Cognitive approaches to summary measurement: Its application to the measurement of diversity in health-related quality of life assessments

This paper describes elements of a cognitive approach to summary measurement, as it is applied to health-related quality of life ( HRQOL) assessment. A summary measure, by its very nature, represents, but does not reproduce, some body of information. As a consequence, how a summary measure is formulated becomes a critical determinant of its usefulness. In most cases, formal ( arithmetic or investigator- based) methods are used. However, it was also noted that a person ordinarily summarizes the information they receive. Qualitative analytic techniques ( e. g., cognitive interviewing methods) can provide insight into the cognitive processes underlying such summary formation. These cognitive processes, formulated as algorithms, would also be expected to vary as a function of different groups of respondents and settings. Finding a common denominator, a common algorithm, would provide a consensus summary measure amongst diverse groups whose HRQOL is being assessed.