The four steps involved in instrument development are: concept identification; item construction; validity testing and reliability testing. The clinician who has begun to identify characteristics associated with a patient group has in reality begun the process of instrument development. The challenge for clinicians and researchers is to transform those observable phenomena into a instrument that measures the attribute of the group. Only with reliable and valid measures can true relationships and differences be determined and effective intervention programs be formulated.
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Alice Davis (1996) studied this question.
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