From the Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas.
Steve Hicks School of Social Work at the University of Texas at Austin, Austin, Texas.
Anesth Analg. 2019 Jan;128(1):176-181. doi: 10.1213/ANE.0000000000003859.
There is a continued mandate for practicing evidence-based medicine and the prerequisite rigorous analysis of the comparative effectiveness of alternative treatments. There is also an increasing emphasis on delivering value-based health care. Both these high priorities and their related endeavors require correct information about the outcomes of care. Accurately measuring and confirming health care outcomes are thus likely now of even greater importance. The present basic statistical tutorial focuses on the germane topic of psychometrics. In its narrower sense, psychometrics is the science of evaluating the attributes of such psychological tests. However, in its broader sense, psychometrics is concerned with the objective measurement of the skills, knowledge, and abilities, as well as the subjective measurement of the interests, values, and attitudes of individuals-both patients and their clinicians. While psychometrics is principally the domain and content expertise of psychiatry, psychology, and social work, it is also very pertinent to patient care, education, and research in anesthesiology, perioperative medicine, critical care, and pain medicine. A key step in selecting an existing or creating a new health-related assessment tool, scale, or survey is confirming or establishing the usefulness of the existing or new measure; this process conventionally involves assessing its reliability and its validity. Assessing reliability involves demonstrating that the measurement instrument generates consistent and hence reproducible results-in other words, whether the instrument produces the same results each time it is used in the same setting, with the same type of subjects. This includes interrater reliability, intrarater reliability, test-retest reliability, and internal reliability. Assessing validity is answering whether the instrument is actually measuring what it is intended to measure. This includes content validity, criterion validity, and construct validity. In evaluating a reported set of research data and its analyses, in a similar manner, it is important to assess the overall internal validity of the attendant study design and the external validity (generalizability) of its findings.
目前，实践循证医学和严格分析替代治疗方法的比较效果仍然是一个重要任务。此外，越来越强调提供基于价值的医疗保健。这两个优先事项及其相关工作都需要有关护理结果的正确信息。因此，准确测量和确认医疗保健结果现在可能更为重要。本基础统计教程重点介绍相关的心理计量学主题。狭义上讲，心理计量学是评估此类心理测试属性的科学。然而，广义上讲，心理计量学涉及到对个体技能、知识和能力的客观测量，以及对个体兴趣、价值观和态度的主观测量，包括患者及其临床医生。虽然心理计量学主要是精神病学、心理学和社会工作的领域和内容专业，但它也与麻醉学、围手术期医学、重症监护和疼痛医学中的患者护理、教育和研究密切相关。选择现有或创建新的与健康相关的评估工具、量表或调查的关键步骤是确认或建立现有或新测量的有用性；这个过程通常涉及评估其可靠性和有效性。评估可靠性涉及证明测量仪器产生一致且可重复的结果，换句话说，就是该仪器在相同的设置、相同类型的受试者中每次使用时是否产生相同的结果。这包括评分者间可靠性、评分者内可靠性、重测信度和内部可靠性。评估有效性是回答仪器是否实际上测量了它打算测量的内容。这包括内容有效性、标准有效性和结构有效性。在以类似的方式评估一组报告的研究数据及其分析时，评估伴随研究设计的整体内部有效性及其研究结果的外部有效性（可推广性）非常重要。
