Data from medical research are typically summarized with various types of outcome measures. We present three arguments in favor of absolute over relative outcome measures. The first argument is from cognitive bias: relative measures promote the reference class fallacy and the overestimation of treatment effectiveness. The second argument is decision-theoretic: absolute measures are superior to relative measures for making a decision between interventions. The third argument is causal: interpreted as measures of causal strength, absolute measures satisfy a set (...) of desirable properties, but relative measures do not. Absolute outcome measures outperform relative measures on all counts. (shrink)

In the introduction to a recent anthology of contemporary issues in philosophy of psychiatry, editors Jeffrey Poland and Şerife Tekin declare this to be a moment of crisis within the field. They suggest that the state of psychiatry today reflects Thomas Kuhn's conception of a period of extraordinary science, which occurs when anomalies begin to build up, confidence in the dominant paradigm is shook, competing theories arise, and philosophical questions come to the fore. Although perhaps not all would agree that (...) the field is in crisis, there is certainly an abundance of pessimism. Within the realm of research, a mood of explanatory pessimism has been growing, characterized by a... (shrink)

There has been much philosophical interest regarding the ‘hierarchy of evidence’ used to determine which study designs are of most value for reporting on questions of effectiveness, prognosis, and so on. There has been much less philosophical interest in the choice of outcome measures with which the results of, say, an RCT or a cohort study are presented. In this paper, we examine the FDA’s recently published guidelines for assessing the psychometric adequacy of patient-reported outcome measures. We focus (...) on their recommendations for demonstrating content validity and also for how researchers should weigh up the sum of psychometric evidence when choosing these measures. We argue that questions regarding judgment and understanding meaning of these measures should play a more central role in determining their adequacy. (shrink)

The typical outcome measure in infertility treatment is the (cumulative) healthy live birth rate per patient or per cycle. This means that those who end the treatment trajectory with a healthy baby in their arms are considered to be successful and those who do not are considered to have failed. In this article, we argue that by adopting the healthy live birth standard as the outcome measure that defines a successful fertility treatment, it becomes an interpretative (...) self-fulfilling prophecy: those who achieve the goal consider themselves successful and those who do not consider themselves failures. This is regardless of the fact that having children is only one out of many ways to alleviate the suffering related to infertility and that stopping fertility treatment can also be a positive decision to move on to other goals, rather than a form of “giving up,” “dropping out,” “nonadherence,” or failure. We suggest that those seeking fertility treatment would be served better by an alternative outcome measure, which can be equally self-fulfilling, according to which a successful treatment is one in which people leave the clinic released from the suffering that accompanied their status as infertile when they first entered the clinic. This new outcome measure still implies that walking out with a healthy baby is a positive outcome. What changes is that walking out without a baby can also be a positive outcome, rather than being marked exclusively as a failure. (shrink)

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff (...) to review outcome measures for use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

It is a plausible speculation that conventional choices in outcome measures might influence the results of meta-analyses. We test that speculation by simulating data from trials on antidepressants. We vary real drug effectiveness while modulating conventional values for outcome measures. We had previously shown that one conventional choice used in meta-analyses of antidepressants falls in a narrow range of values that maximize estimates of effectiveness. Our present analysis investigates why this phenomenon occurs. Moreover, our results suggest the superiority (...) of absolute outcome measures over relative measures. This research program can be extended to test numerous other aspects of clinical research. (shrink)

Patient-reported outcome measures (PROMs) are increasingly used to assess multiple facets of healthcare, including effectiveness, side effects of treatment, symptoms, health care needs, quality of care, and the evaluation of health care options. There are thousands of these measures and yet there is very little discussion of their theoretical underpinnings. In her 2008 Presidential address to the Society for Quality of Life Research (ISOQoL), Professor Donna Lamping challenged researchers to grapple with the theoretical issues that arise from these measures. (...) In this paper, I attempt to do so by arguing for an analogy between PROMs and Hans-Georg Gadamer’s logic of question and answer. While researchers readily admit that the constructs involved in PROMs are imperfectly understood and lack a gold standard, they often ignore the consequences of this fact. Gadamer’s work on questions and their importance to philosophical hermeneutics helps to show that the questions researchers ask about such constructs are also imperfectly understood. I argue that these questions should not be standardized, and I instead propose a theoretical framework that understands PROMs as posing genuine questions to respondents—questions that are open to reinterpretation. (shrink)

