Conceptual and methodological considerations regarding appraisal and response shift

Multivariate analysis of psychological dat

Using structural equation modeling to investigate change and response shift in patient-reported outcomes: practical considerations and recommendations

Background Patient-reported outcomes (PROs) are of increasing importance for health-care evaluations. However, the interpretation of change in PROs may be obfuscated due to changes in the meaning of the self-evaluation, i.e., response shift. Structural equation modeling (SEM) is the most widely used statistical approach for the investigation of response shift. Yet, non-technical descriptions of SEM for response shift investigation are lacking. Moreover, application of SEM is not straightforward and requires sequential decision-making practices that have not received much attention in the literature.Aims To stimulate appropriate applications and interpretations of SEM for the investigation of response shift, the current paper aims to (1) provide an accessible description of the SEM operationalizations of change that are relevant for response shift investigation; (2) discuss practical considerations in applying SEM; and (3) provide guidelines and recommendations for researchers who want to use SEM for the investigation and interpretation of change and response shift in PROs.Conclusion Appropriate applications and interpretations of SEM for the detection of response shift will help to improve our understanding of response shift phenomena and thus change in PROs. Better understanding of patients' perceived health trajectories will ultimately help to adopt more effective treatments and thus enhance patients' wellbeing.Health and self-regulationMultivariate analysis of psychological dat

Human intestinal microbiota composition is associated with local and systemic inflammation in obesity.

OBJECTIVE: Intestinal microbiota have been suggested to contribute to development of obesity, but the mechanism remains elusive. We relationship between microbiota composition, intestinal permeability, inflammation in non-obese and obese subjects. DESIGN AND METHODS: Fecal microbiota composition of 28 subjects (BMI 18.6-60.3kg/m2 ) was analyzed phylogenetic profiling microarray. Fecal calprotectin and plasma C- protein levels were determined to evaluate intestinal and systemic Furthermore, HbA1c , and plasma levels of transaminases and lipids were Gastroduodenal, small intestinal, and colonic permeability were assessed multi-saccharide test. RESULTS: Based on microbiota composition, the population segregated into two clusters with predominantly obese (15/19) exclusively non-obese (9/9) subjects. Whereas intestinal permeability differ between clusters, the obese cluster showed reduced bacterial decreased Bacteroidetes/Firmicutes ratio, and an increased abundance of pro-inflammatory Proteobacteria. Interestingly, fecal calprotectin was detectable in subjects within the obese microbiota cluster (n=8/19, Plasma C-reactive protein was also increased in these subjects correlated with the Bacteroidetes/Firmicutes ratio (rs =-0.41, p=0.03). CONCLUSIONS: Intestinal microbiota alterations in obese subjects are with local and systemic inflammation, suggesting that the obesity- microbiota composition has a pro-inflammatory effect

Response shift after cognitive behavioral therapy targeting severe fatigue: explorative analysis of three randomized controlled trials

Health and self-regulationMultivariate analysis of psychological dat

Response shift after coronary revascularization

Purpose The aims of this study were to investigate (1) the extent to which response shift occurs among patients with coronary artery disease (CAD) after coronary revascularization, (2) whether the assessment of changes in health-related quality of life (HRQoL), controlled for response shift, yield more valid estimates of changes in HRQoL, as indicated by stronger associations with criterion measures of change, than without controlling for response shift, and (3) if occurrences of response shift are related to patient characteristics. Methods Patients with CAD completed the SF-36 and the Seattle Angina Questionnaire (SAQ7) at baseline and 3 months after coronary revascularization. Sociodemographic, clinical and psychosocial variables were measured with the patient version of the New York Heart Association-class, Subjective Significance Questionnaire, Reconstruction of Life Events Questionnaire (RE-LIFE), and HEXACO personality inventory. Oort's Structural Equation Modeling (SEM) approach was used to investigate response shift. Results 191 patient completed questionnaires at baseline and at 3 months after treatment. The SF-36 showed recalibration and reprioritization response shift and the SAQ7 reconceptualization response shift. Controlling for these response shift effects did not result in more valid estimates of change. One significant association was found between reprioritization response shift and complete integration of having CAD into their life story, as indicated by the RE-LIFE. Conclusion Results indicate response shift in HRQoL following coronary revascularization. While we did not find an impact of response shift on the estimates of change, the SEM approach provides a more comprehensive insight into the different types of change in HRQoL following coronary revascularization.Biological, physical and clinical aspects of cancer treatment with ionising radiatio