title: Response shift effects on measuring post-operative quality of life among breast cancer patients: a multicenter cohort study.
abstract: OBJECTIVE
  To characterize response shift effects in patients with breast cancer (BC).
  
  
  METHODS
  The QLQ-C30, BR23, and EurQOL-EQ-5D were assessed at baseline and at the end of the first hospitalization. We used the then-test approach to characterize changes in internal standards by calculating the mean difference between the then-test (retrospective measure) and pre-test baseline QoL assessments. The Ideal Scale Approach was also used to assess changes in standards by comparing health and QoL expectancies between baseline and the end of the first hospitalization. Successive Comparison Approach was used to assess changes in values through the longitudinal assessment of the relative importance of EuroQOL dimensions.
  
  
  RESULTS
  The results of this study showed that recalibration RS effects occurred early after the first hospitalization for 6/15 dimensions of QLQ-C30 (emotional, cognitive, fatigue, insomnia, appetite loss, diarrhea) and 2/8 of BR-23 (future perspective, systemic therapy side effects). Moreover, health and QoL expectancies changed between the baseline and the end of the first hospitalization, and changes in values were seen for the self-care and usual activities dimensions of the EuroQOL-EQ-5D.
  
  
  CONCLUSIONS
  The occurrence of RS early after the first hospitalization suggests that it needs to be taken into account to interpret QoL changes in BC.
authors.affiliation: Biostatistics and Epidemiology Unit, Centre Georges François Leclerc, 1 rue Professeur Marion, 21000, Dijon, France. sdabakuyo@cgfl.fr
authors.forename: T S
authors.initials: TS
authors.lastname: Dabakuyo
authors.forename: F
authors.initials: F
authors.lastname: Guillemin
authors.forename: T
authors.initials: T
authors.lastname: Conroy
authors.forename: M
authors.initials: M
authors.lastname: Velten
authors.forename: D
authors.initials: D
authors.lastname: Jolly
authors.forename: M
authors.initials: M
authors.lastname: Mercier
authors.forename: S
authors.initials: S
authors.lastname: Causeret
authors.forename: J
authors.initials: J
authors.lastname: Cuisenier
authors.forename: O
authors.initials: O
authors.lastname: Graesslin
authors.forename: M
authors.initials: M
authors.lastname: Gauthier
authors.forename: F
authors.initials: F
authors.lastname: Bonnetain
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology*; D005221:Fatigue; D005260:Female; D005602:France; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D012648:Self Care; D057566:Self Report; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale