ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2015
Reflective, causal, and composite indicators of quality of life: A conceptual or an empirical distinction?
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Physical Activity Questionnaires for Pregnancy: A Systematic Review of Measurement Properties.Sports medicine (Auckland, N.Z.) · 2018Pooled it
- Holistic physical exercise training improves physical literacy among physically inactive adults: a pilot intervention study.BMC public health · 2019Trial
- Article
- Development and content validation of a questionnaire of activities in health promotion for primary and secondary education: PromoACTIVA-CE.BMC public health · 2025Article
- Social media use, gaming and quality of life among adolescents in Norway: results from the Young-HUNT study.Health and quality of life outcomes · 2025Article
- PromoACTIVA-SC: A Tool Aiming at Identifying Health Promotion Practice of Civil Society Organizations.Healthcare (Basel, Switzerland) · 2025Article
- Routine Quality-of-Life Measurement in Residential Aged Care: Staff, Resident, and Family Perspectives.The patient · 2025Article
- Development and psychometric evaluation of a patient-reported symptom index for patients with non-muscle invasive bladder cancer: the NMIBC-SI.Journal of patient-reported outcomes · 2025Article
- Patient-reported physical well-being predicts good long-term survival of hematopoietic stem cell transplantation.Cancer medicine · 2024Article
- The Impact of the Intuitionistic Fuzzy Entropy-Based Weights on the Results of Subjective Quality of Life Measurement Using Intuitionistic Fuzzy Synthetic Measure.Entropy (Basel, Switzerland) · 2023Article
- Development of an item bank for measuring prosthetic mobility in people with lower limb amputation: The Prosthetic Limb Users Survey of Mobility (PLUS-M).PM & R : the journal of injury, function, and rehabilitation · 2023Article
- Lung Function Tests, Quality of Life and Telemedicine: Three Windows on the Multifaceted World of Asthma in Adolescents.Children (Basel, Switzerland) · 2022Review
- Internet Use and Quality of Life: The Multiple Mediating Effects of Risk Perception and Internet Addiction.International journal of environmental research and public health · 2022Article
- Combining EQ-5D-5L items into a level summary score: demonstrating feasibility using non-parametric item response theory using an international dataset.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022Article
- Primary Care and Physical Literacy: A Non-Randomized Controlled Pilot Study to Combat the High Prevalence of Physically Inactive Adults in Austria.International journal of environmental research and public health · 2021Article
- How is quality of life defined and assessed in published research?Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2021Review
- Witnessing Quality of Life of Persons with Profound Intellectual and Multiple Disabilities. A practical-Philosophical Approach.Health care analysis : HCA : journal of health philosophy and policy · 2021Article
- Constructing arguments for the interpretation and use of patient-reported outcome measures in research: an application of modern validity theory.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2021Article
- Response shift in health-related quality of life measures in the presence of formative indicators.Health and quality of life outcomes · 2021Article
- A framework for indirect elicitation of the public health impact of gambling problems.BMC public health · 2020Review
Corrections and comments
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Authors and funding
1 author.
Funding
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Abstract
Items (or indicators) that constitute "quality of life" instruments can be classified as either reflective (manifestations of some underlying construct), causal (the construct is an effect of the indicators), or composite (the construct is an exact linear combination of the indicators). Psychometric methods based on inter-item associations are only appropriate for reflective indicators, whereas other statistical and non-statistical validation methods can be used for composite or causal indicators. Thus, the distinction has important practical, as well as theoretical, implications. Attempts have been made to empirically identify which items of the EORTC QLQ-C30, a cancer-specific instrument, are causal and which are reflective. Such attempts, however, first require commitment to a particular definition of quality of life, of which there are many. Whether an indicator forms a composite, is causal or reflective of quality of life will depend on the definition adopted, and therefore, the reflective-composite-causal distinction is, arguably, best established on conceptual rather empirical grounds, guided by the "mental experiments" suggested by Bollen (Structural equations with latent variables, Wiley, New York, 1989). Conceptual models of health status and quality of life, as well as a cognitive-linguistic approach to quality of life assessment, may make some contribution to this practice. Theoretical consideration of indicator content can guide not only instrument development and validation, but also the selection of an appropriate instrument.
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