How to determine the quality of a questionnaire according to the CONsensus-based Standards for the selection of health Measurement INstruments? A simplified guide to the measurement properties of assessment instruments - Part I: basic concepts and reliability
Como determinar a qualidade de um questionário de acordo com o CONsensus-based Standards for the selection of health Measurement INstruments? Um guia simplificado sobre as propriedades de medida de instrumentos de avaliação - Parte I: conceitos básicos e confiabilidade
Thaís Cristina Chaves; Ana Carolina de Jacomo Claudio; Thamiris Costa de Lima; Roger Berg Rodrigues Pereira; Gabriela Zuelli Martins Silva; Helen Cristina Nogueira Carrer
Abstract
Keywords
Resumo
JUSTIFICATIVA E OBJETIVOS: O tipo de questionário que pretende captar a percepção/visão de um paciente sobre um aspecto a ser medido (ex: intensidade da dor) é chamado de Instrumento de Medida Baseado no Relato do Paciente (Patient Reported Outcome Measure - PROM). Um dos maiores desafios que clínicos e pesquisadores costumam enfrentar é quanto a tomar uma decisão sobre qual PROM utilizar para a avaliação de seu paciente com dor, especialmente devido à falta do letramento científico necessário para entender os critérios e termos empregados na área de propriedades de medida. Assim, os objetivos deste estudo (parte I) foram: (I) introduzir conceitos básicos sobre PROMs com enfoque na terminologia e critérios definidos através do COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), e (2) descrever as propriedades de medida do domínio confiabilidade.
MÉTODOS: Utilizando uma busca voltada para os artigos da iniciativa COSMIN, foi elaborado este estudo. Sendo o assunto muito extenso, os autores dividiram o texto em duas partes.
RESULTADOS: O presente artigo descreveu conceitos básicos sobre PROMs (propósitos e construtos), o processo de adaptação transcultural e as propriedades de medida do domínio confiabilidade (confiabilidade, medida de erro e consistência interna). De forma geral, um instrumento com qualidade adequada de confiabilidade deveria atender a alguns critérios, tais como: coeficiente de correlação intraclasse ≥ 0,70, medida de erro < mínima mudança clinicamente importante e α de Cronbach ≥ 0,70.
CONCLUSÃO: O entendimento sobre como determinar a qualidade da propriedade de medida de confiabilidade pode auxiliar os clínicos e pesquisadores na escolha dos melhores PROMs disponíveis. Um checklist para avaliação da qualidade das propriedades de medida de PROMs está descrita na parte II do artigo.
Palavras-chave
References
1 Øvretveit J, Zubkoff L, Nelson EC, Frampton S, Knudsen JL, Zimlichman E. Using patient-reported outcome measurement to improve patient care. Int J Qual Health Care. 2017;29(6):874-9.
2 Elsman EBM, Mokkink LB, Langendoen-Gort M, Rutters F, Beulens J, Elders PJM, Terwee CB. Systematic review on the measurement properties of diabetes-specific patient-reported outcome measures (PROMs) for measuring physical functioning in people with type 2 diabetes. BMJ Open Diabetes Res Care. 2022;10(3):e002729.
3 Davidson M, Keating J. Patient-reported outcome measures (PROMs): how should I interpret reports of measurement properties? A practical guide for clinicians and researchers who are not biostatisticians. Br J Sports Med. 2014;48(9):792-6.
4 Sleijser-Koehorst MLS, Bijker L, Cuijpers P, Scholten-Peeters GGM, Coppieters MW. Preferred self-administered questionnaires to assess fear of movement, coping, self-efficacy, and catastrophizing in patients with musculoskeletal pain-A modified Delphi study. Pain. 2019;160(3):600-6.
5 Black N. Patient reported outcome measures could help transform healthcare. BMJ. 2013;346:f167.
6 De Vet HCW, Terwee CB, Mokkink LB, Knol DL. Measurement in Medicine - A practical guide. 1st edition. New York: Cambridge University Press; 2011.
7 Ware JE, Sherbourne CD. The MOS 36-Item Short-Form Health Survey (SF-36®): I. conceptual framework and item selection. Med Care 1992; 30(6):473-83.
8 Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13.
9 Hill JC, Dunn KM, Lewis M, Mullis R, Main CJ, Foster NE, Hay EM. A primary care back pain screening tool: identifying patient subgroups for initial treatment. Arthritis Rheum. 2008;59(5):632-41.
