Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;29(8):2149-2159.
doi: 10.1007/s11136-020-02488-4. Epub 2020 Apr 18.

Challenges and lessons learned from using anchoring vignettes to explore quality of life response behavior

Janine Topp  1 , Christoph Heesen  2   3 , Matthias Augustin  4 , Valerie Andrees  4 , Christine Blome  4
Affiliations

Challenges and lessons learned from using anchoring vignettes to explore quality of life response behavior

Janine Topp et al. Qual Life Res. 2020 Aug.

Abstract

Purpose: Asking patients to rate health-related quality of life (HRQoL) of hypothetical individuals described in anchoring vignettes has been proposed to enhance knowledge on how patients understand and respond to HRQoL questionnaires. In this article, we describe the development of anchoring vignettes and explore their utility for measuring response shift in patients' self-reports of HRQoL.

Methods: We conducted an explorative mixed-methods study. One hundred patients with multiple sclerosis or psoriasis participated in two interviews at intervals of 3-6 months. During both interviews, patients assessed HRQoL of 16 hypothetical individuals on the SF-12 questionnaire (two vignettes for each of the eight domains of the SF-12). In addition to these quantitative ratings, we used the think-aloud method to explore changes in patients' verbalization of their decision processes during vignette ratings.

Results: Agreement of vignette ratings at baseline and follow-up was low (ICCs < 0.55). In addition, paired sample t-tests revealed no significant directional mean changes in vignette ratings. Thus, ratings changed non-directionally, neither confirming retest reliability nor a systematic change of assessment. Furthermore, patients' verbalization of their decision processes did not indicate whether or not the assessment strategy of individual patients had changed.

Conclusions: Patients' ratings of anchoring vignettes fluctuate non-directionally over time. The think-aloud method appears not to be informative in exploring whether these fluctuations are due to changes in the individual decision process. Overall, vignettes might not be an appropriate approach to explore response shift, at least with regard to the specific target population and the use of the SF-12.

Keywords: Anchoring vignettes; Health-related quality of life; Mixed-methods; Response shift; SF-12.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow chart on development and continuous evaluation of the anchoring vignette approach
Fig. 2
Fig. 2
Graphical representation of which anchoring vignette the patients assessed on which domain of the SF-12
See this image and copyright information in PMC

References

    1. Tourangeau R, Rips LJ, Rasinski K. The Psychology of Survey Response. Cambridge: Cambridge University Press; 2000.
    1. King G, Murray CJL, Salomon JA, Tandon A. Enhancing the validity and cross-cultural comparability of measurement in survey research. American Political Science Review. 2004;98(01):191–207.
    1. Robinson MD, Clore GL. Belief and feeling: Evidence for an accessibility model of emotional self-report. Psychological Bulletin. 2002;128(6):934–960. - PubMed
    1. Norman G. Hi! how are you? Response shift, implicit theories and differing epistemologies. Quality of Life Research. 2003;12(3):239–249. - PubMed
    1. Oort FJ, Visser MRM, Sprangers MAG. Formal definitions of measurement bias and explanation bias clarify measurement and conceptual perspectives on response shift. Journal of Clinical Epidemiology. 2009;62(11):1126–1137. - PubMed