Van Ewijk Lizet, Hilari Katerina, Pais Analisa, Volkmer Anna
Research Group Speech and Language Therapy, Participation through Communication, Research Centre Health and Sustainable Living, HU University of Applied Science, Utrecht, the Netherlands.
Centre for Language and Communication Science Research, School of Health and Psychological Sciences, City, University of London, London, UK.
Int J Lang Commun Disord. 2025 May-Jun;60(3):e70050. doi: 10.1111/1460-6984.70050.
Content validity is a key measurement property that should be considered when selecting or reviewing a patient-reported outcome measure (PROM). In the field of communication disorders, there are several PROMs available, most of which are disease specific. It is unknown what the quality of the content validity of these PROMs is.
This study aimed to evaluate the content validity of existing communication PROMs used with adults with communication disorders.
This study evaluated PROMs drawn from a previously published systematic literature review. Of 31 measures, 25 measures were included in this review, covering a range of communication-related constructs in different communication disorders. The process of rating followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology for assessing the content validity of PROMs. There were three stages to the evaluation process comprising Step 1: evaluating the quality of the PROM development, Step 2: evaluating the quality of content validity studies on the PROM (if available) and Step 3: evaluating the content validity of the PROM overall, based on the quality and results of the available studies and the PROM itself.
Step 1: With regards to the quality of the PROM development, 21 of 25 PROMs were rated as inadequate. Step 2: Content validity studies were available for five of the PROMs. All of these studies were rated doubtful or inadequate. Step 3: The quality of the available evidence on content validity of the included PROMs was overall very low. Only the evidence on the content validity of the Communication Participation Item Bank (CPIB) and the Neuro-QoL (Quality of Life in Neurological Disorders) was rated as of moderate quality.
Results of this study highlight the scarcity of high-quality evidence on the development and content validity of PROMs that aim to capture the construct of communication. This review is a call to action for future PROMs to include both the target population and professionals in development and content validity testing, using rigorous methodology in the process.
What is already known on this subject There are several patient reported outcome measures (PROMs) available for adult communication disorders. Many of these PROMs have been assessed on one or more psychometric properties, typically reliability and validity aspects. Content validity is often overlooked in research. What this study adds Clinimetric and psychometric experts recommend content validity as the first and most important measurement property to consider when selecting a scale. This study is the first to provide a systematic assessment of the quality of content validity of communication PROMs used in adult communication disorders. What are the potential or clinical implications of this work? Using measures with good content validity during outcome measurement ensures that researchers and clinicians capture constructs that are relevant and important to clients. It also ensures that the measures used are accessible to the clients and comprehensively address their needs.
内容效度是一项关键的测量属性，在选择或评估患者报告结局指标（PROM）时应予以考虑。在交流障碍领域，有多种PROM可供使用，其中大多数是针对特定疾病的。这些PROM的内容效度质量如何尚不清楚。
本研究旨在评估现有的用于患有交流障碍的成年人的交流PROM的内容效度。
本研究评估了从先前发表的系统文献综述中提取的PROM。在31项指标中，本综述纳入了25项指标，涵盖了不同交流障碍中一系列与交流相关的结构。评分过程遵循基于共识的健康测量工具选择标准（COSMIN）方法，以评估PROM的内容效度。评估过程分为三个阶段，包括步骤1：评估PROM开发的质量；步骤2：评估关于该PROM的内容效度研究的质量（如果有）；步骤3：根据现有研究的质量和结果以及PROM本身，整体评估PROM的内容效度。
步骤1：关于PROM开发的质量，25项PROM中有21项被评为不合格。步骤2：有五项PROM有内容效度研究。所有这些研究均被评为可疑或不合格。步骤3：纳入的PROM的内容效度的现有证据质量总体非常低。只有关于交流参与项目库（CPIB）和神经生活质量量表（神经疾病生活质量）的内容效度的证据被评为中等质量。
本研究结果凸显了旨在反映交流结构的PROM在开发和内容效度方面高质量证据的稀缺性。本综述呼吁未来的PROM在开发和内容效度测试中纳入目标人群和专业人员，并在过程中采用严格的方法。
关于该主题的已知信息 有多种患者报告结局指标（PROM）可用于成人交流障碍。其中许多PROM已在一种或多种心理测量属性上进行了评估，通常是可靠性和效度方面评估。内容效度在研究中常常被忽视。本研究补充的内容 临床测量和心理测量专家建议将内容效度作为选择量表时首先且最重要的测量属性加以考虑。本研究首次对用于成人交流障碍的交流PROM的内容效度质量进行了系统评估。这项工作的潜在或临床意义是什么？在结局测量中使用具有良好内容效度的指标可确保研究人员和临床医生获取对患者相关且重要的结构。这也确保所使用的指标患者能够理解并全面满足他们的需求。
