Patient Related Outcome Measures (Jul 2023)

Studies on Reliability and Measurement Error of Measurements in Medicine – From Design to Statistics Explained for Medical Researchers

  • Mokkink LB,
  • Eekhout I,
  • Boers M,
  • van der Vleuten CP,
  • de Vet HC

Journal volume & issue
Vol. Volume 14
pp. 193 – 212

Abstract

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Lidwine B Mokkink,1,2 Iris Eekhout,1– 3 Maarten Boers,1,2 Cees PM van der Vleuten,4 Henrica CW de Vet1,2 1Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam, the Netherlands; 2Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; 3Child Health, Netherlands Organisation for Applied Scientific Research, Leiden, the Netherlands; 4Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the NetherlandsCorrespondence: Lidwine B Mokkink, Amsterdam UMC, AMC, J1B -225, Meibergdreef 9, Amsterdam, 1105 AZ, the Netherlands, Tel +31 20 44 44474, Email [email protected]: Reliability and measurement error are measurement properties that quantify the influence of specific sources of variation, such as raters, type of machine, or time, on the score of the individual measurement. Several designs can be chosen to assess reliability and measurement error of a measurement. Differences in design are due to specific choices about which sources of variation are varied over the repeated measurements in stable patients, which potential sources of variation are kept stable (ie, restricted), and about whether or not the entire measurement instrument (or measurement protocol) was repeated or only part of it. We explain how these choices determine how intraclass correlation coefficients and standard errors of measurement formulas are built for different designs by using Venn diagrams. Strategies for improving the measurement are explained, and recommendations for reporting the essentials of these studies are described. We hope that this paper will facilitate the understanding and improve the design, analysis, and reporting of future studies on reliability and measurement error of measurements.Keywords: reliability, measurement error, classical test theory, generalizability theory, intraclass correlation coefficient, standard error of measurement

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