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A methodological framework for assessing health indices.

B Kirshner, G Guyatt

    Journal of Chronic Diseases
    |January 1, 1985
    PubMed
    Summary
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    Developing quality of life instruments requires careful consideration of their intended use. The purpose—discriminating, predicting, or evaluating change—significantly impacts choices in instrument construction, often creating competing requirements.

    Area of Science:

    • Clinical Medicine
    • Social Sciences
    • Health Outcomes Research

    Background:

    • Measurement instruments in medicine and social sciences serve critical roles.
    • These instruments are used for subject discrimination, prognosis prediction, and evaluating changes over time.
    • Quality of life indices are key tools in assessing patient well-being and treatment effectiveness.

    Purpose of the Study:

    • To explore how the intended purpose of a quality of life instrument influences its development.
    • To highlight the competing requirements for instruments designed for discrimination, prediction, and evaluation.
    • To guide researchers in selecting and developing appropriate quality of life measures.

    Main Methods:

    • Examined the stages of quality of life index development: item pool selection, scaling, reduction, reliability, validity, and responsiveness.

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  • Analyzed the implications of instrument purpose on decision-making at each developmental stage.
  • Identified areas where requirements for different purposes conflict.

    • Main Results:

    • The purpose of an instrument (discriminative, predictive, or evaluative) dictates specific choices during development.
    • Requirements for different instrument purposes are often competing, not complementary.
    • Developmental stages like item selection and validation show significant divergence based on intended use.

    Conclusions:

    • Explicitly considering the instrument's purpose is crucial for both developers and users of quality of life measures.
    • Understanding competing requirements aids in creating more robust and appropriate health outcome instruments.
    • This focus enhances the clarity and utility of quality of life assessments in clinical research.