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Extending basic principles of measurement models to the design and validation of Patient Reported Outcomes.

Atkinson MJ, Lennox RD - Health Qual Life Outcomes (2006)

Bottom Line: In their article, they propose a number of validation and performance criteria with which to evaluate such self-report measures.We provide an alternate, yet complementary, perspective by extending the types of measurement models which are available to the instrument designer.Specification of the measurement model has a major influence on decisions about item and scale design, the appropriate application of statistical validation methods, and the suitability of the resulting measure for a particular use in clinical and population-based outcomes research activities.

View Article: PubMed Central - HTML - PubMed

Affiliation: Worldwide Health Outcomes Research, La Jolla Laboratories, Pfizer Inc., San Diego, CA 92121, USA. mjatkinson@ucsd.edu

ABSTRACT
A recently published article by the Scientific Advisory Committee of the Medical Outcomes Trust presents guidelines for selecting and evaluating health status and health-related quality of life measures used in health outcomes research. In their article, they propose a number of validation and performance criteria with which to evaluate such self-report measures. We provide an alternate, yet complementary, perspective by extending the types of measurement models which are available to the instrument designer. During psychometric development or selection of a Patient Reported Outcome measure it is necessary to determine which, of the five types of measurement models, the measure is based on; 1) a Multiple Effect Indicator model, 2) a Multiple Cause Indicator model, 3) a Single Item Effect Indicator model, 4) a Single Item Cause Indicator model, or 5) a Mixed Multiple Indicator model. Specification of the measurement model has a major influence on decisions about item and scale design, the appropriate application of statistical validation methods, and the suitability of the resulting measure for a particular use in clinical and population-based outcomes research activities.

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A general rating scale of 'Current Health' used in the Health Assessment Questionnaire.
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Figure 3: A general rating scale of 'Current Health' used in the Health Assessment Questionnaire.

Mentions: Many PRO measures include a generally worded single item indicator measure instead of, or in addition to, using a multiple item scale. An example of a generally worded SEI indicator of current 'Health' is included in the Health Assessment Questionnaire (see Figure 3). Whether used knowingly or unknowingly, the use of general wording is one way to reduce the unexplained variance across heterogeneous samples, since ratings of more specifically worded items is influenced to a greater extent by individual differences and situational characteristics than ratings of generally worded content. Generally worded items allow respondents the freedom to interpret the meaning of a question and provide ratings based on their own unique experiences and life circumstances. This permits estimation of a general construct over very different observational contexts and respondent groups, since the much of the conditional variance remains essentially unaddressed or inferred [19]. We will return to this point when discussing the activities associated with item design and content validation using various measurement models in Part II of this commentary.


Extending basic principles of measurement models to the design and validation of Patient Reported Outcomes.

Atkinson MJ, Lennox RD - Health Qual Life Outcomes (2006)

A general rating scale of 'Current Health' used in the Health Assessment Questionnaire.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1590011&req=5

Figure 3: A general rating scale of 'Current Health' used in the Health Assessment Questionnaire.
Mentions: Many PRO measures include a generally worded single item indicator measure instead of, or in addition to, using a multiple item scale. An example of a generally worded SEI indicator of current 'Health' is included in the Health Assessment Questionnaire (see Figure 3). Whether used knowingly or unknowingly, the use of general wording is one way to reduce the unexplained variance across heterogeneous samples, since ratings of more specifically worded items is influenced to a greater extent by individual differences and situational characteristics than ratings of generally worded content. Generally worded items allow respondents the freedom to interpret the meaning of a question and provide ratings based on their own unique experiences and life circumstances. This permits estimation of a general construct over very different observational contexts and respondent groups, since the much of the conditional variance remains essentially unaddressed or inferred [19]. We will return to this point when discussing the activities associated with item design and content validation using various measurement models in Part II of this commentary.

Bottom Line: In their article, they propose a number of validation and performance criteria with which to evaluate such self-report measures.We provide an alternate, yet complementary, perspective by extending the types of measurement models which are available to the instrument designer.Specification of the measurement model has a major influence on decisions about item and scale design, the appropriate application of statistical validation methods, and the suitability of the resulting measure for a particular use in clinical and population-based outcomes research activities.

View Article: PubMed Central - HTML - PubMed

Affiliation: Worldwide Health Outcomes Research, La Jolla Laboratories, Pfizer Inc., San Diego, CA 92121, USA. mjatkinson@ucsd.edu

ABSTRACT
A recently published article by the Scientific Advisory Committee of the Medical Outcomes Trust presents guidelines for selecting and evaluating health status and health-related quality of life measures used in health outcomes research. In their article, they propose a number of validation and performance criteria with which to evaluate such self-report measures. We provide an alternate, yet complementary, perspective by extending the types of measurement models which are available to the instrument designer. During psychometric development or selection of a Patient Reported Outcome measure it is necessary to determine which, of the five types of measurement models, the measure is based on; 1) a Multiple Effect Indicator model, 2) a Multiple Cause Indicator model, 3) a Single Item Effect Indicator model, 4) a Single Item Cause Indicator model, or 5) a Mixed Multiple Indicator model. Specification of the measurement model has a major influence on decisions about item and scale design, the appropriate application of statistical validation methods, and the suitability of the resulting measure for a particular use in clinical and population-based outcomes research activities.

Show MeSH
Related in: MedlinePlus