRQL questionnaires. Supplementary questions were appended, asking the patients whether they were aware of having made implicit comparisons. RESULTS: The majority of patients reported considering themselves a year ago (31% at baseline), themselves before becoming ill (23%), or other healthy people (24%), with similar proportions during follow-up. Mean HRQL scores varied substantially according to the declared frame of reference, with differences as big as 19% of the scale score, or a standardized mean effect size of 0.74 standard deviations. CONCLUSION: Reported reference frames were associated with effects of similar magnitude to the differences in HRQL that are regarded as clinically important. This may be of particular concern in trials that randomize patients to management in different settings, such as treatment at home/in hospital, or surgery/chemotherapy and might bias or obscure HRQL differences.
Authors: Clare Robertson; Anne L Langston; Sally Stapley; Elaine McColl; Marion K Campbell; William D Fraser; Graeme Maclennan; Peter L Selby; Stuart H Ralston; Peter M Fayers Journal: Qual Life Res Date: 2009-01-14 Impact factor: 4.147
Authors: Elsbeth F Taminiau-Bloem; Florence J van Zuuren; Margot A Koeneman; Bruce D Rapkin; Mechteld R M Visser; Caro C E Koning; Mirjam A G Sprangers Journal: Health Qual Life Outcomes Date: 2010-07-16 Impact factor: 3.186
Authors: Doerte U Junghaenel; Joan E Broderick; Stefan Schneider; Marcella May; Alicia Bolton; Kelly P McCarrier; Larissa M Stassek; Sarah C Keithly; Arthur A Stone Journal: Appl Res Qual Life Date: 2017-07-06