In contrast to other reliability estimates, test-retest reliability (or reproducibility) captures not only the measurement error of an assessment instrument, but also the stability of the construct measured. Consequently, one would expect any departure from identity (Y = X) of measurement pairs (X first, and Y second measurement) to be treated as 'error' by the respective reproducibility statistic, even if 'true' changes happened, e.g. worsening of a disease due to its natural course. The Pearson correlation, still often advocated for continuous measures in test-retest reliability studies, however captures the degree of linearity (Y = bX + a): perfect relationship can be computed, even if the measurement pairs differ not only by a additive constant 'a', but also because of a multiplication of the X-values with the slope 'b'. Therefore, intraclass correlation coefficients (ICCs) have been proposed as alternative statistics for reproducibility. However, only ICCs with absolute agreement definition of concordance capture the degree of identity. ICCs with a consistency definition of concordance measure the degree of additivity (Y = X + a). ICCs are calculated from repeated measures analyses of variance (ANOVAs), and a common population variance must be is assumed for the different measurements. Given this assumption, an ICC computed from a one-way ANOVA seems to be the best choice for this purpose. Otherwise, Lin's concordance correlation coefficient is recommended as identity measure.
If assessment instruments are used to measure efficacy or effectiveness, for example of rehabilitation programmes, they have to be sensitive (or responsive) to change. However, up to now there has been no consensus on what coefficient should be used for this end. Various effect sizes and criterion measures are widely acknowledged; tests of inferential statistics are also still used. The different coefficients may well provide different rank ordering of competitive instruments. Recently, the so-called 'smallest real difference' (SRD) was proposed as a measure of sensitivity to change. In the original formulation, the SRD was defined as the 95% confidence limit of the standard error of measurement (SEM) of the difference scores. Conceptually this is equivalent to what is known as the 'reliable change index' in psychotherapy research. The absolute values of the SEM/SRD indicate measurement error. In our view, this is merely complementary to the reliability concept and not a measure of sensitivity to change. Instead, we suggest using the percentage of patients reaching the SRD criterion to compare the sensitivity to change of competitive instruments. In contrast to other sensitivity-to-change indices, such an approach takes the different reliabilities of competitive assessment instruments explicitly into account.
See generally PAUL A. SAMUELSON & WILLIAM D. NORDHAUS, ECONOMICS 41 (14th ed. 1992) ("[Efficient exchanges] are made through voluntary exchange of goods for money at market prices .... ").
Refugee Burden-Sharing regions, notably Africa, south and southeast Asia, the Middle East, and the Caribbean, and internally displaced individuals became more numerous than the border-crossing refugees.' By the 1980s, Europe had come to think of the refugee burden as more of a problem for the Third World and the United States than for itself. Protected from large-scale refugee movements by an impregnable Iron Curtain in the east, Europe seemed relatively immune to the threat. It is no longer possible to entertain this comforting illusion. With the dissolution of the Soviet Union, Germany's reunification, the militarization of bitter ethnic conflicts in the Balkans, and the failure of many former European colonies to establish viable political and economic systems, refugees are once again pouring into the very heart of Europe. Moreover, new migration routes, facilitated by cheap transportation and intricate social networks, are bringing migrants to Europe (and thence to the United States) from Asia, Africa, and the Pacific archipelago. 6 Although few of these migrants are likely to meet the legal qualifications for Convention refugee status, 1 many of them nevertheless seek some form of temporary or permanent protection and must be processed in one or another European state until their status can be determined-with the attendant fiscal, social, and political burdens on the receiving state that such processing ordinarily entails.' Europe thus joins the Third World, North America (the United States and Canada), 9 and the other traditional receiving 5. On the growing predominance of the internally displaced, see Weiner, supra note 3. 6. See Raymond Bonner, New Road to West for Illegal Migrants, N.Y. TIMES, June 14, 1995, at A12. 7. The Refugee Convention defines a refugee as a person with a "well-founded fear of being persecuted for reasons of race, religion, nationality, membership in a particular social group, or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country." 1951 Refugee Convention, supra note 1, art. 1, para. A(2). This does not cover the bulk of migrants fleeing the conditions listed in the first paragraph of this Article. 8. The methods for processing refugees in Europe were harmonized in the Dublin Convention and the
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