Methods for assessing responsiveness: a critical review and recommendations.

Area of Science:

• Health Measurement
• Clinical Outcomes Research
• Biostatistics

Background:

• Responsiveness is a key measurement property in health research.
• Existing literature suggests two primary aspects of responsiveness.
• Understanding these aspects is crucial for accurate interpretation of study results.

Purpose of the Study:

• To define and differentiate internal and external responsiveness.
• To examine the properties and interpretation of statistics used for both types of responsiveness.
• To highlight the utility of regression models in assessing external responsiveness.

Main Methods:

• Literature review of existing research on measurement responsiveness.
• Conceptual analysis and definition of internal and external responsiveness.
• Examination of statistical properties and interpretability of responsiveness measures.

Main Results:

• Internal responsiveness measures the change in a score over a set time.
• External responsiveness quantifies how well a measure's change aligns with changes in a clinical reference standard.
• External responsiveness statistics offer particular advantages for interpretation and can be effectively assessed using regression models.

Conclusions:

• Distinguishing between internal and external responsiveness is essential for rigorous health research.
• External responsiveness is highly valuable due to its interpretability and clinical relevance.
• Regression modeling provides a robust framework for evaluating external responsiveness.