Psychometric considerations in evaluating health-related quality of life measures
Abstract
How does one determine if a measure of health-related quality of life (HRQL) is adequate for clinical trials? Psychometric methods are frequently used to answer this question. What is psychometrics all about? In this paper we address these questions, discussing common psychometric evaluation procedures applied to HRQL measures. Specifically, we discuss issues regarding the evaluation of reliability and validity (including responsiveness).
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The quality of a questionnaire to assess health-related quality of life depends on fulfillment of psychometric criteria including objectivity, reliability, validity, and responsiveness to change.
“The quality of a questionnaire to assess health-related QoL depends on the fulfillment of psychometric criteria. These include, in addition to objectivity, the reliability of the instrument as well as its validity, and for evaluative purposes, its responsiveness to change.”
From Quality of life as patient-reported outcomes: principles of assessment (2014) · cites this paper as [13]
Cites
Coefficient Alpha and the Internal Structure of Tests
Cronbach, L. J. (1951) · Psychometrika · doi:10.1007/bf02310555 · Cited by 43,931 · see citing works
(1992) · PubMed · Cited by 33,716 · see citing works
The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection
Ware, J. E., & Sherbourne, C. D. (1992) · Medical Care · doi:10.1097/00005650-199206000-00002 · Cited by 30,033 · see citing works
Intraclass correlations: Uses in assessing rater reliability.
Shrout, P. E., & Fleiss, J. L. (1979) · Psychological Bulletin · doi:10.1037/0033-2909.86.2.420 · Cited by 23,433 · see citing works
The meaning and use of the area under a receiver operating characteristic (ROC) curve.
Hanley, J. A., & McNeil, B. J. (1982) · Radiology · doi:10.1148/radiology.143.1.7063747 · Cited by 21,856 · see citing works
Convergent and discriminant validation by the multitrait-multimethod matrix.
Campbell, D. T., & Fiske, D. W. (1959) · Psychological Bulletin · doi:10.1037/h0046016 · Cited by 17,116 · see citing works
Psychometric theory (2nd ed.).
Sitgreaves, R. (1979) · Contemporary Psychology · doi:10.1037/018882 · Cited by 14,384 · see citing works
Construct validity in psychological tests.
Cronbach, L. J., & Meehl, P. E. (1955) · Psychological Bulletin · doi:10.1037/h0040957 · Cited by 11,195 · see citing works
Hanley, J. A., & McNeil, B. J. (1983) · Radiology · doi:10.1148/radiology.148.3.6878708 · Cited by 7,016 · see citing works
Kushner (2021) · doi:10.12788/jfp · Cited by 3,799 · see citing works
The rand 36‐item health survey 1.0
Hays, R. D., Sherbourne, C. D., & Mazel, R. M. (1993) · Health Economics · doi:10.1002/hec.4730020305 · Cited by 2,893 · see citing works
Self-citationMeasuring Functioning and Well-Being: The Medical Outcomes Study Approach
Stewart, A., & Ware, J. (1992) · doi:10.7249/cb361 · Cited by 2,689 · see citing works
Effect Sizes for Interpreting Changes in Health Status
Kazis, L. E., Anderson, J. J., & Meenan, R. F. (1989) · Medical Care · doi:10.1097/00005650-198903001-00015 · Cited by 2,401 · see citing works
Cross-Cultural Research Methods
Brislin, R. W. (1980) · Environment and Culture · doi:10.1007/978-1-4899-0451-5_3 · Cited by 2,067 · see citing works
Measuring change over time: assessing the usefulness of evaluative instruments.
Guyatt, G., Walter, S. D., & Norman, G. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90069-5 · Cited by 1,997 · see citing works
Short form 36 (SF36) health survey questionnaire: normative data for adults of working age.
