Response shift and disease activity in inflammatory bowel disease

Area of Science:

• Health Services Research
• Psychometrics
• Gastroenterology

Background:

• Response shift (RS) can confound longitudinal health-related quality of life (HRQoL) assessments.
• Chronic conditions, such as inflammatory bowel disease (IBD), involve fluctuating disease activity, potentially influencing RS.
• Understanding RS in IBD is crucial for accurate HRQoL measurement.

Purpose of the Study:

• To investigate the presence and types of response shift (RS) in individuals with inflammatory bowel disease (IBD).
• To examine whether varying disease activity (consistent active, consistent inactive, inconsistent) influences RS over a 6-month period.
• To assess RS using the SF-36 quality of life measure.

Main Methods:

• Utilized data from the Manitoba IBD Cohort Study (N=388).
• Employed multi-group confirmatory factor analysis (MG-CFA) and a structural equation modeling-based RS detection method.
• Analyzed RS (reconceptualization, reprioritization, recalibration) across groups with different disease activity patterns.

Main Results:

• Weak invariance model best fit baseline SF-36 data.
• Reconceptualization and recalibration RS detected in the consistent active IBD group (small effect sizes).
• Recalibration RS observed in consistent inactive and inconsistent disease activity groups (small to moderate effect sizes). No reprioritization RS found.

Conclusions:

• Individuals with chronic diseases like IBD may experience RS even without consistent active symptoms.
• The type and magnitude of RS can vary among patients with fluctuating disease activity.
• RS can impact the interpretation of HRQoL changes in longitudinal studies of chronic conditions.