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For example, estimates of inter-item variation (internal consistency) might differ from person to person because relationships among items might depend upon differences in appraisal processes.
Such items are widely subject to individual differences in appraisal.
Such differences in appraisal are not due to "measurement error" or "unreliability" but to the application of different appraisal criteria.
We would further suggest that the specific inclusion of QOL items shown to be sensitive to differences in appraisal parameters may be quite desirable.
We propose that psychometric models of QOL must be expanded to take differences in appraisal into account by positing the notion of the "contingent true score".
Indeed, the appraisal model predicts that individual differences in appraisal criteria (e.g., goal content) will affect the correlates of QOL ratings, but not their overall levels [ 22].
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In summary, a variety of assessment methods of response shift confirms that QOL assessment involves a subjective process of appraisal, that individual differences in the appraisal process can affect observed QOL scores, and that individuals can change how they appraise QOL over time.
Further investigation is required concerning sex differences in CVR appraisal and its effect on adherence to preventive measures in different cultural environments.
Differences in QOL appraisal are part of human adaptation and inherent in all QOL measurement.
The aim was to provide a conceptual framework to help understand sociodemographic differences in symptom appraisal.
Cognitive techniques to refine survey methods may succeed in bounding individual differences in the appraisal process, but cannot eliminate them.
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