The use of composite outcomes is becoming widespread in clinical trials. By combining individual outcome measures into a composite, researchers claim a composite can increase statistical precision and trial efficiency, expediting the trial by reducing sample size and cost, and consequently enabling researchers to answer questions that could not otherwise be answered. Another rationale given for using a composite is that it provides a measure of the net effect of the intervention that is more patient-relevant than any single (...) outcome measure. Critics, on the other hand, argue that the use of composites threatens the scientific objectivity of the trial by introducing new risks, and that in practice components are inconsistently defined, unreasonably combined, and inadequately reported. Philosophical scrutiny can help shed light in these disagreements and disentangle ethical and epistemological issues of composites in clinical trials. I examine common use of composites in cardiovascular trials, and show how composite results can be problematic, even misleading, if the proper range of scientific decisions and their consequences are ignored when judging the composite. Philosophies of science that are principled on normative versions of the argument from inductive risk can help explicate issues with composites. I conclude by suggesting ways of remedying composite issues in clinical trials. (shrink)

This paper considers the use of outcome measures in the British National Health Service (NHS). Measuring outcomes is a major conceptual and practical problem. Many different measures are currently available yet no consensus has been reached on which should be preferred over others, or about which should take priority when they conflict. Some currently used measures are described, the relationship between these measures and the measured activities are discussed, and fundamental problems with both the measures and their use are (...) revealed. It is shown that however assiduous the search, the ‘perfect’ outcome measure will always remain elusive. (shrink)

The decision-theoretic account of probability in the Everett or many-worlds interpretation, advanced by David Deutsch and David Wallace, is shown to be circular. Talk of probability in Everett presumes the existence of a preferred basis to identify measurement outcomes for the probabilities to range over. But the existence of a preferred basis can only be established by the process of decoherence, which is itself probabilistic.

The decision-theoretic account of probability in the Everett or many-worlds interpretation, advanced by David Deutsch and David Wallace, is shown to be circular. Talk of probability in Everett presumes the existence of a preferred basis to identify measurement outcomes for the probabilities to range over. But the existence of a preferred basis can only be established by the process of decoherence, which is itself probabilistic.

We construct novel measures to assess (i) the extent to which European Union member states are using common standards in recognizing asylum seekers and (ii) the extent to which the responsibilities for asylum applications, acceptances and refugee populations are equally shared among the member states, taking into account population size, gross domestic product (GDP) and GDP expressed in purchasing power parity (GDP-PPP). We track the progression of these measures since the implementation of the Treaty of Amsterdam (1999). These measures display (...) divergent trends and we try to provide an interpretation of the dynamics that are constitutive of these trends. (shrink)

Accumulating evidence for the unique social, behavioral, and physical health benefits of positive emotion and related well-being constructs has led to the development and testing of positive psychological interventions to increase emotional well-being and enhance health promotion and disease prevention. PPIs are specifically aimed at improving emotional well-being and consist of practices such as gratitude, savoring, and acts of kindness. The purpose of this narrative review was to examine the literature on PPIs with a particular focus on positive emotion outcomes. (...) We evaluated the evidence on the effects of PPIs on positive emotion specifically, and discussed the range of evidence regarding the relative responsiveness of emotion measures to PPIs in order to gain a better understanding of the specific emotional pathways through which PPIs influence psychological and physical well-being. We conclude with recommendations for best evaluating effects of PPIs on positive emotion outcomes. (shrink)

Studies of knowledge utilization in public policy-making have important practical and theoretical implications. Accordingly, a voluminous work has been done on understanding and explaining the process of knowledge utilization (see Rich and Oh, 1993). However, we can easily find that there is the conspicuous absence of a greatly expanded understanding of the use of knowledge from those studies (Mandell and Sauter, 1984). Taken as a whole, empirical studies in the area of knowledge utilization have suffered from several critical problems (see (...) Rich, 1991; Oh, 1996a). More importantly, there appears to be serious conceptual and methodological gaps which need to be filled. This article focuses on one of the most significant methodological problems: measuring “knowledge utilization” from an evaluation perspective and offers some suggestions for future studies. (shrink)

