To The Editor:In the paper "Response Shift in Outcome Assessment in Patients
Undergoing Total Knee Arthroplasty," (2006;88:2590-5), Razmjou and
colleagues concluded that patients demonstrated a response shift and that this
finding supports the need for accounting for response shift in clinical
research. The implications of these findings are potentially profound. Unless
authors account for response shift in randomized trials, for example, the
findings should be questioned.