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.
Similar content being viewed by others
Further reading
Aday LA. Designing and Conducting Health Surveys: A Comprehensive Guide. 2nd edn., San Francisco, Calif.: Jossey-Bass, 1996.
American Psychological Association. Standards for Educational and Psychological Testing. Washington, DC: APA, 1985.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-310.
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.
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.
Bowling A. Measuring Health: A Review of Quality of Life Measurement Scales. 2nd edn., London: Open University Press, 1997.
Carmines E. Reliability and Validity Assessment. Newbury Park, Calif.: Sage Publications. 1997.
Cronbach LJ. Essentials of Psychological Testing. 4th edn., New York: Harper and Row. 1984.
Cronbach LJ. Coefficient alpha and the internal structure of tests.Psychometrika 1951; 16: 297-334.
Devellis R. Scale Development: Theory and Applications. Vol.26. Applied Social Research Methods Series. Newbury Park, Calif.: Sage Publications, 1991.
Hambleton RK, Swaminathan H, Rogers HJ. Fundamentals of Item Response Theory. Newbury Park, Calif.: Sage Publications, 1991.
Lohr KN. Health outcomes methodology symposium. Summary and recommendations. Med. Care 2000; 38 (9) (Suppl.II):II194-II208.
Lord FM, Norvick MR. Statistical Theories of Mental Test Scores. Reading, Mass.: Addison-Wesley, 1968.
McDonald RP. Test Theory: A Unified Treatment. Mahwah, NJ: Lawrence Erlbaum Associates, 1999.
McDowell I, Newell C. Measuring Health. A Guide to Rating Scales and Questionnaires. 2nd edn., New York: Oxford University Press, 1996.
McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: Are available health surveys adequate? Qual Life Res 1995; 4: 293-307.
Nunnally JC, Bernstern IH. Psychometric Theory. 3rd edn., New York: McGraw-Hill, 1994.
Payne SL. The Art of Asking Questions. Princeton, NJ: Princeton University Press, 1951.
Patrick DL, Chiang Y-P. (eds) Health outcomes methodology symposium. Med Care 2000; 38 (9) (Suppl.II): II3-II208.
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.
Staquet M, Hays R, Fayers P. Quality of Life Assessment in Clinical Trials: Methods and Practice. New York: Oxford University Press, 1998.
Streiner DL, Norman GR. Health Measurement Scales. 2nd edn., Oxford: Oxford University Press, 1995.
Wainer H, Dorans NJ, Flaugher R, et al. Computerized Adaptive Testing: A Primer. Mahwah, NJ: Lawrence Erlbaum Associates, 1990.
Wilkin D, Hallam L, Doggett MA. Measures of Need and Outcome for Primary Health Care. New York: Oxford University Press, 1992.
Author information
Authors and Affiliations
Corresponding author
Rights 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
Issue Date:
DOI: https://doi.org/10.1023/A:1015291021312