Patient-reported outcomes (PROs) 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 (changes in interpretation) and dispositions (stable characteristics). 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.

中文翻译：

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反应转移和处置方式对患者报告结局的影响可能导致医疗决策不佳：医学伦理学观点

患者报告的结局（PRO）经常用于医疗决策，无论是个人护理还是医疗政策。越来越多的证据表明，PROs可能受到患者反应变化（解释的改变）和性格（稳定特征）的影响。我们确定了响应的变化和处置方式可能会如何影响个人患者护理水平和医疗政策方面的医疗决策。我们提供了这些影响的示例，并从道德原则和公正分配理论的角度分析了后果。如果不考虑反应转移和处置对PRO的影响，因此不考虑医疗决策，患者可能无法获得最佳治疗，健康保险套餐可能包括并非最有效或最具成本效益的治疗方法。我们呼吁医疗保健从业人员，研究人员，政策制定者，健康保险公司和其他利益相关者认真思考使用此类患者报告的原因和方式。