Temporal discounting is the tendency to devalue temporally distant rewards. Past studies have examined the k-value, the indifference point, and the area under the curve as dependent measures on this task. The current study included these three measures and a fourth measure, called the interest rate total score. The interest rate total score was based on scoring only those items in which the delayed choice should be preferred given the expected return based on simple interest rates. In addition, associations (...) with several individual difference measures were examined including intelligence, executive functions (inhibition, working memory, and set-shifting), thinking dispositions (Need for Cognition and Consideration of Future Consequences) and engagement in substance use and gambling behavior. A staircase temporal discounting task was examined in a sample of 99 university students. Replicating previous studies, temporal discounting increased with longer delays to reward and decreased with higher reward magnitudes. A hyperbolic function accounted for variance in temporal discounting better than an exponential function. Reaction time at the indifference point was significantly longer than at the other choice points. The four dependent measures of temporal discounting were all significantly correlated and were also significantly associated with our individual difference measures. That is, the tendency to wait for a larger delayed reward on all of the temporal discounting measures was associated with higher intelligence, higher executive functions and more consideration of future consequences. Associations between our measures of temporal discounting and outcomes related to substance use and gambling behavior were modest in our university sample. (shrink)

Management scholars have paid close attention to the construct of organizational or corporate reputation, particularly in the applied business ethics and corporate social responsibility fields. Extant research demonstrates that CR is one of the key mediators between CSR and important organizational outcomes, which ultimately improve organizational performance. Yet, hitherto the research focused on CR construct has been plagued by multiple definitions, conflicting conceptualizations, and unclear operationalizations. The purpose of this article is to provide theoretical ground for positioning of CR as (...) an assessment construct that is modeled as a second-order factor affecting individual first-order dimensions, and to provide methodological and empirical support toward such conceptualization. We assert that intangible, socially complex, and causally ambiguous CR can be accurately estimated through its individual measurable dimensions. Using survey data from Peru, we empirically test the hypothesized second-order reflective model within a hierarchy of nested and non-nested models, and compare its model fit and predictive power with alternative conceptualizations. Modeling CR as a second-order reflective construct relies on a set of theoretical propositions and yields several methodological advantages, including strong conceptual interpretability and parsimony when tested within a nomological context. We explicitly demonstrate positive organizational outcomes of CR: customer trust, corporate identification, in-role behavior, and extra-role behavior. Then, we demonstrate that the shorter scales of CR can be used as a good proxy for the full construct measure. The paper concludes by highlighting theoretical insights, and methodological and managerial implications of the findings. (shrink)

We develop a systematic approach to quantum probability as a theory of rational betting in quantum gambles. In these games of chance, the agent is betting in advance on the outcomes of several (finitely many) incompatible measurements. One of the measurements is subsequently chosen and performed and the money placed on the other measurements is returned to the agent. We show how the rules of rational betting imply all the interesting features of quantum probability, even in such finite gambles. These (...) include the uncertainty principle and the violation of Bell's inequality among others. Quantum gambles are closely related to quantum logic and provide a new semantics for it. We conclude with a philosophical discussion on the interpretation of quantum mechanics. (shrink)

We develop a systematic approach to quantum probability as a theory of rational betting in quantum gambles. In these games of chance the agent is betting in advance on the outcomes of several incompatible measurements. One of the measurements is subsequently chosen and performed and the money placed on the other measurements is returned to the agent. We show how the rules of rational betting imply all the interesting features of quantum probability, even in such finite gambles. These include the (...) uncertainty principle and the violation of Bell's inequality among others. Quantum gambles are closely related to quantum logic and provide a new semantics to it. We conclude with a philosophical discussion on the interpretation of quantum mechanics. (shrink)