Jenkinson, C., Coulter, A., & Wright, L. (1993) · BMJ · doi:10.1136/bmj.306.6890.1437 · Cited by 1,714 · see citing works
Deyo, R. A., Diehr, P. H., & Patrick, D. L. (1991) · Controlled Clinical Trials · doi:10.1016/s0197-2456(05)80019-4 · Cited by 1,369 · see citing works
Measurement in Cross-Cultural Psychology
Hui, C.-C. H., & Triandis, H. C. (1985) · Journal of Cross-Cultural Psychology · doi:10.1177/0022002185016002001 · Cited by 1,092 · see citing works
Utility of confirmatory factor analysis in test validation research.
Cole, D. A. (1987) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.55.4.584 · Cited by 1,089 · see citing works
A Clinician's Guide to Cost-Effectiveness Analysis
Detsky, A. S., & Naglie, I. G. (1990) · Annals of Internal Medicine · doi:10.7326/0003-4819-113-2-147 · Cited by 707 · see citing works
Liang, M. H., Larson, M. G., Cullen, K. E., & Schwartz, J. A. (1985) · Arthritis & Rheumatism · doi:10.1002/art.1780280513 · Cited by 587 · see citing works
Analysis of the multitrait-multimethod matrix by confirmatory factor analysis.
Kenny, D. A., & Kashy, D. A. (1992) · Psychological Bulletin · doi:10.1037/0033-2909.112.1.165 · Cited by 554 · see citing works
Statistical Inference for Coefficient Alpha
Feldt, L. S., Woodruff, D. J., & Salih, F. A. (1987) · Applied Psychological Measurement · doi:10.1177/014662168701100107 · Cited by 526 · see citing works
Confirmatory Factor Analyses of Multitrait-Multimethod Data: Many Problems and a Few Solutions
Marsh, H. W. (1989) · Applied Psychological Measurement · doi:10.1177/014662168901300402 · Cited by 505 · see citing works
Cross-cultural Research Methods
van de Vijver, F. J. R. (2001) · Elsevier eBooks · doi:10.1016/b0-08-043076-7/00753-1 · Cited by 456 · see citing works
Bravo, G., & Potvin, L. (1991) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(91)90076-l · Cited by 316 · see citing works
The Functional Status of Patients
Nelson, E. C., Landgraf, J. M., Hays, R. D., Wasson, J. H., & Kirk, J. W. (1990) · Medical Care · doi:10.1097/00005650-199012000-00001 · Cited by 302 · see citing works
Self-citationHays, R. D., & Hayashi, T. (1990) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03203140 · Cited by 287 · see citing works
Self-citationResponsiveness to change: an aspect of validity, not a separate dimension
Hays, R. D., & Hadorn, D. C. (1992) · Quality of Life Research · doi:10.1007/bf00435438 · Cited by 277 · see citing works
Self-citationQuality of Life and Antihypertensive Therapy in Men -- A Comparison of Captopril with Enalapril
Testa, M. A., Anderson, R. B., Nackley, J. F., & Hollenberg, N. K. (1993) · New England Journal of Medicine · doi:10.1056/nejm199304013281302 · Cited by 262 · see citing works
Self-citationHornberger, J. C., Redelmeier, D. A., & Petersen, J. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90099-9 · Cited by 209 · see citing works
Methodology for measuring health-state preferences—III: Population and context effects
Froberg, D. G., & Kane, R. L. (1989) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(89)90155-8 · Cited by 204 · see citing works
Bucquet, D., Condon, S., & Ritchie, K. A. (1990) · Social Science & Medicine · doi:10.1016/0277-9536(90)90207-9 · Cited by 182 · see citing works
Can the Sickness Impact Profile measure change? An example of scale assessment
MacKenzie, C. R., Charlson, M. E., DiGioia, D., & Kelley, K. (1986) · Journal of Chronic Diseases · doi:10.1016/0021-9681(86)90110-4 · Cited by 172 · see citing works
Vickrey, B. G., Hays, R. D., Rausch, R., Sutherling, W. W., Engel, J., & Brook, R. H. (1994) · Epilepsia · doi:10.1111/j.1528-1157.1994.tb02480.x · Cited by 160 · see citing works
Self-citationThe structure of self-reported health in chronic disease patients.
