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Relative importance measures for reprioritization response shift

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Abstract

Purpose

Response shift (RS), a change in the meaning of an individual’s self-evaluation of a target construct, such as health-related quality of life (HRQOL), can affect the interpretation of change in measures of the construct collected over time. This study proposes new statistical methods to test for reprioritization RS, in which the relative importance of HRQOL domains changes over time.

Methods

The methods use descriptive discriminant analysis or logistic regression models and bootstrap inference to test for change in relative importance weights (Method 1) or ranks (Method 2) for discriminating between patient groups at two occasions. The methods are demonstrated using data from the Manitoba Inflammatory Bowel Disease (IBD) Cohort Study (n = 388). Reprioritization of domains from the IBD Questionnaire (IBDQ) and SF-36 was investigated for groups with active and inactive disease symptoms.

Results

The IBDQ bowel symptoms and SF-36 bodily pain domains had the highest ranks for group discrimination. Using Method 1, there was evidence of reprioritization RS in the IBDQ social functioning domain and the SF-36 bodily pain and social functioning domains. Method 2 did not detect change for any of the domains.

Conclusions

Compared to IBD patients without active disease symptoms, those with active symptoms were likely to change the meaning of their self-evaluations of pain and social interactions. Further research is needed to compare these new RS detection methods under a variety of data analytic conditions before recommendations about the optimal method can be made.

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Abbreviations

DDA:

Descriptive discriminant analysis

DRC:

Discriminant ratio coefficient

HRQOL:

Health-related quality of life

IBD:

Inflammatory bowel disease

IBDQ:

Inflammatory Bowel Disease Questionnaire

LR:

Logistic regression

LPI:

Logistic Pratt’s index

RS:

Response shift

SDFC:

Standardized discriminant function coefficient

SEM:

Structural equation modeling

SF-36:

36-item Short-Form Questionnaire

SLRC:

Standardized logistic regression coefficient

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Acknowledgments

This research was supported by a Canadian Institutes of Health Research (CIHR) New Investigator award and University of Saskatchewan Centennial Chair to the first author, a CIHR Vanier Graduate Scholarship to the second author, and a CIHR Operating Grant to the research team.

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Authors and Affiliations

  1. School of Public Health, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada

    Lisa M. Lix & Tolulope T. Sajobi

  2. Trinity Western University, Langley, Canada

    Richard Sawatzky

  3. McGill University Health Centre, Montreal, Canada

    Nancy E. Mayo

  4. University of Regina, Regina, Canada

    Yuhui Huang

  5. University of Manitoba, Winnipeg, Canada

    Lesley A. Graff, John R. Walker, Jason Ediger, Ian Clara, Kathryn Sexton, Rachel Carr & Charles N. Bernstein

  6. University of Saskatchewan, Saskatoon, SK, Canada

    Juxin Liu

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  1. Lisa M. Lix
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Correspondence to Lisa M. Lix.

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Lix, L.M., Sajobi, T.T., Sawatzky, R. et al. Relative importance measures for reprioritization response shift. Qual Life Res 22, 695–703 (2013). https://doi.org/10.1007/s11136-012-0198-3

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