This article presents the framework and explores the measurement, correlates, and outcomes of creative adaptability, proposed here as the cognitive–behavioral-emotional ability to respond creatively and adaptively to stressful situations. Data collection was in April 2020, during the peak of the outbreak of the Coronavirus pandemic in Israel. In Study 1, a sample of 310 adults completed the newly developed CA scale, as well as spontaneity, openness to experience, creative self-efficacy, and well-being measurements. The results of exploratory and confirmatory factor analyses (...) corroborated the 9-item CA scale’s theorized underlying construct. The scale’s validity and reliability were also supported. Exploratory analyses suggested that the association between CA and well-being was mediated by creative self-efficacy and that CA may buffer the impact of individuals’ concern about Coronavirus on their well-being. In Study 2, short-term longitudinal data based on a sample of 71 students suggested that CA may predict lower psychological stress over time. Support for the CA scale’s internal consistency reliability was obtained and its test–retest reliability was established. Overall, the results shed light on this new construct as a potential protective factor. Implications for theory, research, and practice are discussed. (shrink)

In this paper we intend to discuss the importance of providing a physical representation of quantum superpositions which goes beyond the mere reference to mathematical structures and measurement outcomes. This proposal goes in the opposite direction to the project present in orthodox contemporary philosophy of physics which attempts to “bridge the gap” between the quantum formalism and common sense “classical reality”—precluding, right from the start, the possibility of interpreting quantum superpositions through non-classical notions. We will argue that in order to (...) restate the problem of interpretation of quantum mechanics in truly ontological terms we require a radical revision of the problems and definitions addressed within the orthodox literature. On the one hand, we will discuss the need of providing a formal redefinition of superpositions which captures explicitly their contextual character. On the other hand, we will attempt to replace the focus on the measurement problem, which concentrates on the justification of measurement outcomes from “weird” superposed states, and introduce the superposition problem which focuses instead on the conceptual representation of superpositions themselves. In this respect, after presenting three necessary conditions for objective physical representation, we will provide arguments which show why the classical representation of physics faces severe difficulties to solve the superposition problem. Finally, we will also argue that, if we are willing to abandon the presupposition according to which ‘Actuality = Reality’, then there is plenty of room to construct a conceptual representation for quantum superpositions. (shrink)

The recently developed technique of Bohrification associates to a (unital) C*-algebra Athe Kripke model, a presheaf topos, of its classical contexts;in this Kripke model a commutative C*-algebra, called the Bohrification of A;the spectrum of the Bohrification as a locale internal in the Kripke model. We propose this locale, the ‘state space’, as a (n intuitionistic) logic of the physical system whose observable algebra is A.We compute a site which externally captures this locale and find that externally its points may be (...) identified with partial measurement outcomes. This prompts us to compare Scott-continuity on the poset of contexts and continuity with respect to the C*-algebra as two ways to mathematically identify measurement outcomes with the same physical interpretation. Finally, we consider the not-not-sheafification of the Kripke model on classical contexts and obtain a space of measurement outcomes which for commutative C*-algebras coincides with the spectrum. The construction is functorial on the category of C*-algebras with commutativity reflecting maps. (shrink)

Social responsibility is typically examined at the firm level, yet there are instances in which consumers’ social responsibility perceptions of the firm’s product brands differ from social responsibility perceptions with regard to the firm [i.e., corporate social responsibility ]. This article conceptualizes brand social responsibility and delineates it from CSR. Following the development of a BSR scale, this research demonstrates variations in consumers’ social responsibility perceptions across product brands even if they are owned by the same corporation and compete in (...) the same product category. BSR is distinct from CSR, and better predicts consumers’ responses to product brands compared to corporate level measures. Consistent with the conceptual distinction, this research demonstrates the unique contribution of BSR and CSR in predicting product brand and corporate outcomes, respectively. From a theoretical viewpoint, this research is one of the few to examine differences between product brand and CSR. From a managerial viewpoint, the consideration of social responsibility at the product brand level facilitates the assessment of social responsibility perceptions across brands in brand portfolios managed under a mixed-branding or house-of-brands strategy. (shrink)

ObjectivesThe purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records.MethodsPregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses. Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were conducted, and (...) logistic models were evaluated for the associations between substance use and each birth outcome.ResultsThe average maternal age was 30 years, 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance u... (shrink)