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Appendix S4
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COSMIN checklist and definitions of measurement properties
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Figure originally published in: Mokkink LB, Terwee CB, Patrick DL et al. The COSMIN
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checklist for assessing the methodological quality of studies on measurement properties of
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health status measurement instruments: an international Delphi study. Qual Life Res 2010;
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19(4):539-549. Reproduced with permission from Springer Publishing©.
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Definitions:
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Internal consistency: The degree of the interrelatedness among the items.
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Reliability The proportion of the total variance in the measurements which is because of
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“true” differences among patients.
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Measurement error: The systematic and random error of a patient’s score that is not attributed
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to true changes in the construct to be measured.
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Validity: The degree to which an health-related patient-reported outcomes (HR-PRO)
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instrument measures the construct(s) it purports to measure.
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Content validity: The degree to which the content of an HR-PRO instrument is an adequate
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reflection of the construct to be measured.
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Face validity: The degree to which (the items of) an HR-PRO instrument indeed looks as
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though they are an adequate reflection of the construct to be measured.
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Construct validity: The degree to which the scores of an HR-PRO instrument are consistent
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with hypotheses (for instance with regard to internal relationships, relationships to scores of
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other instruments, or differences between relevant groups) based on the assumption that the
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HR-PRO instrument validly measures the construct to be measured.
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Structural validity: The degree to which the scores of an HR-PRO instrument are an adequate
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reflection of the dimensionality of the construct to be measured.
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Cross-cultural validity: The degree to which the performance of the items on a translated or
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culturally adapted HR-PRO instrument are an adequate reflection of the performance of the
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items of the original version of the HR-PRO Instrument.
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Criterion validity: The degree to which the scores of an HR-PRO instrument are an adequate
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reflection of a “gold standard”.
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Responsiveness: The ability of an HR-PRO instrument to detect change over time in the
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construct to be measured.
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Interpretability (characteristic but not a measurement property): The degree to which one can
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assign qualitative meaning - that is, clinical or commonly understood connotations - to an
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instrument’s quantitative scores or change in scores.
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Definitions originally published in: Mokkink LB, Terwee CB, Patrick DL et al. The COSMIN
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study reached international consensus on taxonomy, terminology, and definitions of
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measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 2010;
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63(7):737-745. Reproduced with permission from Elsevier Limited ©.
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