ArticleJournal of patient experience2020
Attempts to Limit Censoring in Measures of Patient Satisfaction.
Article in Journal of patient experience, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed.
- Using Text Messaging Ecological Momentary Assessment to Record Changes in e-Cigarette and Combustible Cigarette Use: Pilot Randomized Clinical Trial.JMIR formative research · 2025Trial
- The Compassionate HEART Patient Questionnaire: Validation and Reliability of a Novel Measure of Relationship-Centered Care.Journal of patient-centered research and reviews · 2026Article
- Is It Possible to Develop a Patient-reported Experience Measure With Lower Ceiling Effect?Clinical orthopaedics and related research · 2025Article
- Does Communication Effectiveness Assessed by Communication Scholars Correlate with Patient Perception of Clinician Empathy?Journal of patient experience · 2025Article
- Greater Personal Health Agency Is Associated With Greater Patient Receptiveness to Mindset Exercises.Journal of patient experience · 2025Article
- Satisfaction with radiotherapy care among cancer patients treated in Germany-secondary analysis of a large multicenter study.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Article
- Patient reported satisfaction levels with the use of telemedicine for general surgery-A systematic review of randomized control trials.Surgery in practice and science · 2023Article
- Do Patient Experiences Have Mediating Roles on Patient Loyalty?Journal of patient experience · 2022Article
- Does Adjusting for Social Desirability Reduce Ceiling Effects and Increase Variation of Patient-Reported Experience Measures?Journal of patient experience · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMeasures of patient satisfaction are increasingly used to measure patient experience. Most satisfaction measures have notable ceiling effects, which limits our ability to learn from variation among relatively satisfied patients. This study tested a variety of single-question satisfaction measures for their mean overall score, ceiling and floor effect, and data distribution. In addition, we assessed the correlation between satisfaction and psychological factors and assessed how the various methods for measuring satisfaction affected net promoter scores (NPSs). METHODOLOGY: A total of 212 patients visiting orthopedic offices were enrolled in this randomized controlled trial. Patients were randomized to 1 of 5 newly designed, single-question satisfaction scales: (a) a helpfulness 11-point ordinal scale from 0 to 10, (b) a helpfulness ordinal 11-point scale from 0 to 5 (ie, with 1.5, 2.5, etc), (c) a helpfulness 100-point slider, (d) a satisfaction 11-point ordinal scale from 0 to 10, and (e) a willingness to recommend 11-point ordinal scale from 0 to 10. Additionally, patients completed the 2-item Pain Self-Efficacy Questionnaire (PSEQ-2), 5-item Short Health Anxiety Inventory (SHAI-5) Scale, and Patient-Reported Outcomes Measurement Information System (PROMIS) Depression. We assessed mean and median score, ceiling and floor effect, and skewness and kurtosis for each scale. Spearman's correlation tests were used to test correlations between satisfaction and psychological status. Finally, we assessed the NPS for the various scales.
resultsCeiling effects ranged from 29% to 68%. The 11-point ordinal helpfulness scale from 0 to 10 had the least ceiling effect (29%). All of the scales were asymmetrically distributed, with the 11-point ordinal scale from 0 to 5 having the most Gaussian distribution (skew = 0.64 and kurtosis = 2.3). Satisfaction scores did not correlate with psychological factors: PSEQ-2 (
conclusionsVariations in scale types, text anchors, and lead-in statements do not eliminate the ceiling effect of single-question measures of satisfaction with a visit to an orthopedic specialist. Further studies might test other scale designs and labels. LEVEL OF EVIDENCE: Diagnostic; Level II.
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