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Responses to Comments of Weis Guo, Na; Marra, Carlo A; Marra, Fawziah Jan 15, 2010

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LETTER TO THE EDITOR Open AccessResponses to Comments of WeisNa Guo1, Carlo A Marra1,2*, Fawziah Marra3AbstractA response to Weis and Pasipanodya ‘Measuring health-related quality of life in tuberculosis: a systemic review -Response’.Letter to the EditorWe thank Weis and Pasipanodya for their valuable andinsightful comments on our published manuscript, Mea-suring health-related quality of life in tuberculosis: a sys-temic review [1]. However, we want to address theirquestion regarding our statement “A validated tubercu-losis-specific quality of life instrument was not located”.When we searched for a “validated tuberculosis-specificquality of life instrument” for our literature review,there were two requirements that we had determinedapriori. Firstly, the quality of life (QoL) instrument hadto be originally designed and tailored specifically toassess a tuberculosis (TB) population; and secondly, theinvolved QoL instrument had to be validated in variousTB populations.Subjective measurements, such as QoL, are alwaysprone to inherent biases. Validation is an important pro-cess involving the accumulation of evidences to providea sound scientific basis to support the inferences oftheir psychometric properties. In addition, the quality ofvalidation evidences is very important. Although there isno rule of thumb when validating a QoL instrument, anumber of considerations should be taken into account- for example reliability, validity and responsiveness,representative samples of the targeted population,appropriate analysis techniques, and controls over plau-sible confounding factors [2].Through our literature review, we only found oneQoL instrument, the DR-12 [3], which was designedspecifically for use in TB infected populations. However,as we stated in our manuscript [1], it has only beenused once in a sample of active TB patients and thevalidation was not done in a systematic fashion. Moreapplications with better validation methods are neededto further establish the psychometric properties of theDR-12.Finally, we agree with Weis and Pasipanodya that itembanking is a promising direction for QoL measurements.Item banking is a large collection of items that are mea-suring the same health construct and calibrated ontocommon scales using item response theory (IRT) basedapproaches. A new generation of health outcomes mea-surements, computerized adaptive testing (CAT), whichcombines modern measurement theory, IRT, withadvanced computer technologies, has the potential tooptimize measurement precision [4-8].Author details1Collaboration for Outcomes Research and Evaluation (CORE), Faculty ofPharmaceutical Sciences, University of British Columbia, Vancouver, BC,Canada. 2Centre for Health Evaluation and Outcome Sciences (CHEOS),Providence Health Care Research Institute, Vancouver, BC, Canada. 3Facultyof Pharmaceutical Sciences, University of British Columbia, Vaccine andPharmacy Services, British Columbia Centre for Disease Control (BCCDC),Vancouver, BC, Canada.Received: 2 December 2009Accepted: 15 January 2010 Published: 15 January 2010References1. Guo N, Marra F, Marra C: Measuring health-related quality of life intuberculosis: a systematic review. Health Qual Life Outcomes 2009, 7:14.2. Streiner DL, Norman GR: Health measurement scales: A Practical Guide toTheir Development and Use. Oxford Medical Publications, 3 1995.3. Dhingra VK, Rajpal S: Health related quality of life (HRQL) scoring intuberculosis. India J Tuberc 2003, 50:99-104.4. Bjorner JB, Kosinski M, Ware JE Jr: Calibration of an item pool forassessing the burden of headaches: an application of item responsetheory to the headache impact test (HIT). Qual Life Res 2003, 12:913-933.5. Fliege H, Becker J, Walter OB, Bjorner JB, Klapp BF, Rose M: Developmentof a computer-adaptive test for depression (D-CAT). Qual Life Res 2005,14:2277-2291.6. Lai JS, Cella D, Dineen K, et al: An item bank was created to improve themeasurement of cancer-related fatigue. J Clin Epidemiol 2005, 58:190-197.7. Lai JS, Cella D, Dineen K, Bode R, Von Roenn J, Gershon RC, Shevrin D:Assessment of health-related quality of life in arthritis: conceptualization* Correspondence: Carlo.marra@ubc.ca1Collaboration for Outcomes Research and Evaluation (CORE), Faculty ofPharmaceutical Sciences, University of British Columbia, Vancouver, BC,CanadaGuo et al. Health and Quality of Life Outcomes 2010, 8:6http://www.hqlo.com/content/8/1/6© 2010 Guo et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.and development of five item banks using item response theory. HealthQual Life Outcomes 2006, 4:33.8. Walter OB, Becker J, Bjorner JB, Fliege H, Klapp BF, Rose M: Developmentand evaluation of a computer adaptive test for ‘Anxiety’ (Anxiety-CAT).Qual Life Res 2007, 16(Suppl 1):143-155.doi:10.1186/1477-7525-8-6Cite this article as: Guo et al.: Responses to Comments of Weis. Healthand Quality of Life Outcomes 2010 8:6.Publish with BioMed Central   and  every scientist can read your work free of charge"BioMed Central will be the most significant development for disseminating the results of biomedical research in our lifetime."Sir Paul Nurse, Cancer Research UKYour research papers will be:available free of charge to the entire biomedical communitypeer reviewed and published immediately upon acceptancecited in PubMed and archived on PubMed Central yours — you keep the copyrightSubmit your manuscript here:http://www.biomedcentral.com/info/publishing_adv.aspBioMedcentralGuo et al. Health and Quality of Life Outcomes 2010, 8:6http://www.hqlo.com/content/8/1/6Page 2 of 2


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