How discriminating are discriminative instruments

Hankins, M. (2008) How discriminating are discriminative instruments Health and Quality of Life Outcomes, 6, (1), p. 36. (doi:10.1186/1477-7525-6-36).


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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.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1186/1477-7525-6-36
ISSNs: 1477-7525 (print)
Related URLs:
Organisations: Faculty of Health Sciences
ePrint ID: 343693
Date :
Date Event
May 2008Published
Date Deposited: 11 Oct 2012 10:53
Last Modified: 17 Apr 2017 16:32
Further Information:Google Scholar

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