ArticlePloS one2021
Re-evaluating randomized clinical trials of psychological interventions: Impact of response shift on the interpretation of trial results.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 8 citations in OpenAlex.
- Response shift in oncology: fact or myth.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Review
- Rasch models to assess the impact of lack of measurement invariance and reveal hidden differences in anxiety and depression between groups and over time in patients with early-stage melanoma or breast cancer using the RespOnse Shift ALgorithm at the Item level (ROSALI).BMC medical research methodology · 2026Article
- Long-COVID symptom burden and the experience of adversity: the importance of response-shift effects over 3 years of the pandemic.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- How do we know whether treatment has failed? Paradoxical outcomes in counseling with young people.Frontiers in psychology · 2024Review
- Implications of the syntheses on definition, theory, and methods conducted by the Response Shift - in Sync Working Group.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023Article
- Response Shift After Cognitive Behavioral Therapy Targeting Severe Fatigue: Explorative Analysis of Three Randomized Controlled Trials.International journal of behavioral medicine · 2023Article
- Listening to the elephant in the room: response-shift effects in clinical trials research.Journal of patient-reported outcomes · 2022Article
- The Effect of Noninvariance on the Estimation of the Mediated Effect in the Two-Wave Mediation Model.Structural equation modeling : a multidisciplinary journal · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEffectiveness of psychological treatment is often assessed using patient-reported health evaluations. However, comparison of such scores over time can be hampered due to a change in the meaning of self-evaluations, called 'response shift'. Insight into the occurrence of response shift seems especially relevant in the context of psychological interventions, as they often purposefully intend to change patients' frames of reference.
aimsThe overall aim is to gain insight into the general relevance of response shift for psychological health intervention research. Specifically, the aim is to re-analyse data of published randomized controlled trials (RCTs) investigating the effectiveness of psychological interventions targeting different health aspects, to assess (1) the occurrence of response shift, (2) the impact of response shift on interpretation of treatment effectiveness, and (3) the predictive role of clinical and background variables for detected response shift.
methodWe re-analysed data from RCTs on guided internet delivered cognitive behavioural treatment (CBT) for insomnia in the general population with and without elevated depressive symptoms, an RCT on meaning-centred group psychotherapy targeting personal meaning for cancer survivors, and an RCT on internet-based CBT treatment for persons with diabetes with elevated depressive symptoms. Structural equation modelling was used to test the three objectives.
resultsWe found indications of response shift in the intervention groups of all analysed datasets. However, results were mixed, as response shift was also indicated in some of the control groups, albeit to a lesser extent or in opposite direction. Overall, the detected response shifts only marginally impacted trial results. Relations with selected clinical and background variables helped the interpretation of detected effects and their possible mechanisms.
conclusionThis study showed that response shift effects can occur as a result of psychological health interventions. Response shift did not influence the overall interpretation of trial results, but provide insight into differential treatment effectiveness for specific symptoms and/or domains that can be clinically meaningful.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.