Skip to main content
Log in

Assessing health status and quality-of-life instruments: Attributes and review criteria

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

The field of health status and quality of life (QoL) measurement – as a formal discipline with a cohesive theoretical framework, accepted methods, and diverse applications – has been evolving for the better part of 30 years. To identify health status and QoL instruments and review them against rigorous criteria as a precursor to creating an instrument library for later dissemination, the Medical Outcomes Trust in 1994 created an independently functioning Scientific Advisory Committee (SAC). In the mid-1990s, the SAC defined a set of attributes and criteria to carry out instrument assessments; 5 years later, it updated and revised these materials to take account of the expanding theories and technologies upon which such instruments were being developed. This paper offers the SAC's current conceptualization of eight key attributes of health status and QoL instruments (i.e., conceptual and measurement model; reliability; validity; responsiveness; interpretability; respondent and administrative burden; alternate forms; and cultural and language adaptations) and the criteria by which instruments would be reviewed on each of those attributes. These are suggested guidelines for the field to consider and debate; as measurement techniques become both more familiar and more sophisticated, we expect that experts will wish to update and refine these criteria accordingly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Further reading

  1. Aday LA. Designing and Conducting Health Surveys: A Comprehensive Guide. 2nd edn., San Francisco, Calif.: Jossey-Bass, 1996.

    Google Scholar 

  2. American Psychological Association. Standards for Educational and Psychological Testing. Washington, DC: APA, 1985.

    Google Scholar 

  3. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-310.

    Google Scholar 

  4. Bjorner JB, Thunedborg K, Kristensen TS, Modvig J, Bech P. The Danish SF-36 health survey: Translation and preliminary validity studies. J Clin Epidemiol 1998; 51; 991-999.

    Google Scholar 

  5. Bjorner JB, Kreiner S, Ware JE Jr, Damsgaard MT, Bech P. Different ial item functioning in the Danish translation of the SF-36. J Clin Epidemiol 1998; 51: 1189-1202.

    Google Scholar 

  6. Bowling A. Measuring Health: A Review of Quality of Life Measurement Scales. 2nd edn., London: Open University Press, 1997.

    Google Scholar 

  7. Carmines E. Reliability and Validity Assessment. Newbury Park, Calif.: Sage Publications. 1997.

    Google Scholar 

  8. Cronbach LJ. Essentials of Psychological Testing. 4th edn., New York: Harper and Row. 1984.

    Google Scholar 

  9. Cronbach LJ. Coefficient alpha and the internal structure of tests.Psychometrika 1951; 16: 297-334.

    Google Scholar 

  10. Devellis R. Scale Development: Theory and Applications. Vol.26. Applied Social Research Methods Series. Newbury Park, Calif.: Sage Publications, 1991.

    Google Scholar 

  11. Hambleton RK, Swaminathan H, Rogers HJ. Fundamentals of Item Response Theory. Newbury Park, Calif.: Sage Publications, 1991.

    Google Scholar 

  12. Lohr KN. Health outcomes methodology symposium. Summary and recommendations. Med. Care 2000; 38 (9) (Suppl.II):II194-II208.

    Google Scholar 

  13. Lord FM, Norvick MR. Statistical Theories of Mental Test Scores. Reading, Mass.: Addison-Wesley, 1968.

    Google Scholar 

  14. McDonald RP. Test Theory: A Unified Treatment. Mahwah, NJ: Lawrence Erlbaum Associates, 1999.

    Google Scholar 

  15. McDowell I, Newell C. Measuring Health. A Guide to Rating Scales and Questionnaires. 2nd edn., New York: Oxford University Press, 1996.

    Google Scholar 

  16. McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: Are available health surveys adequate? Qual Life Res 1995; 4: 293-307.

    Google Scholar 

  17. Nunnally JC, Bernstern IH. Psychometric Theory. 3rd edn., New York: McGraw-Hill, 1994.

    Google Scholar 

  18. Payne SL. The Art of Asking Questions. Princeton, NJ: Princeton University Press, 1951.

    Google Scholar 

  19. Patrick DL, Chiang Y-P. (eds) Health outcomes methodology symposium. Med Care 2000; 38 (9) (Suppl.II): II3-II208.

  20. Reise SP, Widaman KF, Pugh RH. Confirmatory factor analysis and item response theory: Two approaches for exploring measurement invariance. Psychol Bull 1993; 114: 552-566.

    Google Scholar 

  21. Staquet M, Hays R, Fayers P. Quality of Life Assessment in Clinical Trials: Methods and Practice. New York: Oxford University Press, 1998.

    Google Scholar 

  22. Streiner DL, Norman GR. Health Measurement Scales. 2nd edn., Oxford: Oxford University Press, 1995.

    Google Scholar 

  23. Wainer H, Dorans NJ, Flaugher R, et al. Computerized Adaptive Testing: A Primer. Mahwah, NJ: Lawrence Erlbaum Associates, 1990.

    Google Scholar 

  24. Wilkin D, Hallam L, Doggett MA. Measures of Need and Outcome for Primary Health Care. New York: Oxford University Press, 1992.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kathleenl N. Lohr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lohr, K.N. Assessing health status and quality-of-life instruments: Attributes and review criteria. Qual Life Res 11, 193–205 (2002). https://doi.org/10.1023/A:1015291021312

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1015291021312

Navigation