It was with great interest that I read the manuscripts produced by the In-Sync Working Group Initiative [
1]. Together, these works provide their audience with a framework to advance the operational definition of response shift in such a way that allows for the generation of testable hypotheses about response-shift phenomena [
2]. Additionally, Sébille, et al., provide a multi-perspective commentary on current response-shift research that critically examined current methods and proposed advancement of new methods [
3]. Finally, the implication for healthcare decision-making based on the results of patient reported outcome measures in the setting of response-shift phenomena were presented at multiple levels to provide the reader with a structure to address the impact of response-shift. …