Generic Health Measurement: Past Accomplishments and a Measurement Paradigm for the 21st Century

doi:10.1059/0003-4819-127-8_Part_2-199710151-00061

Generic Health Measurement: Past Accomplishments and a Measurement Paradigm for the 21st Century

Colleen A. McHorney, PhD

From the University of Wisconsin-Madison Medical School and the William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin. Note: This article is one of a series of articles comprising an Annals of Internal Medicine supplement entitled “Measuring Quality, Outcomes, and Cost of Care Using Large Databases: The Sixth Regenstrief Conference.” To see a complete list of the articles included in this supplement, please view its Table of Contents. Acknowledgments: The author thanks Fredric Wolinsky, PhD, and Earl Bricker, MA, for thoughtful comments on earlier versions of this manuscript; David Kindig, MD, PhD, and Mark Linzer, MD, for intellectual support; and Jody McIntyre and Amy Maloney for contributions as research staff. Grant Support: By the Department of Veterans Affairs (HSR&D HFP #96-001, RR&D C-2016, and IIR #95-033) and by the University of Wisconsin-Madison Medical School. Work on this paper was completed while Dr. McHorney was a 1996 Picker/Commonwealth Scholars Program Finalist. Requests for Reprints: Colleen A. McHorney, PhD, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705.

Abstract

Generic health surveys have been proposed for use in increasingly diverse applications and populations. This paper describes the history of generic tools in the past 30 years and suggests a more modern measurement platform for advances in the 21st century. Many generic tools lack the precision required for effective health care decision making. A meaningful goal for the next era of development of generic measures should be the generation of equiprecise measurement for generic health concepts. Equiprecise tests yield measures of equal precision at all levels of the underlying construct. Equiprecise measurement can be achieved through conjoint use of computerized-adaptive testing as the survey platform and item response theory as the measurement theory.