OBJECTIVES: To examine the existence, direction, and effect of response shift as measured by the total score of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and SF-36 physical and mental component score domains at 6 months and 1 year after primary total knee arthroplasty (TKA). STUDY DESIGN AND SETTING: Consecutive candidates participated in the study. In line with the Then-test design, two sets of questionnaires were completed at 6 months and 1 year postoperatively. Patients were divided into three groups on the basis of minimal clinically important differences (MCIDs). Parametric and nonparametric statistics and generalized mixed effects models were used. RESULTS: Two hundred and thirty-six patients completed the study. The magnitude of response shift increased over time for SF-36 physical and mental component scores. The traditional unadjusted presurgical and 1-year postsurgical assessment failed to reveal any mental health improvement, whereas the adjusted treatment effect demonstrated statistically significant changes. CONCLUSION: Response shift phenomenon increases with time in patients undergoing orthopedic interventions. The traditional pre- and post-assessment of joint replacement surgery may be confounded by a change in perspective and in internal standards of measurement in patients undergoing surgery. Response shift has substantial impact on measuring recovery in this population.
OBJECTIVES: To examine the existence, direction, and effect of response shift as measured by the total score of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and SF-36 physical and mental component score domains at 6 months and 1 year after primary total knee arthroplasty (TKA). STUDY DESIGN AND SETTING: Consecutive candidates participated in the study. In line with the Then-test design, two sets of questionnaires were completed at 6 months and 1 year postoperatively. Patients were divided into three groups on the basis of minimal clinically important differences (MCIDs). Parametric and nonparametric statistics and generalized mixed effects models were used. RESULTS: Two hundred and thirty-six patients completed the study. The magnitude of response shift increased over time for SF-36 physical and mental component scores. The traditional unadjusted presurgical and 1-year postsurgical assessment failed to reveal any mental health improvement, whereas the adjusted treatment effect demonstrated statistically significant changes. CONCLUSION: Response shift phenomenon increases with time in patients undergoing orthopedic interventions. The traditional pre- and post-assessment of joint replacement surgery may be confounded by a change in perspective and in internal standards of measurement in patients undergoing surgery. Response shift has substantial impact on measuring recovery in this population.
Authors: Jennifer S Howard; Carl G Mattacola; David R Mullineaux; Robert A English; Christian Lattermann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-09-06 Impact factor: 4.342
Authors: Sara Ahmed; Richard Sawatzky; Jean-Frédéric Levesque; Deborah Ehrmann-Feldman; Carolyn E Schwartz Journal: Qual Life Res Date: 2014-06-05 Impact factor: 4.147
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Authors: Carolina Machuca; Mario V Vettore; Marta Krasuska; Sarah R Baker; Peter G Robinson Journal: BMC Med Res Methodol Date: 2017-08-14 Impact factor: 4.615
Authors: Daniel R Reissmann; Mike T John; Leah Feuerstahler; Kazuyoshi Baba; Gyula Szabó; Asja Čelebić; Niels Waller Journal: Health Qual Life Outcomes Date: 2016-06-07 Impact factor: 3.186