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Health Qual Life Outcomes. 2015 May 6;13:52. doi: 10.1186/s12955-015-0232-6.

How are you? Do people with inflammatory bowel disease experience response shift on this question?

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Division of Clinical Epidemiology, Ross Pavilion R4. 29, Royal Victoria Hospital Site, McGill University Health Center, Montreal, QC, H3A 1A1, Canada.
Division of Clinical Epidemiology, Ross Pavilion R4. 36 Royal Victoria Hospital Site, McGill University Health Center, Montreal, QC, H3A 1A1, Canada.
University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, 804F-715 McDermot Ave, Winnipeg, MB, R3E 3P4, Canada.
University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, MB, R3E 0W3, Canada.



As individuals experience changes in their health, they may alter the way they evaluate health and quality of life. The purpose of this study is to estimate the extent to which individuals with IBD change their rating of health over time because of response shift (RS).


This is a reanalysis of a population-based longitudinal study of IBD in Manitoba, Canada (nā€‰=ā€‰388). RS was examined using trajectories of the difference between observed and predicted health. Logistic regression and dual trajectories were used to identify predictors of RS.


Disease activity, vitality, pain, somatization, and physical and social function explained 51% of the variation in general health over two years with no evidence of RS in 82% of the sample. Negative RS was found for 8%, who initially rated health better than predicted; positive RS was found for 6%. The positive RS group was younger and had better baseline scores on measures of general health, hostility, pain, mental health and social and role function; less pain and better social function scores at baseline were predictors of negative RS.


In conclusion, the majority of people with IBD did not demonstrate a RS indicating that the health rating over time was stable in relation to that predicted by known time varying clinical variables. This adds to the evidence that the single question on self-rated health is useful for monitoring individuals over time.

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