What are the priming and ceiling effects of one experience measure on another?
Open accessAbstract
Patient-reported experience measures have notable ceiling effects which can hinder efforts to learn and improve. This study tested whether an iterative (Guttman-style) satisfaction questionnaire combined with instructions intended to give people agency to critique us primes responses on an ordinal scale and reduces ceiling effects. Among the 161 subjects randomly assigned to complete an iterative satisfaction questionnaire before or after an ordinal scale, there was no difference in mean satisfaction (no priming). The Guttman scale was more normally distributed and had slightly less ceiling effect when compared to the ordinal scale. Iterative satisfaction scales partially mitigate ceiling effects. The absence of priming suggests that attempts to encourage agency and reflection have limited ability to reduce ceiling effects, and alternative approaches should be tested.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Ceiling effects are commonly observed in patient-reported experience measures focused on satisfaction with care or quality of care.
“Ceiling effects are commonly observed in patient-reported experience measures focused on satisfaction with care or quality of care [63].”
From Using a health equity lens to measure patient experiences of care in diverse health care settings (2024) · cites this paper as [63]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The Pain Catastrophizing Scale: Development and validation.
Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995) · Psychological Assessment · doi:10.1037//1040-3590.7.4.524 · Cited by 8,227 · see citing works
Bargh, J. A., Chen, M., & Burrows, L. (1996) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.71.2.230 · Cited by 2,736 · see citing works
Bargh, J. A., Chen, M. I.-C., & Burrows, L. (1996) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.71.2.230 · Cited by 2,637 · see citing works
Streiner, D. L., & Norman, G. R. (2008) · doi:10.1093/acprof:oso/9780199231881.001.0001 · Cited by 2,631 · see citing works
A Basis for Scaling Qualitative Data
Guttman, L. (1944) · American Sociological Review · doi:10.2307/2086306 · Cited by 1,333 · see citing works
Affect, cognition, and awareness: Affective priming with optimal and suboptimal stimulus exposures.
Murphy, S. T., & Zajonc, R. B. (1993) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.64.5.723 · Cited by 1,323 · see citing works
Defining and measuring patient satisfaction with medical care
Ware, J. E., Snyder, M. K., Wright, W. R., & Davies, A. R. (1983) · Evaluation and Program Planning · doi:10.1016/0149-7189(83)90005-8 · Cited by 1,259 · see citing works
Affect, cognition, and awareness: Affective priming with optimal and suboptimal stimulus exposures.
Murphy, S. T., & Zajonc, R. B. (1993) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.64.5.723 · Cited by 1,169 · see citing works
Patients' Perception of Hospital Care in the United States
Jha, A. K., Orav, E. J., Zheng, J., & Epstein, A. M. (2008) · New England Journal of Medicine · doi:10.1056/nejmsa0804116 · Cited by 887 · see citing works
The relation between perception and behavior, or how to win a game of Trivial Pursuit.
Dijksterhuis, A., & van Knippenberg, A. (1998) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.74.4.865 · Cited by 585 · see citing works
The relation between perception and behavior, or how to win a game of Trivial Pursuit.
Dijksterhuis, A., & van Knippenberg, A. (1998) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.74.4.865 · Cited by 546 · see citing works
Voutilainen, A., Pitkäaho, T., Kvist, T. A., & Vehviläinen-Julkunen, K. M. (2015) · Journal of Advanced Nursing · doi:10.1111/jan.12875 · Cited by 385 · see citing works
Sahlqvist, S., Song, Y., Bull, F., Adams, E. J., Preston, J. M., & Ogilvie, D. (2011) · BMC Medical Research Methodology · doi:10.1186/1471-2288-11-62 · Cited by 362 · see citing works
