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Assessing Patients' Views of Clinical Changes
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To the Editor: In their article on capturing the patient's perspective as an outcome measure, it might have been helpful if Dr Fischer and colleagues1 had discussed some additional issues attendant to the conclusion that "retrospective assessments appear to provide information that is different from serial change data, are more sensitive to change, and are more highly correlated with patient satisfaction." The enhanced correlation between retrospective change and patient satisfaction may be tautological. Patients who perceive that they have experienced better outcomes, for example (which could be due to faulty memory or could be causally influenced by the rapport established with their clinicians), would be expected to be more satisfied with their care irrespective of the validity of these perceptions.
Change scores are not recommended from a psychometric perspective, because they are usually more unreliable than either the baseline or follow-up measures on which they are based.2 Unreliability of a . . . [Full Text of this Article]
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