title: Extending basic principles of measurement models to the design and validation of Patient Reported Outcomes.
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.
authors.affiliation: Worldwide Health Outcomes Research, La Jolla Laboratories, Pfizer Inc., San Diego, CA 92121, USA. mjatkinson@ucsd.edu
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Atkinson
authors.forename: Richard D
authors.initials: RD
authors.lastname: Lennox
mesh_terms: D017408:Guidelines as Topic; D006801:Humans; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017060:Patient Satisfaction; D011594:Psychometrics / Q000295:instrumentation* / Q000379:methods; D019984:Quality Indicators, Health Care; D011788:Quality of Life / Q000523:psychology*; D012107:Research Design; D011795:Surveys and Questionnaires