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Table 4 Proposed interpretations/applications and evidence required to support the measure's validity for low back pain burden

From: A validity-driven approach to the understanding of the personal and societal burden of low back pain: development of a conceptual and measurement model

Proposed interpretation/application Evidence of validity or activities to obtain this evidence
Interpretations/applications applied to groups - supported through initial development processes
Describe the burden of low back pain on a set of scales that reflects the full range of the experience of people with low back pain Thorough, grounded identification of the range of issues that contribute to low back pain burden
  Iterative process of organizing these into domains and potential scales
  Comparison with interview data at a number of stages of development
Quantify variations in the effects of low back pain across a broad range of sufferers on a range of scales Cluster analysis to identify score profiles and qualitative confirmation of these
  Tests of structural invariance across groups
Interpretations/applications applied to groups - supported through subsequent applications of the tool a
Describe the relative importance of different domains of low back pain burden in comparing one population with another (for example, needs identification) Accumulated evidence about what is a high average score and what is a low average score for each scaleb
  Establishment of whole of population norms and subgroup norms
  Tests of structural invariance
Validly assess changes in low back pain burden in a group over time or as a result of interventions Application for a range of evaluation purposes including comparison with other subjective and objective indicators of change
  Development of estimates of meaningful change
Interpretations/applications applied to individuals
Assess the relative needs of an individual with low back pain across a range of domains Attention to item scaling properties during psychometric development
  Comparison with other subjective and objective indicators of status
Measure changes in individuals over time or in response to interventions Comparison with other subjective and objective indicators of change
  Development of estimates of meaningful change
  1. aTwo further possible applications are the development of an overall score to compare the total burden of one population group with another, and also the attachment of utilities to scores to enable comparisons with other conditions. At this stage we do not propose to pursue either of these applications. bIt is important to note that we do not assume the scales all scale equally or that an average score of 3.5 on one scale will necessarily indicate a greater problem than a score of 4 on another scale. These relative weightings are necessarily dependent on the values of individuals or on some estimate of the average values of groups and populations.