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Response shifting: a qualitative meta-synthesis on response shift.

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Updated: Nov 17, 2025

New Variations for Strategy Set-shifting in the Rat
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Critical examination of current response shift methods and proposal for advancing new methods.

Véronique Sébille1, Lisa M Lix2, Olawale F Ayilara2

  • 1UMR INSERM 1246, SPHERE "methodS in Patient-Centered Outcomes and HEalth ResEarch", University of Nantes, University of Tours, Nantes, France. veronique.sebille@univ-nantes.fr.

Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation
|February 17, 2021
PubMed
Summary

Current methods for response shift in patient-reported outcomes have limitations. New approaches are needed to accurately capture individual changes over time and improve interpretation of results.

Keywords:
MethodsOperationalizationPatient-reported outcomesResponse shift

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Area of Science:

  • Health Outcomes Research
  • Psychometrics
  • Statistical Modeling

Background:

  • Patient-reported outcome measures (PROMs) are crucial in research.
  • Response shift can alter the interpretation of PROM results.
  • Existing methods for response shift have limitations.

Purpose of the Study:

  • To critically examine current methods for response shift.
  • To identify limitations of existing response shift methodologies.
  • To propose advancements for new response shift methods.

Main Methods:

  • Literature review of design-based, qualitative, individualized, and preference-based methods.
  • Appraisal of methods based on definition, operationalization, and detection capabilities.
  • Evaluation of statistical approaches including latent variable models.

Main Results:

  • Eleven methods for operationalizing response shift were examined.
  • Six methods differentiate between observed and target change.
  • Limitations highlight the need for methods addressing individual variation and multiple time points.

Conclusions:

  • No single response shift method is universally optimal.
  • Accurate interpretation of results requires additional steps.
  • Advancing new methods and conducting comparative simulation studies are recommended.