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      The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study


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          Aim of the COSMIN study (COnsensus-based Standards for the selection of health status Measurement INstruments) was to develop a consensus-based checklist to evaluate the methodological quality of studies on measurement properties. We present the COSMIN checklist and the agreement of the panel on the items of the checklist.


          A four-round Delphi study was performed with international experts (psychologists, epidemiologists, statisticians and clinicians). Of the 91 invited experts, 57 agreed to participate (63%). Panel members were asked to rate their (dis)agreement with each proposal on a five-point scale. Consensus was considered to be reached when at least 67% of the panel members indicated ‘agree’ or ‘strongly agree’.


          Consensus was reached on the inclusion of the following measurement properties: internal consistency, reliability, measurement error, content validity (including face validity), construct validity (including structural validity, hypotheses testing and cross-cultural validity), criterion validity, responsiveness, and interpretability. The latter was not considered a measurement property. The panel also reached consensus on how these properties should be assessed.


          The resulting COSMIN checklist could be useful when selecting a measurement instrument, peer-reviewing a manuscript, designing or reporting a study on measurement properties, or for educational purposes.

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          Statistical methods for assessing agreement between two methods of clinical measurement.

          In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
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            Criteria list for assessment of methodological quality of economic evaluations: Consensus on Health Economic Criteria.

            The aim of the Consensus on Health Economic Criteria (CHEC) project is to develop a criteria list for assessment of the methodological quality of economic evaluations in systematic reviews. The criteria list resulting from this CHEC project should be regarded as a minimum standard. The criteria list has been developed using a Delphi method. Three Delphi rounds were needed to reach consensus. Twenty-three international experts participated in the Delphi panel. The Delphi panel achieved consensus over a generic core set of items for the quality assessment of economic evaluations. Each item of the CHEC-list was formulated as a question that can be answered by yes or no. To standardize the interpretation of the list and facilitate its use, the project team also provided an operationalization of the criteria list items. There was consensus among a group of international experts regarding a core set of items that can be used to assess the quality of economic evaluations in systematic reviews. Using this checklist will make future systematic reviews of economic evaluations more transparent, informative, and comparable. Consequently, researchers and policy-makers might use these systematic reviews more easily. The CHEC-list can be downloaded freely from http://www.beoz.unimaas.nl/chec/.
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              Unpublished rating scales: a major source of bias in randomised controlled trials of treatments for schizophrenia.

              A recent review suggested an association between using unpublished scales in clinical trials and finding significant results. To determine whether such an association existed in schizophrenia trials. Three hundred trials were randomly selected from the Cochrane Schizophrenia Group's Register. All comparisons between treatment groups and control groups using rating scales were identified. The publication status of each scale was determined and claims of a significant treatment effect were recorded. Trials were more likely to report that a treatment was superior to control when an unpublished scale was used to make the comparison (relative risk 1.37 (95% CI 1.12-1.68)). This effect increased when a 'gold-standard' definition of treatment superiority was applied (RR 1.94 (95% CI 1.35-2.79)). In non-pharmacological trials, one-third of 'gold-standard' claims of treatment superiority would not have been made if published scales had been used. Unpublished scales are a source of bias in schizophrenia trials.

                Author and article information

                +31-20-4441771 , +31-20-4446775 , w.mokkink@vumc.nl , www.emgo.nl , www.cosmin.nl
                Qual Life Res
                Quality of Life Research
                Springer Netherlands (Dordrecht )
                19 February 2010
                19 February 2010
                May 2010
                : 19
                : 4
                : 539-549
                [1 ]Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
                [2 ]Department of Health Services, University of Washington, Thur Canal St Research Office, 146N Canal Suite 310, Seattle, WA 98103 USA
                [3 ]Health Services Research Unit, Institut Municipal d’Investigacio Medica (IMIM-Hospital del Mar), Doctor Aiguader 88, 08003 Barcelona, Spain
                [4 ]CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
                [5 ]School of Rehabilitation Science and Department of Clinical Epidemiology and Biostatistics, McMaster University, 1400 Main St. West, Hamilton, ON Canada
                [6 ]Executive Board of VU University Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands
                © The Author(s) 2010
                : 2 February 2010
                Custom metadata
                © Springer Science+Business Media B.V. 2010

                Public health
                outcome assessment,questionnaire,psychometrics,quality of life,delphi technique
                Public health
                outcome assessment, questionnaire, psychometrics, quality of life, delphi technique


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