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01-05-2010 | Uitgave 4/2010

Quality of Life Research 4/2010

Guidelines for improving the stringency of response shift research using the thentest

Quality of Life Research > Uitgave 4/2010
Carolyn E. Schwartz, Mirjam A. G. Sprangers
Belangrijke opmerkingen
Carolyn E. Schwartz and Mirjam A. G. Sprangers contributed equally to this work.



Health-state changes can lead to response shifts in internal standards. The most commonly used method for detecting such recalibration response shift is the retrospective pretest–posttest design, here referred to as thentest. Since this design faces significant problems, there is a pressing need to improve the stringency of studies using the thentest approach. Our objective is to provide guidelines for the optimal use of the thentest approach for detecting recalibration response shift.


Discussion of methods based on relevant literature.


A checklist is provided that includes recommendations for studies using the thentest approach focusing on: (1) designing the study; (2) formulating hypotheses; (3) constructing the thentest; (4) identifying change; (6) taking alternative explanations into account; (7) using analytic standards; and (8) interpreting results.


The guidelines-checklist has the potential to stimulate rigorous and replicable research using the thentest. This checklist might also be of use for journal editors and reviewers as ‘gate keepers’ of stringent research. Many of these suggestions also apply to other methods of detecting response shift.

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