Integrating Qualitative and Quantitative Data in the Development of Outcome Measures: The Case of the Recovering Quality of Life (ReQoL) Measures in Mental Health Populations

Abstract

While it is important to treat symptoms, there is growing recognition that in order to help people with mental health problems lead meaningful and fulfilling lives, it is crucial to capture the impact of their conditions on wider aspects of their social lives. We constructed two versions of the Recovering Quality of Life (ReQoL) measure—ReQoL-10 and ReQoL-20—for use in routine settings and clinical trials from a larger pool of items by combining qualitative and quantitative evidence covering six domains. Qualitative evidence was gathered through interviews and focus groups with over 76 service users, clinicians, and a translatability assessment. Psychometric evidence generated from data from over 6200 service users was obtained from confirmatory factor models and item response theory analyses. In this paper we present an approach based on a traffic light pictorial format that was developed to present qualitative and quantitative evidence to a group of service users, clinicians, and researchers to help to make the final selection. This work provides a pragmatic yet rigorous approach to combining qualitative and quantitative evidence to ensure that ReQoL is psychometrically robust and has high relevance to service users and clinicians. This approach can be extended to the development of patient reported outcome measures in general.

Recovering Quality of Life (ReQoL): a new generic self-reported outcome measure for use with people experiencing mental health difficulties

“…Detailed psychometrics results are presented elsewhere. 28 Redundancy found in the factor analysis results in study 1 were combined with the qualitative evidence on the items from stage II in order to reduce the item-set from 61 to 40 items ( Fig. 1 ).…”

Exploring the item sets of the Recovering Quality of Life (ReQoL) measures using factor analysis

“…These results, qualitative evidence and other quantitative evidence informed reduction of the item sets even further. These decisions are discussed more fully elsewhere [ 20 ].…”

Assessment of the psychometric properties and refinement of the Health and Self-Management in Diabetes Questionnaire (HASMID)

“…Both assessments were used, in conjunction with clinical opinion to inform the final selection of items. This approach has been used by others in PRO development [18,19]. There are benefits to considering alternative sources of evidence.…”