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Qual Life Res. 2009 Apr;18(3):335-46. doi: 10.1007/s11136-009-9450-x. Epub 2009 Feb 25.

Response shift: a brief overview and proposed research priorities.

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Department of Physical Therapy, School of Medical Rehabilitation, University of Manitoba, R106-771 McDermot Ave., Winnipeg, MB, R3E 0T6, Canada.



The objective of this overview is to review current methodologies of response shift research in patient-reported outcomes to facilitate and stimulate further research in this area.


This paper is a narrative overview of research in response shift.


The following research priorities emerged: (1) obtain a consensus on terminology and theoretical models used, to ensure that all researchers and clinicians are at the same starting point; (2) determine the clinical importance of response shift; (3) determine the best way to measure and adjust for response shift as a clinically important confounder; (4) ascertain how response shift can best be identified when response shift is the focus of clinical treatment; and (5) establish what methods can be used to translate response shift knowledge into real-world settings.


With the adoption of these research priorities, we anticipate that the theories and processes of response shift will be better understood, current methods to analyze this phenomenon will be improved while new ones may also be developed, and the clinical importance and impact of response shift in measuring changes in health-related quality of life (HRQL) will be determined.

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