No one size fits all for measuring what matters: Supporting the use of PRO data in healthcare


  • Richard Sawatzky
    Trinity Western University
  • Jae-Yung Kwon International Society for Quality of Life Research, University of British Columbia


  • Ronak Brahmbhatt
    Trinity Western University

Patient reported outcomes (PROs), which allow patients to report on their physical and mental health and wellbeing, are increasingly used in clinical practice and decision making. However, patients may not be consistent in how they interpret and respond to these questions.

Differences in the meaning of PROs across individuals or over time are known as differential item functioning (DIF) and response shift (RS). Ignoring these differences could lead to erroneous healthcare decisions. Although there are statistical methods to adjust for DIF and RS, these are complex to interpret and apply. To address this, our team is developing resources on DIF and RS (introductory video, webinar, and analysis software code).

Building on this prior work, we now propose to facilitate wider uptake of knowledge for interpreting and analyzing PROs by developing a webinar that includes case studies and an online interactive learning module specifically for clinically-oriented audiences (clinicians and decision support analysts).

Expected outcomes include:

  1. Increased awareness of DIF and RS and their implications for clinical practice and decision making, and
  2. increased ability to analyze and interpret PROs data while accounting for DIF and RS.