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. 2019 Sep 11;20(1):61.
doi: 10.1186/s12910-019-0397-3.

Influence of response shift and disposition on patient-reported outcomes may lead to suboptimal medical decisions: a medical ethics perspective

Iris D Hartog  1   2 , Dick L Willems  3 , Wilbert B van den Hout  4 , Michael Scherer-Rath  5 , Tom H Oreel  6 , José P S Henriques  7 , Pythia T Nieuwkerk  6 , Hanneke W M van Laarhoven  8 , Mirjam A G Sprangers  6
Affiliations

Influence of response shift and disposition on patient-reported outcomes may lead to suboptimal medical decisions: a medical ethics perspective

Iris D Hartog et al. BMC Med Ethics. .

Abstract

Background: Patient-reported outcomes (PROs) are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients' response shifts (changes in interpretation) and dispositions (stable characteristics).

Main text: We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution.

Conclusion: If influences of response shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Health states and reported HRQoL after treatment with regimen A versus regimen B (Scenario 1)
See this image and copyright information in PMC

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