Steps in developing a generic or disease specific health related quality of life (HRQOL) instrument
| Step | Method |
| Item generation12 | Identify all possible consequences of a particular disorder |
| Literature review | |
| Patient focus groups | |
| Expert opinion | |
| Item reduction12 | Reduce items to a manageable number. |
| Most prevalent issues (frequency) | |
| Greatest impact (important) | |
| Facilitated by factor analysis | |
| Pre-testing12 | Ensure clear wording, patient understanding, and acceptability |
| Psychometric assessment4 | Validity Reliability |
| Responsiveness | |
| Cross cultural adaptation13 | Independent forward and backward translation. Harmonisation among questionnaires. |
| Pre-testing and examining score weighting. |