The significance of response shift in sinus surgery outcomes
Identifieur interne : 001632 ( Main/Curation ); précédent : 001631; suivant : 001633The significance of response shift in sinus surgery outcomes
Auteurs : Jj Liu [États-Unis] ; Ge Davis [États-Unis]Source :
- International forum of allergy & rhinology [ 2042-6976 ] ; 2014.
Abstract
Functional endoscopic sinus surgery (FESS) aims to improve quality-of-life (QOL). Perception of QOL can change according to one’s current medical or emotional state. This is known as response shift. It can be measured by the Then-test, which asks patients to report pre-treatment symptoms after receiving treatment. Patients often do not understand their disease burden until their symptoms are improved. This study aims to assess the significance of response shift in FESS outcomes.
This was a prospective cohort study that included chronic rhinosinusitis patients from 2010–2012 who completed a pre-operative sino-nasal outcome test (SNOT-20). Two SNOT-20’s were mailed approximately 6 months after surgery. Patients completed one SNOT-20 according to their pre-operative symptoms in light of their current state of health (“then-test”) and the other based on post-operative symptoms. The pre- and post-operative SNOT-20 difference represented the treatment effect and the pre-operative SNOT-20 and then-test difference represented response shift.
32 completed responses were obtained. Using a zero to five scale, mean treatment effect was −0.96 (P < 0.01), which signifies a QOL improvement. Mean response shift was +0.42 (P=0.01). This positive value signifies that patients felt they were worse off pre-operatively, likely due to a positive change in health status. The actual treatment effect is the sum of the measured treatment effect and response shift, which was −1.38.
Response shift exists and can be quantified. The actual treatment effect was more profound when response shift was included. Therefore, future studies should account for this often unmeasured, potential change in QOL.
Url:
DOI: 10.1002/alr.21420
PubMed: 25278286
PubMed Central: 4285584
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PMC:4285584Le document en format XML
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<author><name sortKey="Davis, Ge" sort="Davis, Ge" uniqKey="Davis G" first="Ge" last="Davis">Ge Davis</name>
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<author><name sortKey="Davis, Ge" sort="Davis, Ge" uniqKey="Davis G" first="Ge" last="Davis">Ge Davis</name>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Functional endoscopic sinus surgery (FESS) aims to improve quality-of-life (QOL). Perception of QOL can change according to one’s current medical or emotional state. This is known as response shift. It can be measured by the Then-test, which asks patients to report pre-treatment symptoms after receiving treatment. Patients often do not understand their disease burden until their symptoms are improved. This study aims to assess the significance of response shift in FESS outcomes.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">This was a prospective cohort study that included chronic rhinosinusitis patients from 2010–2012 who completed a pre-operative sino-nasal outcome test (SNOT-20). Two SNOT-20’s were mailed approximately 6 months after surgery. Patients completed one SNOT-20 according to their pre-operative symptoms in light of their current state of health (“then-test”) and the other based on post-operative symptoms. The pre- and post-operative SNOT-20 difference represented the treatment effect and the pre-operative SNOT-20 and then-test difference represented response shift.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">32 completed responses were obtained. Using a zero to five scale, mean treatment effect was −0.96 (P < 0.01), which signifies a QOL improvement. Mean response shift was +0.42 (P=0.01). This positive value signifies that patients felt they were worse off pre-operatively, likely due to a positive change in health status. The actual treatment effect is the sum of the measured treatment effect and response shift, which was −1.38.</p>
</sec>
<sec id="S4"><title>Discussion</title>
<p id="P4">Response shift exists and can be quantified. The actual treatment effect was more profound when response shift was included. Therefore, future studies should account for this often unmeasured, potential change in QOL.</p>
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