Part of the assertion that any survey researcher can make about the validity of their results needs to contain an analysis of questions and their responses from the respondent`s viewpoint. Claims concerning the validity, reliability and sensitivity of health-related quality of life measures tend to be based on the quantitative approach of psychometrics, which fails to identify when respondents: misinterpret questions; do not recall the information requested; or give answers that present themselves in a better or worse light. The paper presents some approaches to pre-testing and piloting survey questionnaires to check the interpretation of survey questions, using illustrations from the KENQOL project. The paper describes: how the intended referential and connotative meaning of each question was established; the criteria to judge the appropriateness of each question; the methods used to make those judgements; and the process of reviewing questions based on findings. The role of piloting is highlighted, and further reading is suggested for readers wishing to develop a model for their own investigation.
Health Policy and Planning (2002) 17 (3) 322-330 [doi:10.1093/heapol/17.3.322]