Measurement in Medicine: A Practical Guide

The success of the Apgar score demonstrates the astounding power of an appropriate clinical instrument. This down-to-earth book provides practical advice, underpinned by theoretical principles, on developing and evaluating measurement instruments in all fields of medicine. It equips you to choose the most appropriate instrument for specific purposes. The book covers measurement theories, methods and criteria for evaluating and selecting instruments. It provides methods to assess measurement properties, such as reliability, validity and responsiveness, and interpret the results. Worked examples and end-of-chapter assignments use real data and well-known instruments to build your skills at implementation and interpretation through hands-on analysis of real-life cases. All data and solutions are available online. This is a perfect course book for students and a perfect companion for professionals/researchers in the medical and health sciences who care about the quality and meaning of the measurements they perform.

Henrica C. W. de Vet is Professor of Clinimetrics in the Department of Epidemiology and Biostatistics, and the EMGO Institute for Health and Care Research at VU University Medical Center, Amsterdam. Caroline B. Terwee is Assistant Professor of Clinimetrics in the Department of Epidemiology and Biostatistics, and the EMGO Institute for Health and Care Research at VU University Medical Center, Amsterdam. Lidwine B. Mokkink is Research Fellow in the Department of Epidemiology and Biostatistics, and the EMGO Institute for Health and Care Research at VU University Medical Center, Amsterdam. Dirk L. Knol is Assistant Professor of Statistics in the Department of Epidemiology and Biostatistics, and the EMGO Institute for Health and Care Research at VU University Medical Center, Amsterdam.

Preface	p. ix
Introduction	p. 1
Why this textbook on measurement in medicine?	p. 1
Clinimetrics versus psychometrics	p. 2
Terminology and definitions	p. 2
Scope of measurements in medicine	p. 3
For whom is this book written?	p. 4
Structure of the book	p. 5
Examples, data sets, software and assignments	p. 6
Concepts, theories and models, and types of measurements	p. 7
Introduction	p. 7
Conceptual models	p. 7
Characteristics of measurements	p. 10
Conceptual framework: reflective and formative models	p. 13
Measurement theories	p. 17
Summary	p. 26
Development of a measurement instrument	p. 30
Introduction	p. 30
Definition and elaboration of the construct to be measured	p. 33
Choice of measurement method	p. 35
Selecting items	p. 37
Scores for items	p. 46
Scores for scales and indexes	p. 49
Pilot-testing	p. 57
Summary	p. 60
Field-testing: item reduction and data structure	p. 65
Introduction	p. 65
Examining the item scores	p. 66
Importance of the items	p. 70
Examining the dimensionality of the data: factor analysis	p. 71
Internal consistency	p. 80
Examining the items in a scale with item response theory	p. 84
Field-testing as part of a clinical study	p. 91
Summary	p. 92
Reliability	p. 96
Introduction	p. 96
Example	p. 98
The concept of reliability	p. 98
Parameters for continuous variables	p. 103
Parameters for categorical variables	p. 115
Interpretation of the parameters	p. 120
Which parameter to use in which situation?	p. 123
Design of simple reliability studies	p. 124
Sample size for reliability studies	p. 126
Design of reliability studies for more complex situations	p. 128
Generalizability and decision studies	p. 131
Cronbach's alpha as a reliability parameter	p. 137
Reliability parameters and measurement error obtained by item response theory analysis	p. 139
Reliability and computer adaptive testing	p. 141
Reliability at group level and individual level	p. 142
Improving the reliability of measurements	p. 144
Summary	p. 145
Validity	p. 150
Introduction	p. 150
The concept of validity	p. 151
Content validity (including face validity)	p. 154
Criterion validity	p. 159
Construct validity	p. 169
Validation in context	p. 191
Summary	p. 196
Responsiveness	p. 202
Introduction	p. 202
The concept of responsiveness	p. 203
Criterion approach	p. 206
Construct approach	p. 211
Inappropriate measures of responsiveness	p. 215
Other design issues	p. 220
Summary	p. 221
Interpretability	p. 227
Introduction	p. 227
The concept of interpretability	p. 228
Distribution of scores of the instrument	p. 228
Interpretation of single scores	p. 235
Interpretation of change scores	p. 241
Summary	p. 268
Systematic reviews of measurement properties	p. 275
Introduction	p. 275
Research question	p. 276
Literature search	p. 278
Eligibility criteria	p. 282
Selection of articles	p. 283
Evaluation of the methodological quality of the included studies	p. 284
Data extraction	p. 291
Content comparison	p. 294
Data synthesis: evaluation of the evidence for adequacy of the measurement properties	p. 296
Overall conclusions of the systematic review	p. 300
Report on a systematic review of measurement properties	p. 302
State of affairs	p. 309
Comprehensiveness of systematic reviews of measurement properties	p. 310
Summary	p. 311
References	p. 315
Index	p. 328
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