In a mailed physician survey, questionnaire length had a threshold effect on response rate
Jepson, C., Asch, D. A., Hershey, J. C., & Ubel, P. A. (2005) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2004.06.004 · Cited by 253 · see citing works
Measuring patients' experiences and outcomes
Black, N. A., & Jenkinson, C. (2009) · BMJ · doi:10.1136/bmj.b2495 · Cited by 240 · see citing works
Boudreaux, E. D., Ary, R. D., Mandry, C. V., & McCabe, B. (2000) · The American Journal of Emergency Medicine · doi:10.1053/ajem.2000.7316 · Cited by 187 · see citing works
Effect of Social Category Priming on Personal Attitudes
Kawakami, K., Dovidio, J. F., & Dijksterhuis, A. (2003) · Psychological Science · doi:10.1111/1467-9280.14451 · Cited by 130 · see citing works
National Culture and Social Desirability Bias in Measuring Public Service Motivation
Kim, S. H., & Kim, S. (2016) · Administration & Society · doi:10.1177/0095399713498749 · Cited by 124 · see citing works
Evidence‐Based Survey Design: Ceiling Effects Associated with Response Scales
Chyung, S. Y., Hutchinson, D., & Shamsy, J. A. (2020) · Performance Improvement Journal · doi:10.1002/pfi.21920 · Cited by 110 · see citing works
Moret, L., Nguyen, J., Pillet, N., Falissard, B., Lombrail, P., & Gasquet, I. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-197 · Cited by 100 · see citing works
Patient Satisfaction and its Relation to Perceived Visit Duration With a Hand Surgeon
Parrish, R. C., Menendez, M. E., Mudgal, C. S., Jupiter, J. B., Chen, N. C., & Ring, D. (2015) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2015.11.015 · Cited by 84 · see citing works
Waters, S., Edmondston, S. J., Yates, P., & Gucciardi, D. F. (2016) · Manual Therapy · doi:10.1016/j.math.2016.05.334 · Cited by 72 · see citing works
The Relation Between Perception and Behavior, or How to Win a Game of Trivial Pursuit
Dijksterhuis, A., & van Knippenberg, A. (2004) · Psychology Press eBooks · doi:10.4324/9780203496398-16 · Cited by 66 · see citing works
Macfarlane, F., Barton-Sweeney, C., Woodard, F., & Greenhalgh, T. (2013) · Social Science & Medicine · doi:10.1016/j.socscimed.2013.01.005 · Cited by 66 · see citing works
The Association of Patient Satisfaction with Pain, Anxiety, and Self-Reported Physical Function
Tyser, A. R., Gaffney, C. J., Zhang, C., & Presson, A. P. (2018) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.17.00372 · Cited by 58 · see citing works
Factors Associated With Patient Satisfaction
Vranceanu, A., & Ring, D. (2011) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2011.06.001 · Cited by 57 · see citing works
Abbreviated psychologic questionnaires are valid in patients with hand conditions
Bot, A. G. J., Becker, S. J. E., van Dijk, N. C., Ring, D., & Vranceanu, A.-M. (2013) · Clinical Orthopaedics & Related Research · doi:10.1007/s11999-013-3213-2 · Cited by 55 · see citing works
Time Seeing a Hand Surgeon Is Not Associated With Patient Satisfaction
Teunis, T., Thornton, E. R., Jayakumar, P., & Ring, D. (2014) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-014-4090-z · Cited by 51 · see citing works
Hageman, M. G. J. S., Briët, J. P., Bossen, J. K. J., Blok, R. D., Ring, D., & Vranceanu, A. (2014) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-014-3970-6 · Cited by 45 · see citing works
Patient Satisfaction in an Outpatient Hand Surgery Office
Menendez, M. E., Loeffler, M., & Ring, D. (2015) · Quality Management in Health Care · doi:10.1097/qmh.0000000000000074 · Cited by 38 · see citing works
Measurement of Perceived Physician Empathy in Orthopedic Patients
Keulen, M. H. F., Teunis, T., Kortlever, J. T. P., Vagner, G. A., Ring, D., & Reichel, L. M. (2019) · Journal of Patient Experience · doi:10.1177/2374373519875842 · Cited by 27 · see citing works
Influence of Priming on Patient-Reported Outcome Measures: A Randomized Controlled Trial.
