Influence of response shift and disposition on patient-reported outcomes may lead to suboptimal medical decisions: a medical ethics perspective

BMC Medical Ethics 20 (1):1-7 (2019)
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Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of response shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used.



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Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - New York: Oxford University Press.
Just Health: Meeting Health Needs Fairly.Norman Daniels - 2007 - Cambridge University Press.
Health as a Theoretical Concept.Christopher Boorse - 1977 - Philosophy of Science 44 (4):542-573.
Just Health Care.Norman Daniels - 1985 - Cambridge University Press.
A Second Rebuttal On Health.Christopher Boorse - 2014 - Journal of Medicine and Philosophy 39 (6):683-724.

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