Hays, R. D., & Stewart, A. L. (1990) · Psychological Assessment: A Journal of Consulting and Clinical Psychology · doi:10.1037/1040-3590.2.1.22 · Cited by 159 · see citing works
Self-citationSummary and Discussion of MOS Measures
Stewart, A., Sherbourne, C. D., Hays, R. D., Wells, K. B., Nelson, E. C., KAMBERG, C. J., Rogers, W. H., Berry, S. H., & Ware, J. E. (1992) · Cited by 131 · see citing works
Self-citationA cross-cultural comparison of health status values.
Patrick, D. L., Sittampalam, Y., Somerville, S. M., Carter, W. B., & Bergner, M. (1985) · American Journal of Public Health · doi:10.2105/ajph.75.12.1402 · Cited by 118 · see citing works
Bozzette, S. A., Hays, R. D., Berry, S. H., & Kanouse, D. E. (1994) · Medical Care · doi:10.1097/00005650-199407000-00005 · Cited by 74 · see citing works
Self-citationMultitrait-Multimethod Analysis of Health-Related Quality-of-Life Measures
Hadorn, D. C., & Hays, R. D. (1991) · Medical Care · doi:10.1097/00005650-199109000-00004 · Cited by 73 · see citing works
Self-citationCross-cultural issues in the use of socio-medical indicators
Hunt, S. M. (1986) · Health Policy · doi:10.1016/0168-8510(86)90004-7 · Cited by 70 · see citing works
Influence of Age on Measurement of Health Status in Patients Undergoing Elective Surgery
Mangione, C. M., Marcantonio, E. R., Goldman, L., et al. (1993) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1993.tb06944.x · Cited by 63 · see citing works
Multidimensionality of Health Status in an Elderly Population
Hall, J. A., Epstein, A. M., & McNeil, B. J. (1989) · Medical Care · doi:10.1097/00005650-198903001-00014 · Cited by 56 · see citing works
Detecting cross-cultural commonalities and differences: Intergroup factor analysis.
Buss, A. R., & Royce, J. R. (1975) · Psychological Bulletin · doi:10.1037/h0076156 · Cited by 53 · see citing works
Revicki, D. A., Turner, R., Brown, R. E., & Martindale, J. J. (1992) · Quality of Life Research · doi:10.1007/bf00435635 · Cited by 46 · see citing works
Self-citationSensitivity to Change and the Effect of Mode of Administration on Health Status Measurement
Chambers, L. W., Haight, M. E., Norman, G., & Macdonald, L. A. (1987) · Medical Care · doi:10.1097/00005650-198706000-00002 · Cited by 44 · see citing works
Measuring Functioning and Health in the Very Old
Siu, A. L., Hays, R. D., Ouslander, J. G., Osterwell, D., Valdez, R. B., Krynski, M. D., & Gross, A. (1993) · Journal of Gerontology · doi:10.1093/geronj/48.1.m10 · Cited by 37 · see citing works
Self-citationChange in self-reported functioning in older persons entering a residential care facility
Siu, A. L., Ouslander, J. G., Osterweil, D. G., Reuben, D. B., & Hays, R. D. (1993) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(93)90108-d · Cited by 36 · see citing works
Self-citationThe ?states versus weights? dilemma in quality of life measurement
Hays, R. D., Stewart, A. L., Sherbourne, C. D., & Marshall, G. N. (1993) · Quality of Life Research · doi:10.1007/bf00435220 · Cited by 33 · see citing works
Self-citationA microcomputer program for analyzing multitrait-multimethod matrices
Hayashi, T., & Hays, R. D. (1987) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03202573 · Cited by 33 · see citing works
Self-citationComparing Factor Trait and State Scores Across Ages and Cultures
Cattell, R. B. (1969) · Journal of Gerontology · doi:10.1093/geronj/24.3.348 · Cited by 33 · see citing works
Wells, K. B. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810040021004 · Cited by 27 · see citing works
Revicki, D. A., Allen, H. M., Jr., Bungay, K. M., et al. (1994) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(94)90077-9 · Cited by 22 · see citing works
Self-citationComparative research in social epidemiology: measurement issues.
