Anticipated adaptation or scale recalibration?

Health and Quality of Life Outcomes, 2013 · DOI: 10.1186/1477-7525-11-171 · Published: October 18, 2013

Spinal Cord Injury Participation Research Methodology & Design

Simple Explanation

The study investigates how well patients with spinal cord injuries (SCI) can predict their future quality of life (QoL) and recall their past QoL, focusing on the concepts of anticipated adaptation and scale recalibration. Scale recalibration refers to how patients might change their internal standards when using a rating scale, potentially affecting the accuracy of their QoL assessments over time. The researchers used two different methods, a Visual Analog Scale (VAS) and a Time Trade-Off (TTO), to measure QoL and compared the results to understand whether patients' predictions and recollections were accurate.

Study Duration

Not specified

Participants

44 patients with Spinal Cord Injury (SCI)

Evidence Level

Observational longitudinal study

Key Findings

1
Patients with SCI accurately predicted their future health states and recalled their previous health states using the TTO method.
2
Patients tended to overpredict improvements in their health on the VAS, suggesting that scale recalibration might have influenced their ratings.
3
Individual-level data showed that a minority of respondents made accurate predictions, and the deviation of accuracy was larger for the TTO than the VAS.

Research Summary

The study aimed to disentangle scale recalibration from anticipated adaptation in patients with spinal cord injury (SCI) by comparing their predicted, recalled, and actual quality of life (QoL) ratings using Visual Analogue Scale (VAS) and Time Trade-Off (TTO) methods. The findings suggest that patients with SCI were able to accurately anticipate their adaptation when using the TTO method, whereas valuations on the VAS seemed to be biased by scale recalibration. The study concludes that valuations given on the VAS seem biased by scale recalibration and further research is needed to examine the effect of scale recalibration on the TTO.

Practical Implications

Clinical Practice

When assessing quality of life in patients with SCI over time, the TTO method may provide more accurate and reliable results compared to the VAS due to the potential for scale recalibration bias in the latter.

Research Methodology

Researchers should consider using both TTO and VAS methods to measure QoL in longitudinal studies to better understand the influence of adaptation and scale recalibration on patient-reported outcomes.

Theoretical Understanding

Further empirical and theoretical investigation is needed to clarify the relationship between the different aspects of response shift (reconceptualization, reprioritization, and scale recalibration) and their impact on QoL measurements.

Study Limitations

1
The small sample size may limit the generalizability of the findings and reduce the power of the analyses.
2
The study relied on subjective valuations of health states, without objective measures or a 'gold standard' for comparison.
3
The assumption that TTO is less vulnerable to scale recalibration is only theoretical, without empirical evidence to support it.

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