UMMS Affiliation

Department of Medicine, Division of Preventive and Behavioral Medicine

Publication Date


Document Type



Adaptation, Psychological; Humans; *Models, Psychological; Observer Variation; Psychometrics; Quality of Life; Reproducibility of Results; *Sickness Impact Profile; Time Factors


Behavioral Disciplines and Activities | Health Services Research | Life Sciences | Medicine and Health Sciences


The increasing evidence for response shift phenomena in quality of life (QOL) assessment points to the necessity to reconsider both the measurement model and the application of psychometric analyses. The proposed psychometric model posits that the QOL true score is always contingent upon parameters of the appraisal process. This new model calls into question existing methods for establishing the reliability and validity of QOL assessment tools and suggests several new approaches for describing the psychometric properties of these scales. Recommendations for integrating the assessment of appraisal into QOL research and clinical practice are discussed.

Rights and Permissions

© 2004 Schwartz and Rapkin; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

DOI of Published Version



Health Qual Life Outcomes. 2004 Mar 23;2:16. Link to article on publisher's site

Journal/Book/Conference Title

Health and quality of life outcomes

Related Resources

Link to Article in PubMed

PubMed ID




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