Strategy and Methodology for Choice of Items in Psychometric Measurement: Designing a Quality of Life Instrument for Hip and Knee Osteoarthritis

  • Francis Guillemin
  • Joel Coste
  • Nathalie Retel-Rude
  • Elisabeth Spitz
  • Michèle Baumann
  • Cyrille Tarquinio
  • Catherine Luttenbacher
  • Jacques Pouchot
  • The French Quality of Life in Rheumatology Group


The construction of composite health status or quality of life (QoL) measurement scales includes various steps, and aims to generate items with meaningful content. Standard scale construction has three stages: a qualitative stage, designed to achieve coverage of all potentially affected areas, a quantitative stage designed to test instrument scaling properties, and a stage of item selection to address feasibility and acceptability of the scale. The objectives of this paper are to investigate the relative contribution of several methods of item development and choice, to highlight the need for structuring the conceptual reflection on building an instrument, and to propose guidelines for structuring a quality of life questionnaire. As a model, we present a protocol for developing a QoL instrument for lower limbs osteoarthritis (OA). OA is a chronic disease with prevalence increasing with age. It may produce potentially severe ability limitations and social participation restrictions according to the ICIDH-2 classification. However, no real OA quality of life questionnaire has been yet developed. This study was conducted with 3 working hypotheses: (1) a generic questionnaire, the SF-36, is relevant to target consequences of lower limbs OA on patients QoL; (2) a condition specific questionnaire for lower limbs OA can be built as the combination of the SF-36 and a disease specific module; and (3) various item generation methods may each contribute relevant statements and words. These methods include cognitive interview of patients, individual or focus group interviews of patients, individual or focus group interviews of health professionals, followed by various methods of content analysis. Accordingly, the study will comprise five pathways aimed at generating items. A total of 128 OA patients and 32 health professionals will be interviewed. A trained team of sociologists will perform a semantic theme content analysis of tape-recorded and transcribed interviews. The next step consists of running content analysis completed by hierarchical cluster analysis. This will be used to identify relevant QoL dimensions. The second task will be to review the data analysis to identify verbatims pertaining to each dimension. Further analyses will identify the respective contribution of each method employed to generate items. The primary stages of composite scale construction include concepts specification and content descriptions. We expect to better document the relative contribution of each approach within each stage. We hope to contribute to future methodological guidelines to generate quality of life questionnaires.


Chronic Fatigue Syndrome Item Response Theory Focus Group Interview Cognitive Interview Item Selection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media Dordrecht 2002

Authors and Affiliations

  • Francis Guillemin
    • 1
  • Joel Coste
    • 2
  • Nathalie Retel-Rude
    • 3
  • Elisabeth Spitz
    • 4
  • Michèle Baumann
    • 1
  • Cyrille Tarquinio
    • 4
  • Catherine Luttenbacher
    • 3
  • Jacques Pouchot
    • 5
  • The French Quality of Life in Rheumatology Group
  1. 1.University of NancyFrance
  2. 2.Hôpital Cochin-ParisFrance
  3. 3.Université de BesançonFrance
  4. 4.Université de MetzFrance
  5. 5.Hôpital Louis Mourier-ParisFrance

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