Claessen, F., Mellema, J. J., Stoop, N., Lubberts, B., Ring, D., & Poolman, R. (2016) · Psychosomatics · doi:10.1016/j.psym.2015.09.005 · Cited by 26 · see citing works
Tongue, J. R., Epps, H. R., & Forese, L. L. (2005) · PubMed · Cited by 24 · see citing works
Constructions of patient agency in healthcare settings: Textual and patient perspectives
Hunter, J., Franken, M., & Balmer, D. (2015) · Discourse Context & Media · doi:10.1016/j.dcm.2015.01.002 · Cited by 23 · see citing works
Keulen, M. H. F., Teunis, T., Vagner, G. A., Ring, D., & Reichel, L. M. (2018) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2018.04.020 · Cited by 15 · see citing works
Mellema, J. J., O’Connor, C., Overbeek, C., Hageman, M., & Ring, D. (2015) · HAND · doi:10.1007/s11552-015-9742-2 · Cited by 11 · see citing works
Özkan, S., Claessen, F. M. A. P., Eberlin, K. R., Lee, S.-G. P., Ring, D., & Vranceanu, A. (2016) · Hand · doi:10.1177/1558944716681975 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Using a health equity lens to measure patient experiences of care in diverse health care settings
Browne, A. J., Varcoe, C., Ford-Gilboe, M., Wathen, C. N., Wilson, E., Bungay, V., & Perrin, N. (2024) · PLOS ONE · doi:10.1371/journal.pone.0297721 · Cited by 17 · see citing works
Caronni, A., Ramella, M., Arcuri, P., Salatino, C., Pigini, L., Saruggia, M., Folini, C., Scarano, S., & Converti, R. M. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20021036 · Cited by 14 · see citing works
Rose, A. L., Belus, J. M., Hines, A. C., Barrie, I., Regenauer, K. S., Andersen, L. S., Joska, J. A., Ciya, N., Ndamase, S., MYERS, B. J., et al. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.47 · Cited by 14 · see citing works
Rossano, A., Salman, A. A., Ring, D., Guzman, J. M., & Fatehi, A. (2021) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000002005 · Cited by 13 · see citing works
Self-citationA Systematic Review of Satisfaction Measures in Hand and Wrist Surgery
Wilson, C. D., Mand, D., Ring, D., & Ramtin, S. (2022) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2022.10.012 · Cited by 13 · see citing works
Walter, J. K., Madrigal, V., Shah, P., Kubis, S. E., Himebauch, A. S., & Feudtner, C. (2021) · Journal of Pediatric Intensive Care · doi:10.1055/s-0041-1740360 · Cited by 11 · see citing works
Virdun, C., Button, E., Phillips, J. L., Yates, P. M., & Luckett, T. (2023) · Palliative Medicine · doi:10.1177/02692163231209845 · Cited by 10 · see citing works
Universal pictures: A lithophane codex helps teenagers with blindness visualize nanoscopic systems
Alonzo, E. A., Lato, T. J., Gonzalez, M., Olson, T. L., Savage, Q. R., Garza, L. N., Green, M. T., Koone, J. C., Cook, N. E., Dashnaw, C. M., et al. (2024) · Science Advances · doi:10.1126/sciadv.adj8099 · Cited by 9 · see citing works
Ngcobo, B. C., & Bornman, J. (2024) · South African Journal of Education · doi:10.15700/saje.v44n3a2467 · Cited by 8 · see citing works
Porter, L. L., Simons, K. S., van der Hoeven, J. G., van den Boogaard, M., & Zegers, M. (2025) · Intensive Care Medicine · doi:10.1007/s00134-025-07812-5 · Cited by 11 · see citing works
Virdun, C., Button, E., Phillips, J. L., Saunders, C. H., Yates, P. M., & Luckett, T. (2024) · Palliative Medicine · doi:10.1177/02692163241291343 · Cited by 7 · see citing works
Charting a path to high‐quality end‐of‐life care for children with cancer
Ananth, P. J., Wolfe, J., & Johnston, E. E. (2022) · Cancer · doi:10.1002/cncr.34419 · Cited by 6 · see citing works
Jackson, L. E., Yazdany, J., Leach, J. M., Saag, K. G., Aaron, K., Curtis, J. R., Goglin, S. E., Margaretten, M. E., Chae, D. H., Paez, D., et al. (2025) · Annals of the Rheumatic Diseases · doi:10.1016/j.ard.2025.03.003 · Cited by 4 · see citing works
Cobos, F. M., Aguiar-Leiva, V. P., Argüello-Suárez, C., Colacicchi, P., Calleja-Cartón, L. A., & Leiva-Fernández, F. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13082281 · Cited by 4 · see citing works
Wiljén, A., Chaplin, J. E., Nilsson, S., Karlsson, K., Öhlén, J., & Schwarz, A. (2025) · European Journal of Pediatrics · doi:10.1007/s00431-025-05979-z · Cited by 3 · see citing works
Larsen, T., Sawatzky, R. G., Wijk, H., Wikström, E., & Wolf, A. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13178-7 · Cited by 3 · see citing works
Perspectives on implementing an ambulatory age-friendly health system pilot project
Vonnes, C., Gallenstein, D., Poiley, L., McDaniel, G. A., & Mason, T. M. (2022) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2022.06.012 · Cited by 3 · see citing works
