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The draft questionnaire was reviewed by clinicians and researchers to assess comprehensiveness of items (face validity) and clarity of wording.
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The comprehensiveness of the items can be improved by including items concerning communication and care.
During cognitive interviews, patients' comprehension of the instrument and the comprehensiveness of the items were assessed, and patients were asked to provide feedback on the instrument's instructions, as well as the appropriateness of the recall period and response options.
Panel feedback was very positive about the comprehensiveness of the items; most said it was challenging to reduce the items as all were viewed as important.
The current language versions of the self-assessments are extremely important to study before extensive use since the translation might not capture the meaning of the item adequately and cultural characteristics affect the comprehensiveness of the items.
To define its psychological content dimensions and evaluate the comprehensiveness of its items, we performed a principal components analysis of the 550 MMPI items on a sample of 1,576 male and female patients referred for coronary angiography.
Before conducting our preliminary research, five nursing experts based on their clinical professions and experiences examined the content validity; that is, when experts were asked whether they missed items this could be considered as an indication that the comprehensiveness of the items was assessed.
Currently, the International Classification of Functioning, disability and Health ICFF) provides a comprehensive frame of reference, which allows the relevance and comprehensiveness of the items of PF scales to be examined directly by linking them to their respective ICF codes.
An indication that the comprehensiveness of the items was assessed could be that patients or experts were asked whether they missed items.
To assess the comprehensiveness of the items (D4) three aspects should be taken into account: the content coverage of the items, the description of the domains, and the theoretical foundation.
In our study, we confirmed the relevance and comprehensiveness of KOOS items.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com