I thank Drs Zyzanski and Perloff for their complimentary remarks, and particularly for their open acknowledgment, as psychometric authorities, that "clinical knowledge" and "the essential ingredient of clinical insight" are important for appraising the "complex intangible phenomena" of patient care. This acknowledgment has not always occurred during the "blind application of the statistical or psychometric approach" when multi-item instruments were initially constructed for complex clinical phenomena, or when credulous clinicians used and gave obeisance to the instruments.
Feinstein AR. Clinimetrics and Psychometrics Work Hand in Hand. Arch Intern Med. 1999;159(15):1811-1817. doi: