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The significance of response shift in sinus surgery outcomes

Identifieur interne : 001632 ( Main/Exploration ); précédent : 001631; suivant : 001633

The 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.

RBID : PMC:4285584

Abstract

Background

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.

Methods

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.

Results

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.

Discussion

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:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285584

DOI: 10.1002/alr.21420
PubMed: 25278286
PubMed Central: 4285584

Affiliations:

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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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The significance of response shift in sinus surgery outcomes

The significance of response shift in sinus surgery outcomes

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