Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Apr 2003
ReviewCurrent issues in cross-cultural quality of life instrument development.
As a result of an increased demand for international cooperation in health care, cross-cultural quality of life (QOL) measures have been developed and tested. At present, a considerable number of QOL instruments are available in various languages, and some have been validated and normed in specific countries. ⋯ This article presents the current issues confronting cross-cultural instrument development in QOL. It describes the steps of international QOL instrument development and highlights some of the challenges, referring in particular to an ongoing project devoted to children with disabilities and chronic conditions.
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Arch Phys Med Rehabil · Apr 2003
ReviewMeasurement of quality of life in rehabilitation medicine: emerging issues.
The articles in the current supplement (Part II) present emerging issues in the measurement of quality of life (QOL). The articles were prepared based on presentations at a meeting held in November 2001. Part I (December 2002) provided important background information, definitions, and approaches that have been used in various rehabilitation populations. ⋯ Novel solutions are offered. We hope that this information can be used to set a research agenda for improving the measurement of QOL in rehabilitation medicine. The present article outlines these issues and provides a context for the information that has been presented in the 2 supplements.
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Arch Phys Med Rehabil · Apr 2003
ReviewHealth outcomes assessment in vulnerable populations: measurement challenges and recommendations.
With growing recognition that some population subgroups are particularly vulnerable to receiving suboptimal health care and achieving poor health outcomes, innovative techniques are required for collecting and evaluating health outcomes data. Research is also needed to better understand the causal pathways linking vulnerability with health outcomes. This article focuses on patients with a chronic illness (cancer) who also have low literacy and/or poor English language skills. ⋯ Appropriate methods are also needed to evaluate measurement equivalence across diverse patient groups, that is, the extent to which items in a questionnaire perform similarly across groups. Item response theory measurement models provide a strategy for differentiating between measurement bias and real differences that may exist between groups. Recommendations for clinical practice and research are offered specifically to address medically underserved and vulnerable populations.
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Arch Phys Med Rehabil · Apr 2003
ReviewIndividualization in quality of life measurement: instruments and approaches.
Quality of life (QOL) and health-related QOL (HRQOL) instruments abound in the health care literature, but many appear to measure nothing more than what in previous decades was called health status. As such, they fail to include numerous domains of life that are salient to many people, they omit items tapping into meaning and feelings of well-being, and they do not allow for individualization to take into account personal preferences. Based on a conceptualization of QOL and a corresponding 2-dimensional scheme for classification of instruments, several measures published in the literature are presented that allow for subject selection of domains, specification of standards and aspirations, and/or report of subjective reactions to status on various domains. The advantages and disadvantages of standardized versus individualized instruments are discussed, as well as methodologic questions with respect to the latter that future research needs to address.
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Arch Phys Med Rehabil · Apr 2003
ReviewConceptualization and measurement of health-related quality of life: comments on an evolving field.
This article summarizes personal views on the rapidly evolving field of functional health assessment and comments on their implications for advances in assessment methods used in rehabilitation medicine. Topics of strategic importance included (1). a new formulation of the structure of health status designed to distinguish role participation from the physical and mental components of health for purposes of international studies; (2). applications of item response theory that offer advantages in constructing better functional health measures and cross-calibrating their underlying metrics; (3). computerized dynamic assessment technology, well proven in education and psychology, which may lead to more practical assessments and more precise score estimates across a wide range of functional health levels; and (4). intellectual property issues involved in standardizing and promoting readily available assessment tools, ensuring their scientific validity, and achieving the best possible partnership between the scientific community and those developing commercial applications. ⋯ Someday, all tools used to measure each functional health concept, including the best single-item measure and the most precise computerized dynamic health assessment, will be scored on the same metric and their results will be directly comparable. To achieve this goal in rehabilitation medicine, we have much work to do.