Influence of explanatory and confounding variables on HRQoL after controlling for measurement bias and response shift in measurement.

Research paper by Pranav K PK Gandhi, L Douglas LD Ried, Carole L CL Kimberlin, Teresa L TL Kauf, I-Chan IC Huang

Indexed on: 14 Nov '13Published on: 14 Nov '13Published in: Expert review of pharmacoeconomics & outcomes research


The purpose of this study was to examine the influence of explanatory and confounding variables on health-related quality of life after accounting for response shift, measurement bias and response shift in measurement using structural equation modeling. Hypertensive patients with coronary artery disease randomized to anti-hypertensive treatment, completed the ShortForm-36 questionnaire at both baseline and 1 year (n = 788). Three measurement biases were found and all three were considered as response shift in measurement. Older patients reported worse scores for both physical functioning (PF) and role-physical at baseline and 1 year later compared to younger patients; and males reported better PF than females after conditioning on the latent trait of general physical health. Before controlling for response shift, patients' PF scores were not statistically different over time; however, PF scores significantly improved (p < 0.01) after controlling for recalibration response shift. Assessment of how patients perceive their change in health-related quality of life over time is warranted.