Prospective vs retrospective assessment of lower urinary tract symptoms in patients with advanced prostate cancer: the effect of 'response shift'.

Abstract:

OBJECTIVE:To compare prospectively obtained symptom scores (pre-tests) with retrospective assessment (then-tests) in patients with newly diagnosed advanced prostate cancer. PATIENTS AND METHODS:Patients with newly diagnosed locally advanced or metastatic prostate cancer were recruited. They completed the International Prostate Symptom Score (IPSS) and Symptom Problem Index (SPI) before starting treatment. At 3 and 6 months after diagnosis they again completed these questionnaires, but also retrospectively reassessed their initial symptom level. Healthy age-matched controls were recruited from primary care and completed the same questionnaires; in all, 76 patients and 17 controls participated. RESULTS:The IPSS and SPI scores decreased significantly over the 6 months of the study. Patients retrospectively rated their level of symptoms and symptom bother as higher than their contemporaneous assessments. This was not the case in the control group. CONCLUSION:These results question the assumption that contemporaneously collected pre-test scores are interchangeable with retrospectively assessed then-tests. This suggests that caution is required when comparing the results of studies that use these two alternative techniques of data collection. The difference between then-test and pre-test scores may represent an example of a phenomenon termed 'response shift', in which, by adapting to their disease, patients changed the internal standards by which they assessed their symptoms.

journal_name

BJU Int

journal_title

BJU international

authors

Rees J,Waldron D,O'Boyle C,Ewings P,MacDonagh R

doi

10.1046/j.1464-410x.2003.04462.x

keywords:

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

703-6

issue

7

eissn

1464-4096

issn

1464-410X

pii

4462

journal_volume

92

pub_type

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