Original article
The validity of health assessments: Resolving some recent differences

https://doi.org/10.1016/0895-4356(93)90169-2Get rights and content

Abstract

The purpose of this paper is to examine what is meant by a valid measure of health. Guyatt, Kirshner and Jaeschke propose that health tests should be designed so as to have one of several kinds of validity: “longitudinal construct validity” for those which are used for longitudinal research designs, and “cross-sectional construct validity” for those which are used for cross-sectional designs. Williams and Naylor argue that this approach to test classification and validation confuses what a test purports to measure with the -purpose for which it is used, and that some tests: have multiple uses. A review of the meanings of validity in the psychological test literature shows that both sets of authors use the term validity in an idiosyncratic way. Although the use of a test (evaluated by content validity) should not be conflated with whether the test actually measures a specified construct (evaluated by construct validity), if health is actually made up of several constructs (as suggested in Hyland's interactional model) then there may be an association between types of construct and types of purpose. Evidence is reviewed that people make several, independent judgements about their health: cognitive perceptions of health problems are likely to be more sensitive to change in a longitudinal research design, whereas emotional evaluations of health provide less bias in cross-sectional designs. Thus, a classification of health measures in terms of the purpose of the test may parallel a classification in terms of what tests purport to measure.

References (21)

There are more references available in the full text version of this article.

Cited by (25)

  • What is self-rated health and why does it predict mortality? Towards a unified conceptual model

    2009, Social Science and Medicine
    Citation Excerpt :

    depending upon one's hypothesis such a self-rating may or may not be valid” (Suchman et al., 1958, p. 232)? In his discussion about the validity of health assessments, Hyland (1993) emphasizes that validity should not be understood as an abstract term but established with reference to particular use, and that a measure can be valid in more than one way. As I argued earlier in this paper, the absence of a direct objective measure of “true health” means that there is no gold standard, no clear criterion for the validity of self-rated health.

  • Health-related quality of life in children with otitis media

    2005, International Journal of Pediatric Otorhinolaryngology
  • A taxonomy for responsiveness

    2001, Journal of Clinical Epidemiology
View all citing articles on Scopus
View full text