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Testing the interval-level measurement property of multi-item visual analogue scales

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Abstract

Background:

Conditions were studied that may invalidate health-state values derived from the visual analogue scale (VAS).

Methods:

Respondents were asked to place cards with descriptions of EQ-5D health states on a 20 cm EuroQol VAS and modified versions of it, positioning them such that the distances between the states reflect their valuation for these states. Anchor-point bias was examined using the standard EuroQol VAS (n = 212) and a modified version (n = 97) with a different lower anchor. Context bias was examined in another group of respondents (n = 112) who valued three different sets of EQ-5D health states. Marker bias was studied in yet another group of respondents (n = 100) who placed the same EQ-5D states on the standard EuroQol VAS and on a modified VAS without anchors, categories, or measurement markers.

Results:

No indication for the existence of the anchor-point and the marker bias was found. However, the VAS valuations were significantly affected by the context of the set of health states in the scaling task.

Conclusion:

Advanced methodologies should be incorporated in VAS valuation studies to deal with the context bias.

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Acknowledgments

We would like to thank Arto Ohinmaa and Jeffrey Johnson for the constructive comments they made during the 21st Plenary EuroQol Group Meeting, Chicago, 16–18 October 2004. This research was made possible by a grant from the ZonMw National Research Council (945-10-033/047) and a supplementary grant from the EuroQol Group. Respondents were recruited by the Global Data Contact Centre (Rotterdam).

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Authors and Affiliations

  1. Department of Medical Technology Assessment (138), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    Paul F.M. Krabbe & Peep F.M. Stalmeier

  2. Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    Peep F.M. Stalmeier

  3. Institute for Medical Technology Assessment, Erasmus University Medical Center Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands

    Leida M. Lamers

  4. Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands

    Jan J.V. Busschbach

Authors
  1. Paul F.M. Krabbe
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  2. Peep F.M. Stalmeier
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  3. Leida M. Lamers
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  4. Jan J.V. Busschbach
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Correspondence to Paul F.M. Krabbe.

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Krabbe, P., Stalmeier, P., Lamers, L. et al. Testing the interval-level measurement property of multi-item visual analogue scales. Qual Life Res 15, 1651–1661 (2006). https://doi.org/10.1007/s11136-006-0027-7

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  • DOI: https://doi.org/10.1007/s11136-006-0027-7

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