Reflective, causal, and composite indicators of quality of life: A conceptual or an empirical distinction?

Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation
Daniel S J Costa

Abstract

Items (or indicators) that constitute "quality of life" instruments can be classified as either reflective (manifestations of some underlying construct), causal (the construct is an effect of the indicators), or composite (the construct is an exact linear combination of the indicators). Psychometric methods based on inter-item associations are only appropriate for reflective indicators, whereas other statistical and non-statistical validation methods can be used for composite or causal indicators. Thus, the distinction has important practical, as well as theoretical, implications. Attempts have been made to empirically identify which items of the EORTC QLQ-C30, a cancer-specific instrument, are causal and which are reflective. Such attempts, however, first require commitment to a particular definition of quality of life, of which there are many. Whether an indicator forms a composite, is causal or reflective of quality of life will depend on the definition adopted, and therefore, the reflective-composite-causal distinction is, arguably, best established on conceptual rather empirical grounds, guided by the "mental experiments" suggested by Bollen (Structural equations with latent variables, Wiley, New York, 1989). Conceptual mo...Continue Reading

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Citations

Dec 15, 2015·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Ipek EnsariEdward McAuley
Jul 14, 2016·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Michèle KoleckBertrand Glize
Feb 25, 2018·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Niels SmitsJan R Böhnke
May 20, 2019·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Paul OosterveldNiels Smits
May 15, 2020·Logopedics, Phoniatrics, Vocology·Annerose KeilmannTadeus Nawka
Jul 17, 2020·Journal of Trauma & Dissociation : the Official Journal of the International Society for the Study of Dissociation (ISSD)·Man Cheung Chung, Zhuo Sheng Chen
Mar 28, 2017·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Pierre MichelLaurent Boyer
Dec 19, 2017·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Madeleine T KingUNKNOWN GCIG Symptom Benefit group
Oct 21, 2020·Health and Quality of Life Outcomes·Agnes VinczeAdrienne Stauder
Oct 28, 2020·Journal of Patient-reported Outcomes·Carolyn E SchwartzBruce D Rapkin
Nov 18, 2020·BMC Public Health·Matthew BrowneNerilee Hing
Jan 8, 2021·Health and Quality of Life Outcomes·Silvia TestaRosalba Rosato
Feb 26, 2021·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Kevin P Weinfurt
Mar 18, 2021·Health Care Analysis : HCA : Journal of Health Philosophy and Policy·Erik OlsmanDick L Willems
Apr 2, 2021·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Daniel S J CostaMadeleine T King
Jul 9, 2021·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·You-Shan FengThomas Kohlmann
Aug 28, 2021·International Journal of Environmental Research and Public Health·Peter HollerMireille van Poppel

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