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The problem with health measurement

机译：健康测量的问题

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Abstract: In this review we discuss health measurement with a focus on psychometric methods and methodology. In particular, we examine some of the key issues currently facing the use of clinician and patient rating scales to measure the health outcomes of disease and treatment. We present three key facts and flag one crucial problem. First, the numbers generated by scales are increasingly used as the measurements of the central dependent variables upon which clinical decisions are frequently made. The rising profile of rating scales has significant implications for scale construction, evaluation, and selection, as well as for interpreting studies. Second, rating scale science is well established. Therefore, it is important to learn the lessons from those who have built and established the science over the last century. Finally, the goal of a rating scale is to measure. As such, over the last half century, developments in rating scale (psychometric) methods have caused a refocus in the way we should be measuring health. In particular, newer methods have significant clinical advantages over traditional approaches. These should be seriously considered for inclusion in everyday practice. This leads us to the central problem with health measurement, which is that we cannot currently be sure what most rating scales are measuring. This is because the methods we have in place to ensure the validity of rating scales fall short of what is actually required. We expand on this point, and provide some potential routes forward to help address this important problem.
机译：摘要：在这篇综述中，我们讨论了健康测量，重点是心理测量方法和方法论。特别是，我们研究了使用临床医生和患者评分量表来衡量疾病和治疗的健康结果目前面临的一些关键问题。我们提出了三个关键事实，并提出了一个关键问题。首先，由标尺产生的数字越来越多地用作对中心因变量的测量，而这些因变量往往是根据其做出临床决策。等级量表的不断提高对量表的构建，评估和选择以及解释研究具有重要意义。第二，评级量表科学已经建立。因此，从上个世纪建立和建立科学的人那里汲取教训是很重要的。最后，评级量表的目标是衡量。因此，在过去的半个世纪中，评分量表（心理计量学）方法的发展引起了人们对健康测量方法的关注。特别是，较之传统方法，新方法具有明显的临床优势。这些应该被认真考虑以纳入日常实践中。这导致我们面临健康测量的核心问题，即我们目前无法确定大多数等级量表正在测量什么。这是因为我们用于确保评分量表有效性的方法未达到实际要求。我们在这一点上进行扩展，并提供一些可能的途径来帮助解决这一重要问题。

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