Noor, N. M. M., Ibrahim, M. I., Hairon, S. M., Zain, M. M., & Satiman, M. S. N. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20021380 · Cited by 3 · see citing works
Neve, O. M., van Buchem, M. M., Kunneman, M., van Benthem, P. P. G., Boosman, H., & Hensen, E. F. (2023) · PEC Innovation · doi:10.1016/j.pecinn.2023.100204 · Cited by 3 · see citing works
Tacchini-Jacquier, N., Monnay, S., Coquoz, N., Bonvin, É., & Verloo, H. (2024) · JMIR Public Health and Surveillance · doi:10.2196/47465 · Cited by 2 · see citing works
Instruments evaluating the duration and pace of clinical encounters: A scoping review
Jacome, C. S., Suárez, N. R. E., Golembiewski, E. H., Gravholt, D., Crowley, A. P., Urtecho, M., León‐García, M., Mandhana, D. M., Ballard, D. I., Kunneman, M., et al. (2024) · Patient Education and Counseling · doi:10.1016/j.pec.2024.108591 · Cited by 2 · see citing works
Noor, N. M. M., Ibrahim, M. I., Hairon, S. M., Zain, M. M., & Satiman, M. S. N. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192013486 · Cited by 2 · see citing works
Ring, D. (2022) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000002113 · Cited by 1 · see citing works
Clinician Interruptions and Patient-Rated Clinician Empathy in Specialty Visits
Pierson, S. R., Lam, R., Ngoue, M., Rajagopalan, D., Ring, D., & Ramtin, S. (2023) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/jaaos-d-23-00071 · Cited by 1 · see citing works
Team-Based Care Model Improves Timely Access to Care and Patient Satisfaction in General Cardiology
Sharpe, C. M., & Eastham, L. (2023) · Journal for Healthcare Quality · doi:10.1097/jhq.0000000000000413 · Cited by 1 · see citing works
Noviyanti, A. A. V., & Antari, N. P. U. (2024) · JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) · doi:10.22146/jmpf.86099 · Cited by 1 · see citing works
Artiles, A. (2025) · American Politics Research · doi:10.1177/1532673x251382569 · Cited by 1 · see citing works
Jemere, D. M., Ratcliffe, J., Khadka, J., & Milte, R. (2025) · Quality of Life Research · doi:10.1007/s11136-025-04081-z · Cited by 1 · see citing works
Ghozali, M. T. (2023) · International Conference on Emerging Smart Technologies and Applications (eSmarTA) · doi:10.1109/esmarta59349.2023.10293383
Factors Associated with Outcome in Extremity Surgery
Salman, A. A. (2023) · doi:10.33612/diss.846875520
Self-citationMeasuring aversion to health inequality in Canada: an equity-efficiency trade-off experimentPreprint
Iragorri, N., Ali, S., Mishra, S., & Sander, B. (2024) · medRxiv · doi:10.1101/2024.09.27.24314482
Dintrans, P. V., Echeverría, A., & Inzunza, C. (2024) · Gerontology · doi:10.1159/000541754
Chuan, A., Hatty, M. A., Shelley, M., Wilson, A., Lan, A., & Bogdanovych, A. (2024) · Journal of Medical Extended Reality · doi:10.1089/jmxr.2024.0019
Fayinto, A. I., Okunade, K. S., PITAN, S., & Roberts, A. A. (2025) · Research Square · doi:10.21203/rs.3.rs-6649257/v1
Are Canadian Municipal Politics Ideological? Experimental Evidence from Canadian Municipal Officials
Artiles, A. (2025) · Urban Affairs Review · doi:10.1177/10780874251360597
Ferede, Y. M., Westerbotn, M., Gebrie, M. H., Beshah, D. T., & Erlandsson, K. (2026) · PLoS ONE · doi:10.1371/journal.pone.0329197
Bonafede, C., Plessis, A. D., van der Merwe, E., Coetzee, D., & Kramer, M. (2026) · South African Journal of Childhood Education · doi:10.4102/sajce.v16i1.1827
Mercadante, S., Ferrera, P., Settepani, S., & Cascio, A. L. (2026) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091261500128
ter Stege, M. H. P., Luong, K. P., Slijper, H. P., & Selles, R. W. (2026) · BMJ Open Quality · doi:10.1136/bmjoq-2026-004294
- Authors
- Salman, A. A., Kopp, B. J., Thomas, J. E., Ring, D., & Fatehi, A.
- Affiliations
- The University of Texas at Austin (US)
- Corresponding author
- Ring, David
- Venue
- Journal of Patient Experience
- Publisher
- SAGE Publications
- Published
- 2020-08-31
- Volume
- 7
- Issue
- 6
- Pages
- 1755-1759
- ISSN
- 2374-3735 (ISSN-L)
- 2374-3743
- PMC
- PMC7786675
- OpenAlex
- W3082095671
- Cited by
- 40
- References
- 37
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 11 · 2023: 8 · 2022: 7 · 2021: 2
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Patient Experience (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Keywords
- ceiling effect, patient-reported experience measures, Guttman scale, response priming, patient satisfaction, ordinal scale, patient agency, response distribution
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