10 Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med. Singapore. 1994;23(2):129-38.
11 Vigatto R, Alexandre NM, Correa Filho HR. Development of a Brazilian Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability, and validity. Spine (Phila Pa 1976). 2007;32(4):481-6.
12 Michell J. An Introduction to the Logic of Psychological Measurement. Hillsdale, NJ: Lawrence Erlbaum Associates. 1990. 190p.
13 Prinsen CAC, Mokkink LB, Bouter LM, Alonso J, Patrick DL, de Vet HCW, Terwee CB. COSMIN guideline for systematic reviews of patient-reported outcome measures. Qual Life Res. 2018;27(5):1147-57.
14 Mokkink LB, de Vet HCW, Prinsen CAC, Patrick DL, Alonso J, Bouter LM, Terwee CB. COSMIN risk of bias checklist for systematic reviews of patient-reported outcome measures. Qual Life Res. 2018 May;27(5):1171-9.
15 Terwee CB, Prinsen CAC, Chiarotto A, Westerman MJ, Patrick DL, Alonso J, Bouter LM, de Vet HCW, Mokkink LB. COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res. 2018;27(5):1159-1170.
16 Mokkink LB, Prinsen CA, Bouter LM, Vet HC, Terwee CB. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument. Braz J Phys Ther. 2016;20(2):105-13.
17 Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737-45.
18 Chiarotto A, Ostelo RW, Boers M, Terwee CB. A systematic review highlights the need to investigate the content validity of patient-reported outcome measures for physical functioning in patients with low back pain. J Clin Epidemiol. 2018;95:73-93.
19 Swinkels RA, van Peppen RP, Wittink H, Custers JW, Beurskens AJ. Current use and barriers and facilitators for implementation of standardised measures in physical therapy in the Netherlands. BMC Musculoskelet Disord. 2011;22;12:106.
20 Beaton, Dorcas E. BScOT, MSc, PhD; Bombardier, Claire MD, FRCP; Guillemin, Francis MD, MSc; Ferraz, Marcos Bosi MD, MSc, PhD. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. Spine. 2000;25:3186-91.
21 Marques AP, Mendes YC, Taddei U, Pereira CA, Assumpção A. Brazilian-Portuguese translation and crosscultural adaptation of the activities-specific balance confidence (ABC) scale. Braz J Phys Ther. 2013; 17(2):170-8.
22 Mokkink LB, Prinsen CAC, Patrick DL, Alonso J, Bouter LM, de Vet HCW, Terwee CB. COSMIN Study Design checklist for Patient-reported outcome measurement instruments. Documento disponível em
23 Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42.
24 Kottner J, Gajewski BJ, Streiner DL. Guidelines for Reporting Reliability and Agreement Studies (GRRAS). Int J Nurs Stud. 2011;48(6):659-60.
25 Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833-40.
26 Barraza F, Arancibia M, Madrid E, Papuzinski C. General concepts in biostatistics and clinical epidemiology: Random error and systematic error. Medwave. 2019;19(7):e7687.
27 Altman DG, Bland JM. Measurement in Medicine: The analysis of method comparison studies. Statistician. 1983;32(3):307-17
28 Chiarotto A, Maxwell LJ, Ostelo RW, Boers M, Tugwell P, Terwee CB. Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in patients with low back pain: a systematic review. J Pain. 2019;20(3):245-63.
29 Apgar V. A proposal for a new method of evaluation of newborn infants. Anesth Analg. 1953;32:260-7.
30 Guyon H. The fallacy of the theoretical meaning of formative constructs. Front Psychol. 2018;15;9:179.
31 Prinsen CA, Vohra S, Rose MR, Boers M, Tugwell P, Clarke M, Williamson PR, Terwee CB. How to select outcome measurement instruments for outcomes included in a “Core Outcome Set” - a practical guideline. Trials. 2016;17(1):449.
32 Greghi SM, Dos Santos Aguiar A, Bataglion C, Ferracini GN, La Touche R, Chaves TC. Brazilian Portuguese Version of the Craniofacial Pain and Disability Inventory: Cross-Cultural Reliability, Internal Consistency, and Construct and Structural Validity. J Oral Facial Pain Headache. 2018;32(4):389-99.
Submitted date:
09/06/2023
Accepted date:
10/10/2023