Conclusion
Responsiveness, validity and precision are interlinked. However, each one is important, acting independently in the assessment of the psychometric characteristics of the instruments (Figure 1). Items can be removed when the results are not the expected, either in each step or at last, if the result was not good in all evaluations.
Other psychometric characteristics, although less used, include items bias, cultural bias, response burden, administrative burden. Alternative forms can be found in the following: Lohr et al. 6, Both et al. 28, Hunt et al. 29and Lord and Novick 30.
In case of a questionnaire construction from de beginning, a more detailed clinical evaluation should be executed 31,32.