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Hi! How are you? Response shift, implicit theories and differing epistemologies.
1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. norman@mcmaster.ca
Summary
Assessing Health Related Quality of Life (HRQL) involves trade-offs between standardized and individualized methods. Understanding cognitive theories like response shift can improve HRQL assessment validity.
Area of Science:
- Health Economics
- Psychometrics
- Health Services Research
Background:
- Health-Related Quality of Life (HRQL) assessment uses diverse methods, from econometric tools to global measures.
- Each approach has distinct assumptions, strengths, and weaknesses, leading to ongoing debate.
Purpose of the Study:
- To explore theories explaining health assessment over time: 'response shift' and the 'implicit theory of change'.
- To analyze the implications of these theories for prospective versus retrospective judgments.
- To discuss the epistemological differences between individualized and standardized HRQL measures.
Main Methods:
- Theoretical analysis of cognitive models of health assessment.
- Examination of the validity of prospective and retrospective HRQL judgments.
- Philosophical discussion on individualized versus standardized assessment approaches.
Main Results:
- 'Response shift' and 'implicit theory of change' offer contrasting predictions on judgment validity.
- Cognitive processes significantly influence how individuals evaluate their health status over time.
- A fundamental epistemological difference exists between individualized and standardized HRQL measures.
Conclusions:
- A nuanced understanding of assessment goals is crucial for resolving HRQL measurement debates.
- Integrating insights from cognitive psychology can enhance the validity and utility of HRQL measures.
- Careful consideration of specific assessment objectives can guide the selection of appropriate HRQL methodologies.