Gale, V. orcid.org/0000-0001-7472-2039, Powell, P.A. orcid.org/0000-0003-1169-3431 and Carlton, J. orcid.org/0000-0002-9373-7663 (2024) The comprehensibility continuum: a novel method for analysing comprehensibility of patient reported outcome measures. Quality of Life Research. ISSN 0962-9343
Abstract
Purpose
Evidence of comprehensibility is frequently required during the development of patient reported outcome measures (PROMs); the respondent’s interpretation of PROM items needs to align with intended meanings. Cognitive interviews are recommended for investigating PROM comprehensibility, yet guidance for analysis is lacking. Consequently, the quality and trustworthiness of cognitive interview data and analysis is threatened, as there is no clear procedure detailing how analysts can systematically, and consistently, identify evidence that respondent interpretations align/misalign with intended meanings.
Methods
This paper presents a novel, structured approach to comprehensibility analysis - the ‘Comprehensibility Continuum’ – that builds upon existing cognitive interview guidance.
Results
The Comprehensibility Continuum comprises a structured rating scale to code depth of alignment between intended item meaning and respondent interpretation and consists of five main stages: before cognitive interviews are conducted, researchers must (1) Define intended meanings of PROM items; and (2) Determine comprehensibility thresholds for both participant- and item-level. After conducting interviews, they (3) Prepare data by transcribing interviews ‘intelligent’ verbatim; (4) Code transcripts using the Comprehensibility Continuum scale in iterative sets, assigning an overall code for each item at participant-level; and (5) Compare participant-level codes across all participants to determine overall item comprehensibility, such that decisions can be made to retain, modify, or remove items.
Conclusion
Quality in qualitative data analysis is achieved through rigorous methods that are clearly described and justified. Given insufficiency in guidelines, cognitive interviewers must reflect on how best to demonstrate PROM comprehensibility systematically and consistently from interview data, and the Comprehensibility Continuum method offers a potential solution.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
Keywords: | Analysis; Cognitive interview; Content validity; Patient-reported outcomes measures |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 18 Dec 2024 11:36 |
Last Modified: | 18 Dec 2024 11:36 |
Status: | Published online |
Publisher: | Springer Science and Business Media LLC |
Refereed: | Yes |
Identification Number: | 10.1007/s11136-024-03858-y |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:220575 |