Dressler, W. W., Viteri, F. E., Chávez, A. C. F., et al. (1991) · PubMed · Cited by 22 · see citing works
Repeatability of automated ambulatory blood pressure measurements.
Prisant, L. M., Carr, A. A., Bottini, P. B., et al. (1992) · PubMed · Cited by 16 · see citing works
Wells, K. B., Manning, W. G., & Valdez, R. B. (1989) · Cited by 2 · see citing works
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Varni, J. W., Seid, M., & Kurtin, P. S. (2001) · Medical Care · doi:10.1097/00005650-200108000-00006 · Cited by 5,131 · see citing works
Individual-patient monitoring in clinical practice: are available health status surveys adequate?
McHorney, C. A., & Tarlov, A. R. (1995) · Quality of Life Research · doi:10.1007/bf01593882 · Cited by 2,206 · see citing works
Evaluating patient-based outcome measures for use in clinical trials.
Fitzpatrick, Davey, Buxton, & Jones (1998) · Health Technology Assessment · doi:10.3310/hta2140 · Cited by 1,715 · see citing works
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Eiser, C., & Morse, R. (2001) · Health Technology Assessment · doi:10.3310/hta5040 · Cited by 872 · see citing works
Hilari, K., Byng, S., Lamping, D. L., & Smith, S. C. (2003) · Stroke · doi:10.1161/01.str.0000081987.46660.ed · Cited by 509 · see citing works
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Leentjens, A. F. G., Dujardin, K., Pontone, G. M., Starkstein, S. E., Weintraub, D., & Martinez‐Martin, P. (2014) · Movement Disorders · doi:10.1002/mds.25919 · Cited by 270 · see citing works
Psychometric Comparison of the Standard EQ-5D to a 5 Level Version in Cancer Patients
Pickard, A. S., De Leon, M. C., Kohlmann, T., Cella, D., & Rosenbloom, S. (2007) · Medical Care · doi:10.1097/01.mlr.0000254515.63841.81 · Cited by 259 · see citing works
Boyle, M. H., Furlong, W., Feeny, D., Torrance, G. W., & Hatcher, J. (1995) · Quality of Life Research · doi:10.1007/bf02260864 · Cited by 194 · see citing works
Apolone, G., Filiberti, A., Cifani, S., Ruggiata, R., & Mosconi, P. (1998) · Annals of Oncology · doi:10.1023/a:1008264412398 · Cited by 189 · see citing works
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Bullinger, M., & Quitmann, J. (2014) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2014.16.2/mbullinger · Cited by 158 · see citing works
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Eisen, S. V., Ranganathan, G., Seal, P., & Spiro, A. (2007) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-007-9066-2 · Cited by 126 · see citing works
Cane, D., Nielson, W. R., McCarthy, M., & Mazmanian, D. (2013) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e31825e452f · Cited by 89 · see citing works
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- Authors
- Hays, R. D., Anderson, R., & Revicki, D.
- Affiliations
- RAND Corporation (US)
- Atrium Health Wake Forest Baptist (US)
- Battelle (US)
- Venue
- Quality of Life Research
- Published
- 1993-12
- Volume
- 2
- Issue
- 6
- Pages
- 441-449
- ISSN
- 0962-9343 (ISSN-L)
- 1573-2649
- OpenAlex
- W1995509648
- Cited by
- 513
- References
- 56
- Citations by year
- 2026: 4 · 2025: 14 · 2024: 10 · 2023: 19 · 2022: 21 · 2021: 15 · 2020: 20 · 2019: 23 · 2018: 12 · 2017: 14 · 2016: 18 · 2015: 25 · 2014: 18 · 2013: 23 · 2012: 28
- FWCI
- 6.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Quality of Life Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Education › Health Education and Validation
- Keywords
- health-related quality of life, psychometric assessment, reliability statistics, validity, responsiveness, clinical trials, patient-reported outcome measures
- MeSH terms
- Cross-Cultural Comparison, Health Surveys, Humans, Psychometrics, Quality of Life, Surveys and Questionnaires, Reproducibility of Results
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