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How discriminating are discriminative instruments?

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journal contribution
posted on 2023-06-07, 15:08 authored by Matthew Hankins
The McMaster framework introduced by Kirshner & Guyatt is the dominant paradigm for the development of measures of health status and health-related quality of life (HRQL). The framework defines the functions of such instruments as evaluative, predictive or discriminative. Evaluative instruments are required to be sensitive to change (responsiveness), but there is no corresponding index of the degree to which discriminative instruments are sensitive to cross-sectional differences. This paper argues that indices of validity and reliability are not sufficient to demonstrate that a discriminative instrument performs its function of discriminating between individuals, and that the McMaster framework would be augmented by the addition of a separate index of discrimination. The coefficient proposed by Ferguson (Delta) is easily adapted to HRQL instruments and is a direct, non-parametric index of the degree to which an instrument distinguishes between individuals. While Delta should prove useful in the development and evaluation of discriminative instruments, further research is required to elucidate the relationship between the measurement properties of discrimination, reliability and responsiveness.

History

Publication status

  • Published

File Version

  • Published version

Journal

Health and Quality of Life Outcomes

ISSN

1477-7525

Publisher

BioMed Central

Volume

6

Page range

36

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2009-06-29

First Open Access (FOA) Date

2018-03-20

First Compliant Deposit (FCD) Date

2018-03-20

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