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Validity, Reliability, and the Questionable Role of Psychometrics in Plastic Surgery

Swanson, Eric MD

Plastic and Reconstructive Surgery - Global Open: June 2014 - Volume 2 - Issue 6 - p e161
doi: 10.1097/GOX.0000000000000103
Special Topics
United States

Summary: This report examines the meaning of validity and reliability and the role of psychometrics in plastic surgery. Study titles increasingly include the word “valid” to support the authors’ claims. Studies by other investigators may be labeled “not validated.” Validity simply refers to the ability of a device to measure what it intends to measure. Validity is not an intrinsic test property. It is a relative term most credibly assigned by the independent user. Similarly, the word “reliable” is subject to interpretation. In psychometrics, its meaning is synonymous with “reproducible.” The definitions of valid and reliable are analogous to accuracy and precision. Reliability (both the reliability of the data and the consistency of measurements) is a prerequisite for validity. Outcome measures in plastic surgery are intended to be surveys, not tests. The role of psychometric modeling in plastic surgery is unclear, and this discipline introduces difficult jargon that can discourage investigators. Standard statistical tests suffice. The unambiguous term “reproducible” is preferred when discussing data consistency. Study design and methodology are essential considerations when assessing a study’s validity.

From the Swanson Center, Leawood, Kans.

Received for publication February 3, 2014; accepted April 3, 2014.

Disclosure: The author has no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the author.

Eric Swanson, MD, Swanson Center, 11413 Ash Street, Leawood, KS 66211, E-mail:

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© 2014 American Society of Plastic Surgeons