In the clinical setting, PROs are used to support clinicians to make decisions about care and thus they may have a substantial influence on a person’s life. When considering the development of a questionnaire, the saying; “garbage in, garbage out” holds true. Therefore it is critical that the methods used to generate the questionnaire are based on both the patient perspective and the clinician perspective.
This presentation will review the relative merits of traditional and modern approaches to questionnaire generation. Practical examples will be drawn from the literature and from the author’s work in developing questionnaires to measure back pain burden, osteoarthritis burden, the need for joint replacement surgery, and impact of patient education programs.
Key elements for initial question and questionnaire development:
1. Clear declaration of the purpose of the questionnaire. Exactly how will the questionnaire and the resulting data be used to improve care?
2. Understanding the construct (or “thing”) that needs to be measured. The use of Concept Mapping and other qualitative and quantitative techniques.
3. Question wording that has emanated from patients and the patient-clinician interaction, and be faithful to the purpose of the questionnaire.
4. Draft questions undergo cognitive testing in naïve patient groups to verify the question being answered is the one intended.
5. Verification of the construct validity in target patient populations through modern psychometric analyses.
Finally, the fallacy of a “validated questionnaire” will be discussed – it needs to be recognised that construct validation is an ongoing process, and that an instrument is never validated per se but that each interpretation of the scores needs to be validated in specific clinical settings.
Disclosure of Interest None Declared
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