The Use of Cognitive Interviews in the Development of Patient Reported Outcome (PRO) Measures

DHP-logo2Used  increasingly in the development of questionnaires to detect questionnaire items not understood by respondents, cognitive interviews can be used to revise and develop patient reported outcome (PRO) measures  and patient reported experience questionnaires (PREMs).

Used generally in the pretesting phase of instrument development, cognitive interviewing methods are based on a theoretical model of how respondents answer survey questions which involves four stages:

  • Comprehension
  • Retrieval of information
  • Judgement editing
  • Response editing

First, the respondent must understand what the questionnaire item is asking, after which the relevant information is recalled. However, before responding a judgement is made as whether to respond or not, for example due to social desirability. This stage is then followed by the respondent editing the relevant information into a format suitable to respond to the answer categories provided.

There are different cognitive interviewing techniques which are:

  • Think aloud – when respondents are instructed to think aloud (verbalise their thoughts) as they answer the question
  • Verbal probing– the interviewer asks the respondent questions specific to the question using a range of probes into the basis for the respondent’s answer.

Verbal probing can be:

  • Retrospective – the respondent is asked the probe questions after the entire questionnaire has been answered by the respondent
  • Concurrent – after answering each question the respondent is asked a number of specific probes

Verbal probing can be both scripted (prepared prior to interview) based on specific features of the questions such as the language used and spontaneous, resulting from the interview itself, for example, based on what the interviewee says or the interviewer observes.

Below is a selection of slides taken from our one-day workshop Cognitive Interviewing Skills.

To download the slide selection click on this link: A Selection of Slides from Our Cognitive Interview Training Workshop

Contact us now to know more about our next Cognitive Interviewing Skills Workshop in July email:

Front cover

1 Introduction to cognitive theory2 The process

3 Sequencing the interview5 Conducting the interviews

Categories: Patient reported experience, Patient reported outcomes, Questionnaire design, Training and events

Tags: , , , , , ,

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