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Response shift effect on gastrointestinal quality of life index after laparoscopic cholecystectomy

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Abstract

Purpose

Traditional pre- and post-surgery quality of life assessments are inadequate for assessing change in health-related quality of life (HRQoL) after laparoscopic cholecystectomy (LC). This study examined whether a response shift, a change in the internal standards of a patient, occurs in patients who have received LC.

Methods

Self-administered gastrointestinal quality of life index (GIQLI) was used to evaluate preoperative, postoperative, and retrospective postoperative HRQoL. Response shifts, unadjusted treatment effects, adjusted treatment effects, and their effect sizes were calculated.

Results

In all GIQLI domains, a significant response shift was indicated by the significantly higher pre-test scores compared to then-test scores (P < 0.05). The effect size of the response shift ranged from 0.19 for the physical impairment domain of the GIQLI to 0.49 for the total GIQLI score. It was observed the treatment effect was greater after adjusting for the presence of response shift.

Conclusion

Patients who have received LC undergo a response shift that affects their outcome measurement at 6 months postoperative. Response shift is a potentially confounding factor and should be considered when designing clinical studies that employ self-administered HRQoL measures. This evidence of confounding effects warrants further study of response shift at longer intervals after LC, after other health care interventions, and in patients with varying preoperative health status.

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Authors and Affiliations

  1. Graduate Institute of Healthcare Administration, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80756, Taiwan

    Hon-Yi Shi & King-Teh Lee

  2. Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Hospital, 100, Zihyou 1st Road, Kaohsiung, 807, Taiwan

    King-Teh Lee

  3. Department of Surgery, Chi Mei Medical Center, Liou Ying Campus, 201, Taikang Village, Liou Ying Township, Tainan, 736, Taiwan

    Hao-Hsien Lee & Chong-Chi Chiu

  4. Department of Surgery, Chi Mei Medical Center, Tainan, 702, Taiwan

    Yih-Huei Uen

  5. Chia Nan University of Pharmacy and Science, Tainan, Taiwan

    Chong-Chi Chiu

  6. Taipei Medical University, Taipei, Taiwan

    Chong-Chi Chiu

Authors
  1. Hon-Yi Shi
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  2. King-Teh Lee
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  3. Hao-Hsien Lee
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  4. Yih-Huei Uen
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  5. Chong-Chi Chiu
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Correspondence to Chong-Chi Chiu.

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Shi, HY., Lee, KT., Lee, HH. et al. Response shift effect on gastrointestinal quality of life index after laparoscopic cholecystectomy. Qual Life Res 20, 335–341 (2011). https://doi.org/10.1007/s11136-010-9760-z

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  • DOI: https://doi.org/10.1007/s11136-010-9760-z

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